Inspection on 13/06/05 for Oakland Grange

This inspection was carried out on 13th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Oakland Grange 22/02/07

Oakland Grange 31/10/05

Oakland Grange 01/11/04

Oakland Grange 25/05/04

Similar services:

Hillview Farm

St Vincents

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

Newbeech House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Oakland Grange 10 - 12 Merton Road southsea Hampshire PO5 2AG Lead Inspector Richard Slimm Unannounced 13 June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Oakland Grange H55-H03 S11767 oakland grange V225396 130605.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Oakland Grange Address 10-12 Merton Road, Southsea, Hampshire, PO5 2AG Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 023 9282 0141 Crescent Care Limited Mrs Angela Kish Care Home 43 Category(ies) of PE(E) - 2 registration, with number DE(E) - 6 of places OP - 43 MD(E) - 6 Oakland Grange H55-H03 S11767 oakland grange V225396 130605.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than six service users in the categories MD(E) and DE(E) may be accomodated at any one time. 2. No more than 2 service users in the category PD(E) may be accomodated at any one time. 3. Four named service users between 55 and 65 years of age in categories of LD and MD may be accomodated. Date of last inspection 01/11/04 Brief Description of the Service: Oakland Grange is a large, period, detached residence situated in a quiet residential area of Portsmouth. The home is maintained to a good standard providing a valuing environment to residents. The home is registered with the Commission for Social Care Inspection (CSCI) to accommodate up to 43 older people, including up to six with an age related mental health problem and two service users with a physical disability. Accommodation is organised over a number of floors with access available to frail persons via the provision of a shaft lift. It is one of a number of registered care homes that the owner has an interest in. The home is centrally placed and is close to the shopping area in Southsea where there is a wide range of shops situated. The local bus stop, where buses run regularly into Portsmouth’s main shopping centre is nearby as is the main seafront at Southsea. Oakland Grange H55-H03 S11767 oakland grange V225396 130605.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on the 13th June 2005 over 1 day. The day was spent visiting service users in their own rooms, and communal areas of the home and interviewing them in order to establish their views of the quality of service provided by the home, the inspector also joined residents for lunch in the main dining area of the home. The inspector checked records and other relevant documentation, interviewing care, and management staff. Two visitors were spoken to and both made positive comments about the services provided at the home, to their loved ones and confirmed that they could visit whenever they wished, were always able to see their relative in private if they wished, and were always made welcome at the home. The visit was positive and residents were found to be generally satisfied but the inspector did feed back some concerns about personal support issues for more disabled people at the meal table. Twenty-one residents were spoken to and all confirmed that they were satisfied with the general quality of the service provided, and a significant number of residents were found to be very happy living at the home. This report will make three recommendations covering six national minimum standards, aimed at supporting the ongoing development of the service. What the service does well: The home provides a good level of care and support on a practical basis. However, there is a need to improve care-planning systems in place to identify all relevant resident daily needs. Residents were very helpful and spoke candidly about their experiences, saying that the staff team are usually very good and caring and treat them with dignity, kindness and respect. A number of residents spoken to were found to be very happy living at the home, and considered Oakland Grange to be their home, this is a challenge for staff and managers in such a large establishment. Managers and staff were committed to providing the best possible service and a commitment to ongoing improvement and development of the home was evident. The move of a number of residents from other care homes that had closed locally had been handled with sensitivity and care, and those residents had been enabled to settle into their new surroundings. Residents were found to be aware of who to speak to if they had any concerns. There was a clear commitment to providing staff who were appropriately trained, experienced and qualified. The home provides a range of structured activities throughout the week, that are displayed for residents on a notice board. Residents’ are given the opportunity to be involved in anonymous resident surveys as to the quality and satisfaction with the service provided, and regular resident meetings are held to consult and involve residents in the running of their home. Oakland Grange H55-H03 S11767 oakland grange V225396 130605.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Oakland Grange H55-H03 S11767 oakland grange V225396 130605.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Oakland Grange H55-H03 S11767 oakland grange V225396 130605.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The home does not record assessment information about residents’ personal interests and wishes adequately. The home does not actively / adequately involve residents and/or advocates of residents in their own assessments and the development of their care plans. EVIDENCE: The home has a system of assessment and care planning. While assessments continue to develop in line with the needs of residents and the national minimum standards (NMS), increased emphasis should be placed on establishing what potential residents want from the home, and find out what their interest, hobbies and types of activities they would like to become involved in at the home and outside of the home. A number of residents spoken to were not fully aware of the existence of their care plans and assessments. Consequently there was a lack of clarity for these people of what they could expect in the context of their daily support from staff. Oakland Grange H55-H03 S11767 oakland grange V225396 130605.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7-8-9-10 Personal and some aspects of residents’ social care needs are known and understood by the staff team. Care plans did not contain all relevant information in sufficient detail to quality assure staff interventions. The home promotes independence where possible, and supports residents to access appropriate health care support when needed. The home promotes the residents’ right to self –administer their own medications where appropriate. More complex and/or dangerous medications are usually administered with the support of the staff. The home maintains signed records of medications administered by staff members. Residents are treated with respect by the staff of the home. The core values for residents are promoted. EVIDENCE: Care planning systems take account of residents’ health care needs at the home. Plans in place provided documented information to guide staff in meeting certain needs of residents. There was a need to ensure that residents independence is fully promoted by the provision of relevant aids and adaptations, and care plans need to specify in detail the actions needed by staff to ensure that residents with physical disabilities are assisted to the dining table in a manner that enables them to remain independent. A number of care plans had not been signed by the resident concerned and/or their representative. There was a lack of clarity in regard to allocated key workers, Oakland Grange H55-H03 S11767 oakland grange V225396 130605.doc Version 1.30 Page 10 and what the duties of key workers were at the home. Care plans and assessments of need could be shared more with residents, and increased emphasis put on residents wishes. Medicine administration records were available, signed and up to date, residents confirmed that they were happy with the support they get to ensure they have their medications at the appropriate times. Residents’ spoken to confirmed that they were happy with their GPs and the arrangements made at the home to meet their health care needs. Staff members were observed to interact in a professional, sympathetic, good humoured and polite manner with residents’. Residents’ confirmed that they could have access to GPs or other health services on request. Staff members spoken to were found to be aware of the need to promote the core values of privacy, respect, choice, independence and rights for residents. Managers were found to be keen to develop ways to increase residents’ rights at the home. Residents’ confirmed that care staff treated them with dignity and respect. Oakland Grange H55-H03 S11767 oakland grange V225396 130605.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12-13-14-15 The home actively listens to the views of residents. The home promotes residents rights to stay in contact with family and loved ones, and to maintain links with people from outside of the home. The home strives to promote further resident choice and control over their lives. The home provides a full varied and nutritious diet. EVIDENCE: Assessment materials did not appear to focus closely on areas such as social and recreational wishes and interests. Residents confirmed that there were a number of activities regularly available within the home, and this information was available on the notice board. A number of residents stated that some of the activities were of no interest to them. Two visiting relatives were spoken to, and residents confirmed that they were free to contact family and friends whenever they chose to. Both of the two relatives spoken to were very positive about the support provided to their relatives living at the home and were confident that if they had any concerns these could be passed back to the manager of the home who would deal with them. Residents were observed to have full freedom of movement around the home. The home has frequent resident meetings and residents confirmed that they were aware of these meetings and attended them. The home also has in place anonymous resident surveys, and the managers consult residents at their meeting as to the quality of service provided. Those residents spoken to indicated that they were happy with the variety, quantity and quality of food provided at the home. The Oakland Grange H55-H03 S11767 oakland grange V225396 130605.doc Version 1.30 Page 12 inspector had lunch with residents, and the meal served was both appertising and well presented, and options were available. Oakland Grange H55-H03 S11767 oakland grange V225396 130605.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16-18 The home provides all residents and/or their advocates with a complaints procedure. The home takes all complaints seriously and fully investigates complaints and ensures complaints are fully documented. The home makes appropriate arrangements for the protection of residents from abuse. The home makes arrangements to promote the safety of residents. EVIDENCE: The inspector was advised that all new residents are provided with information about the home in the welcome pack and this contains details of the complaints procedure. Two residents spoken to, who had recently been admitted to Oakland Grange, confirmed that they had been provided with information including the complaints procedure. A number of other residents said that they were aware of who they would need to speak to if they had any complaints. A visitor to the home was observed to bring an issue to the attention of a senior staff member at the time of the visit, and this matter was addressed. There had been no formal complaints since the last inspection visit, however, systems are in place to ensure that any complaints are recorded and dealt with in a professional manner. The home has copies of the adult protection procedures for Portsmouth City Council. Staff members training in adult protection are provided and an update course is planned for July 2005. Residents spoken to confirmed that they felt safe at the home. Oakland Grange H55-H03 S11767 oakland grange V225396 130605.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19-26 The home provides a safe, well-maintained and valuing environment for residents. The home was cleaned to a good standard. EVIDENCE: The home employs separate domestic staff and a handy person who work hard to keep the home maintained, clean and tidy. The home was well presented, maintained and decorated to a good standard, both internally and externally. Residents said they liked the colour schemes around the home and the way their individual rooms had been decorated, residents confirmed that they had been encouraged and supported to personalise their own rooms and would be consulted about redecoration. Residents were appreciative of the efforts made by both care and domestic staff. The home had benefited from improvements to the decoration, including the provision of double-glazing, new boilers and the refurbishment of the kitchen. Oakland Grange is a valuing environment for people to live in. Oakland Grange H55-H03 S11767 oakland grange V225396 130605.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27-29-30 Care staffing levels at the time of the visit were in accordance with previously agreed standards, and were sufficient to meet the needs of the current resident group. The home provides staff with training and development opportunities. The homes’ staff recruitment practices met legal requirements. The manager of the home is not NVQ 4 RMA qualified. Staff supervision needs review. EVIDENCE: The home undertakes all checks on staff necessary to protect residents. Staff records were available on site as required by the legislation. The staff roster indicated that the home was providing 700 care staffing hours for the week to meet the needs of the residents accommodated and these arrangements were found to be in line with previously agreed levels. National guidance for new providers would recommend 727.05 care staff for the week. Care staff hours were 27.5 hours short of this recommended standard. However, the overall staffing of the home including all ancillary and management hours was 17.1. hours over the standard. The home is providing opportunities for staff to be trained to NVQ 2 and 3. The registered manager does not currently have NVQ 4 or the registered managers award, but has over 17 years experience working with older persons and NVQ 3. Other training opportunities are provided to ensure that baseline training is given to staff in such areas as food hygiene, basic first aid, manual handling and moving, fire training and health and safety. First aid and epilepsy training was taking place at the time of the visit. Residents stated that they were very happy with the staff working at the home. Staff supervision takes place, and this would benefit from further development in order to ensure that care practices and development of careOakland Grange H55-H03 S11767 oakland grange V225396 130605.doc Version 1.30 Page 16 plans, for those care staff’s key residents, are monitored during these individual sessions. Oakland Grange H55-H03 S11767 oakland grange V225396 130605.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31-33-35-36-38 The home has formally surveyed the views of residents in an anonymous format. Residents are consulted about the daily running of their home. The registered persons comply with their legal responsibilities when handling residents’ personal monies. The registered manager is not NVQ 4 qualified and has not currently gained the registered managers award. The home promotes the health and safety of staff and residents. The responsible individual is arranging for reports from Regulation 26 visits to be made available the Commission. Staff supervision needs further development. EVIDENCE: A number residents’ stated that they felt the degree that they were consulted in the daily running of their home was sufficient. Anonymous resident surveys have been carried out with residents, and regular resident meetings are held. The certificate of registration was displayed. The manager is qualified to NVQ level 3 with over 17 years experience of working with older persons, however, the manager does not currently have the NVQ 4 registered managers award. Residents’ confirmed that the manager was approachable and worked long Oakland Grange H55-H03 S11767 oakland grange V225396 130605.doc Version 1.30 Page 18 hours at the home. Arrangements made for handling residents’ money deposited with the home for safe – keeping, were found to be satisfactory, and wherever possible the home encourages residents to be as independent in this aspect of their lives as possible. Monthly Regulation 26 visits from a representative of the registered persons take place and a report is provided, the inspector was advised that visits take place in the region of every two weeks to monitor the homes conduct, and to support the manager. The manager of the home takes all reasonable steps to promote a safe working environment. Residents confirmed that there are frequent fire alarm tests at the home. Staff supervision could be further formalised and developed in line with current best practice, individual staff supervision sessions could focus more on practice development, care planning and outcomes for residents in respect of their quality of life. There was evidence that the manager holds a significant amount of information to memory, however, as care plans develop to include this information, it may be possible to increase the amount of safe delegation within the staff team, and to improve the quality assurance processes at the home, and outcomes for residents. Oakland Grange H55-H03 S11767 oakland grange V225396 130605.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 x 3 x 3 2 x 3 Oakland Grange H55-H03 S11767 oakland grange V225396 130605.doc Version 1.30 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 3/7/12/15 Good Practice Recommendations Assessments could be further developed to include more information about the resident prior to admission, their likes dislikes interests, hobbies etc. Personal profiles could assist in improving the quality of assessments detail/information. Care plans need to include more specific information as obtained via assessment, based on the needs and wishes of residents. Increased care to ensure physically disabled residents needs at the meal table are met, aids provided where necessary, and care plans need to identify how residents need support in this and any other aspect of daily living, in sufficient detail to guide care staff in their interventions with residents. Clarification should be sought formally by the registered persons, from a college registered with the Skills for Care Agency (formerly TOPPS), or directly with Skills for Care with regard to the action needed to gain the NVQ 4 registered managers award. New guidance issued since the inspection indicates that existing managers who do not have the NVQ 4 RMA will need to be registered with a training agency to gain this qualification by 30th H55-H03 S11767 oakland grange V225396 130605.doc Version 1.30 Page 21 2. 30/31 Oakland Grange 3. 36/7 Spetember 2005, and have completed the qualification by 30th September 2007. Staff supervision would benefit form further development to provide staff with support to develop care practices, (linking to recommendation one above) and skills such as the completion of care plans with their key residents. Key worker systems also need to develop in order to ensure that staff practices and outcomes for residents are monitored by managers, and to support safe delegation of work across the staff team relevant to the experience and training of staff members. Oakland Grange H55-H03 S11767 oakland grange V225396 130605.doc Version 1.30 Page 22 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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