Inspection on 22/02/07 for Oakland Grange

This inspection was carried out on 22nd February 2007.

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 31/10/05

Oakland Grange 13/06/05

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 Jan Everitt key Unannounced Inspection 22nd February 2007 09:30 X10015.doc Version 1.40 Page 1 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 Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 2 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 DS0000011767.V325671.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakland Grange Address 10-12 Merton Road Southsea Hampshire PO5 2AG Telephone number Fax number Email address Provider Web 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 Dementia - over 65 years of age (6), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (6), Old age, not falling within any other category (43), Physical disability over 65 years of age (2) Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. No more than six service users in the categories MD(E) and DE(E) may be accommodated at any one time No more than two service users in the category PD(E) may be accommodated at any one time Four named service users between 55 and 65 years of age in the categories LD and MD may be accommodated 31st October 2005 Date of last inspection 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 Portsmouths main shopping centre is nearby as is the main seafront at Southsea. Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit to Oaklands Grange, Southsea, which was unannounced, took place over a one-day period on the 22nd February 2007 and was attended by one inspector. The visit to Oakland Grange formed part of the process of the inspection of the service to measure the service against the key national minimum standards for the year 2006/7. The focus of this visit was to support the information gathered prior to the visit. The judgements made in this report were made from information gathered prior to the visit; pre-inspection information submitted to the commission by the registered manager, information from the previous report, the service history correspondence and contact sheets appertaining to the service were also taken into consideration. A number of comment survey cards were sent to relatives prior to the visit of which six were returned. They were generally very positive about the care and services. Fifteen service users comment cards were also received prior to the visit and these were taken into consideration when formulating the judgements. Further evidence was gathered on the day of the site visit. The inspector toured the building and spoke with a number of the residents, relatives and spoke to staff and interviewed three staff members. A sample of records was also viewed. What the service does well: The manager has a vast experience of managing a care home and as a consequence is able to thoroughly assess service users before they are admitted to the home to ensure the home can meet their needs. The care planning system is comprehensive and details how service users prefer their care and activities of daily living to take place. The service users and relatives returned positive comments to the inspector about the services and care received in the home. “Quite satisfied with my care”. “I am very happy living here” “The staff are very kind” Relative’s comments were Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 6 “Its home from home and my brother is very happy”. “We are very impressed with the facilities, décor and hygiene and friendliness of staff” Our relative has settled well and is very happy” “Staff are very helpful” Visiting professionals also said that they considered the home provides good care. The inspector observed that staff were attentive to the residents and their relatives and interacted well as a team. The manager has well organised management systems in place and has a supportive senior staff to manage the day-to-day delivery of care. The manager and providers are committed to staff training and have a varied and appropriate training programme in progress. The home provides residents with a warm homely environment that is well maintained. The home maintains high standards of cleanliness. The cook provides a wholesome nutritious diet that service users report is: “Excellent” “I can have what I want”. What has improved since the last inspection? What they could do better: The polices and procedures that guide the security and safe administration of medication must be adhered to by all staff. MAR sheets should be signed at the point of witnessing the service user taking their medication. The cleaning chemicals under the COSHH guidelines must be stored in a locked environment to ensure service users are not at risk. Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. 6 is not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Potential service users have their needs assessed prior to admission to the home to ensure the home can meet those needs. EVIDENCE: The inspector discussed the admission process with the manager. She described the process that if she received an enquiry she would send a brochure to that person. The Statement of Purpose and Service User Guide would be given to the service user/relative at the time of their visit or admission. The inspector viewed a sample of service user’s personal files and care plans. The assessment process has been developed and the assessment detailed. The manager reported that she or her deputy visit the potential service user Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 10 either in his or her own home or in the clinical area to assess their needs. They encourage relatives to be involved with this process and also encourage service users and/or their relatives to visit the home prior to making any final decisions about moving in. Service user responses from the survey indicated that they had received sufficient information about the home prior to their admission. Some service users spoken to at the time of this visit said that they had visited the home prior to making a decision about coming to live there. Others reported that their relatives had visited the home because they had been unable to. A relative spoken to said they were very impressed with the facilities and the general friendliness of the home. The personal files viewed by the inspector demonstrated that terms and conditions of residency contracts are issued and state the fees and are signed by the service user or their representative. Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service user’ s health, personal and social care needs are set out in individual care plans with their involvement. Service users are assured that their health care needs are met. However, sufficient supply of continence aids from the primary care trust is in dispute. Service users are protected by the home’s policies and procedures for the management of their medication and are supported to maintain their own medication. However, the procedure for the administration of medication is not strictly followed. Service users are treated with respect and are encouraged to make decisions about their daily lives. EVIDENCE: Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 12 A sample of care plans was viewed. On admission to the home the service user will have an assessment of their needs undertaken with risk assessments and from this, together with the pre-admission assessment, care plans are drawn up. The detailed care planning system takes account of all of the residents’ personal, social and healthcare needs. The care plans also record a detailed pen picture of the resident’s past life. Service users/ relatives sign the care plan as evidence of their participation and agreement with the care. This was evidenced in the care plans. Service user survey responses recorded a high degree of satisfaction with the care they are receiving and also the relatives survey indicated that they were very satisfied with the services of the home. Service users are registered with a number of different GP’s. The district nurse was visiting the home at the time of this visit to see three residents who needed their wounds dressed. Another district nurse visited to assess a gentleman that needed end of life care and she was planning and organising appropriate equipment and care for him. The manager reported that she had been fully involved with the GP and the decision for the home to care for him there, with the support of the primary care team. The CSCI has received a complaint, a part of which detailed the insufficient stock of continence pads. This was discussed with the manager who reported that the service users who have been assessed by the primary care trust are supplied with three pads a day, and this does not allow for any variation in the service user’s needs. Continence is promoted in the home with toileting regimens but the manager said that she admits there are not sufficient pads at times. The inspector discussed with the district nurse who said she couldn’t influence the assessment and supply of aid. The manager was advised to discuss this with the continence assessment nurse. Also visiting the home was the community psychiatric nurse. She told the inspector that she had been coming to the home for about twenty years and considered it to be good. She said the communication from the manager and staff was good and that staff follow her advice and found the home very responsive to her prescribed treatment. She said that they call her to visit residents appropriately. Arrangements are made for dental checks to be carried out in the local community and service users visit an optician in the local community. The local GP surgery provides service users with access to all relevant health care professionals and a visiting chiropodist visits every 5-6 weeks. Service users spoken with at the time of this visit said they were happy with their GPs and the home responds to their health needs appropriately and calls a doctor is they are unwell. Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 13 The inspector viewed the medication charts and the policies and procedures for the management of medication. The home has a cassette system that is prepared by the pharmacist for each service user and is delivered weekly. These are ordered by the deputy manager and she reports this is done monthly and that if there are changes in the medication regimen she informs the pharmacist of the change. The inspector viewed the cupboards and trolley that were clean and tidy with medication not being stock piled. The inspector observed the MAR sheets and found that they had not been documented for that morning but the deputy reported that medication had been administered. This was discussed with the deputy as to the procedures not being followed and that this practice could lead to mistakes with medication being given inappropriately at the wrong time. A requirement will be made around these findings. At the time of this visit there was no resident choosing to self-medicate fully, with two residents maintaining their own prescribed inhalers, which was reflected on the MAR sheets. The policy of self-medication did not identify that service user must have a lockable storage space to store medications if they chose to self-medicate. The manager told the inspector that each room had a lockable draw. The inspector did evidence this on a tour of the home. The inspector advised the manager to reflect the necessity for lockable storage in the policy. The manager showed the inspector the training records for the recent medication training that staff are in the process of undertaking. This had taken place in the home and had been supplied by a training company. Staff responses from the surveys, and the inspector speaking to staff at the time of this visit, confirmed they have received this training. The content of the training was described in the literature from the company and would promote safe practice. Service users spoken to confirmed they received their medication appropriately and that they did not wish to self-medicate it. The inspector observed the routines and practices of the home during this visit. The staff were friendly and had obvious good relationships with the service users and were familiar with their needs. Staff knocked on doors before entering a room and spoke to service users with respect. One member of staff spoken with described her fondness for the resident that was very unwell and reported that she wished to sit with him for as long as possible during the terminal stages of his life. The inspector also observed that those service users with less mental capacity were being interacted and communicated with by staff in an appropriate manner. Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 14 Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a range of activities for service users, which meet their expectations and the religious and recreational interests of service users at the home are provided for. Service users are able to maintain contact with family and friends and visitors are welcome at any time. Service users are supported to exercise choice and control over their lives as much as their physical and mental capacity allows. The home provides service users with a wholesome balance diet that is taken in pleasant surroundings of their choice. EVIDENCE: The programme on the notice board demonstrated that the home provides activities for the service users to choose from on six days of the week. The inspector did not observe any activities taking place on the day of this visit but Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 16 service users spoken to at the time confirmed that activities do take place such as quizzes, games, exercise programmes and outside entertainers. Some service users reported that they enjoy the activities and others told the inspector that they chose to just observe or preferred to stay in their rooms. Records are maintained of what activities take place every day and the inspector suggested to the manager that the carers record who participates and to what degree record those who choose not to. A staff member commented in the response to the survey that ‘the home works hard at providing suitable entertainment and trying to stimulate the service users’. A number of service users can go out either with support or their relatives. One service user visits the local newsagents to get papers and any shopping for other residents. Another service user is able to visit her bank to enable her to manage her own finances. Responses from the relative surveys suggest that relatives are made welcome to the home at any time. At the time of this visit the inspector spoke to two visitors who reported that they come to the home regularly and that there are no restrictions and are made very welcome. Service users were observed to be able to move around the home freely. Resident’s meetings are held and a record of these maintained. It is at this time residents have the opportunity to raise any issues. Residents spoken to said they attend these meetings when they take place. Service users were observed to have choices with when they get up and go to bed and their preferences were documented at assessment and these were respected. Service user’s responses to the survey confirmed that they have choices within their daily lives. The manager submitted with the pre-inspection documentation a four-week menu plan. The content looked nutritious and varied. The kitchen was visited and the inspector spoke to the cook. The kitchen was clean, well decorated and the storage of food was well organised in an appropriate environment. The inspector observed the lunchtime meal being served, which was a roast dinner with fresh vegetables, upside down pineapple cake and custard. The cook reported that most residents chose to have roast dinner but she is familiar with likes and dislikes and there is always an alternative choice if a resident does not want the main menu. The inspector evidenced in the cook’s diary the alternative diets that were provided. Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 17 The service users were observed to be enjoying their lunch and told the inspector that the food is very good and they have plenty of it. One comment on the survey response was ‘the meals are very good’. The inspector asked the cook if she had received training in special diets. She reported that she had received some training, but that her years of experience she had gained a vast amount of knowledge. She also reported that she receives information about diets from the wholesale provider. The CSCI had received a complaint in recent weeks stating that residents did not have a choice of food at breakfast time. The inspector observed on her tour of the home that one service user was taking a late breakfast and had chosen egg on toast. The cook was asked about breakfast choices. She reported that two service users choose to have early breakfast of cereal in their room and this is prepared and served by the night staff. The remainder of residents come to breakfast as and when they choose and breakfast can go on as late as 09.30. The cook said that some residents, particularly the men, choose to have cooked breakfast and others, cereal and toast, but that she will always cook a breakfast if the resident requests this. Residents spoken to report that they have a choice of menu at every mealtime. The inspector observed in the care plans that the service user’s weights were recorded monthly but there was no evidence of nutritional risk assessments. The manager told the inspector that the service users are risk assessed if a problem is identified through the regular weight monitoring. She would then inform the GP who would refer on to a dietician. The inspector was shown one care plan of a resident that had been referred to the dietician with swallow problems. The dietician had documented in the care plans of this consultation and the prescribed action to be carried out. The inspector observed throughout the day that hot and cold drinks were readily available to residents. The inspector asked a group of residents if they had access to enough drink other than the regular hot drinks. They all agreed they did with a lady saying ‘they give us too much drink sometimes’. Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 18 Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and relatives are confident that if they complain their complaints will be listened to and responded to appropriately. Service users are protected from abuse. EVIDENCE: The home has a complaints policy and procedure that forms part of the Statement of Purpose and sets out clearly the process to be taken should a service user or visitor which to complain. The policy needs amending to reflect the current name and address of the regulatory body and the manager agreed to do this immediately. The inspector viewed the complaints log. These are clearly recorded but the outcomes of any action taken are not. This was discussed with the manager and it was recommended that she record any outcomes of action taken as a result of a complaint. One complaint has been received by the CSCI and this was discussed with the manager. The outcome of this complaint and the action taken as a result of this situation was also discussed and has now been resolved with the complainant. The inspector could find no evidence to support the issues Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 20 raised in the complaint apart from the insufficient continence supplies, over which the manager solely, has no control. The service user’s response to the survey all indicated that if they wished to complain they would speak to the manager or a carer. Service users spoken with confirmed that they were aware of whom to go to if they wished to complain. One service users said’ I have nothing to complain about’. The home has a copy of the adult protection procedure. The home has in the recent past demonstrated that they have followed the procedures when they reported to social services the potential abuse of a resident’s finances. The manager demonstrated that she had knowledge of how the process was carried through to conclusion. The recent complaint was also reported to adult protection at Portsmouth social services department. This has subsequently been resolved with no action being taken and no evidence of abuse having been substantiated. Abuse awareness training is part of the induction for all staff. From staff surveys and speaking with staff at the time of this visit, they demonstrated that they are aware of what constitutes abuse and how they would report it to the senior person on duty or the manager. Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a safe, well-maintained environment that is clean and hygienic. EVIDENCE: The inspector toured the building and all areas of the home were warm, clean and tidy and furniture was in a good state of repair. There are attractive gardens to the front and back of the home. The home employs a maintenance man who carries out routine maintenance and decoration and this is carried out on a needs led basis. This was demonstrated on the day of this visit. A call bell had broken off of the wire and the manager had found this on the tour of the building. She alerted the maintenance man who immediately replaced the call bell. Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 22 The home was well presented, maintained and decorated to a good standard, both internally and externally. The manager told the inspector that the home is constantly being maintained and the providers are very responsive to her requests for repair and redecoration. The pre-inspection document details that the home has undergone considerable redecoration and refurbishment since the last inspection and double glazing fitted where they were permitted to, as the building is listed and there are restrictions on alterations that would change the aesthetics of the building. The inspector observed some stained patches on two ceilings. The manager said that this was in hand to be repainted once the ceiling had dried out from a previous roof leak. Service users said they liked the colour schemes around their 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. The laundry was visited. New washing machines have been purchased and are fit for purpose. The laundry was clean and well organised. The inspector detected that some rooms were colder than others, although generally the home was very warm. The manager explained that there were two service users who do not like warm bedrooms and therefore their thermostats were turned low. This was documented in the care plans. The pre-inspection document states that the home has an infection control policy in place. Staff have gloves and aprons available to them to use appropriately as part of that policy. The policy for risk assessment for handling hazardous substances states the process for handling soiled linen but omits to state that gloves and aprons should be worn when handling this. This was discussed with the manager, who agreed to add it to the policy. The inspector observed from the training programme that a number of training sessions on infection control have been booked for 2007. The home has a policy in place that states water tanks in the roof are tested for Legionella annually and shower heads are cleaned monthly. The inspector viewed the certificate for testing water. Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 23 Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 24 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home employs sufficient numbers of staff with the appropriate skill mix to meet the needs of the service users in residence. Service users are protected by the home’s recruitment policy and practices. The home provides staff with training and development opportunities in addition to NVQ training. EVIDENCE: The pre-inspection documents enclosed a four-week staff rota and demonstrated that sufficient staff were on duty at any one time to meet the service users needs. The manager told the inspector that as they have a very sick resident at the moment, she will ensure that the person that sleeps in will be allocated an awake duty so that there are three awake at night. The manager and the deputy are supernumerary to the rota when on duty and work together three days of the week. Staff responses from the surveys and service users surveys indicated that they considered that there was staff always available when they needed them. It was a very busy morning on the day of the visit but the staff were present Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 25 around the house going about their jobs in a relaxed manner, making time to speak to service users and respond to their needs. The pre-inspection information stated that over 50 of staff have NVQ level 2 training. This was discussed with the manager who told the inspector that the staff are supported and encouraged to take up training opportunities and that the providers will fund and support staff doing NVQ level 3 but they must sign an undertaking to commit to the home for a further two years. An induction programme for new staff is in place. The manager described this as an initial introduction to the home and residents, core values and the health and safety policies. They then view videos on health and safety in the care home. Staff spoken to and responses from staff surveys reported that they had received induction training. The home has not yet embraced the Skills for Care induction programme. The home has engaged a training organisation that offers the mandatory health and safety training and specialist training for staff. The manager is in the process of selecting staff to attend training, which she is identifying through her supervision with the staff. The inspector viewed the training matrix, which detailed a training plan for the coming year with allocated places for each member of staff. The preinspection document identifies that mandatory training has taken place in the past year for all staff and most staff have been on an NVQ training programme, this was supported by the information received in the staff surveys and the inspector speaking to staff. The home funds all staff training and has a mission statement for training and development, which states that the organisation is committed to support and fund staff training. The inspector viewed a sample of four staff recruitment files. The files were well documented and contained all the necessary checks and information as stated in Schedule 2/4 of the Care Home Regulations. They also contain training records and records of staff supervision. Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 26 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed by a person who is fit to be in charge and is able to discharge her responsibilities fully. The home is run in the best interests of the service users. Service users financial interests are now protected. The health, safety and welfare of the service users and staff are promoted and protected. Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 27 EVIDENCE: The manager of the home has been in post for 17 years. She and her deputy have recently completed their NVQ level 4 in care and are both booked on the registered manager’s award imminently. There are clear lines of management in the home and the manager and deputy work simultaneously for three days a week and then on opposite shifts the other days, this ensures that there is always a senior member of duty throughout a seven day period. The manager accompanied the inspector on the tour of the home and it was evident that she was very familiar with the service users and their needs and demonstrated good communication and relationships with them. The service user surveys demonstrated that they are aware of whom to go to should they have any issues and would speak to ‘Angela’. Staff spoken to report that they consider they are well supported by their manager and the deputy and that from observations of the day, good relationships exist between the staff and managers. This was supported in the analyses of the staff survey responses. The home surveys the level of service user satisfaction anonymously and the manager addresses areas of concern. The results of these surveys indicate a high level of satisfaction with the services delivered in the home. This was supported by the observations made at the time of this visit and comments from relatives and residents. The staff spoken with and those responses from the survey stated that staff meetings take place every three months. The deputy reported that she audits the MAR sheets following every medication round to ensure they have been documented. There was no evidence of this taking place. The previous report required that, adequate records for those service users personal valuable and monies held by the home, be maintained. The manager has made alternative arrangement for these records. The inspector viewed a sample of the monies held. Service users have individual storage containers with receipts and monies held for them. Each has an account book that documents the incoming and outgoing monies. These are audited every time monies are taken out or added. The manager told the inspector that an inventory of resident’s belongings such a pieces of furniture are documented in their personal files when they are admitted. The inspector evidenced this on a file. Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 28 The manager discussed staff appraisal and supervision. She has not formulated a structured appraisal system for staff as yet but is in the process of doing so. She supervises the staff on a one to one bases and evidence of this was found in staff personnel files, at which time training needs are discussed and any other issues the staff member wishes talk about. She reports that she has an ‘open door policy’ and that staff come to see and talk to her on a regular basis. This was demonstrated in the responses from the staff surveys and from conversations with the staff on the day of the visit that they have good relationships with the management team and feel valued. The fire log was viewed by the inspector and the necessary checks and training was documented appropriately. The inspector viewed the accident book. The reports were documented appropriately but not stored in line with the Date Protection guidelines. This was discussed with the manager that alternative storage of this information should be found and that she must maintain her own records as part of the quality assurance system for the home. A report was audit trailed by the inspector who could find no mention of the accident in the daily notes and therefore this information about a resident may well be lost in the handover meetings for staff. The inspector observed on her tour of the building that the cupboard containing the cleaning chemicals that come under COSHH, was not locked. The necessity for this door to be secured to ensure service users were not at risk was discussed with the manager. Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 29 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 2 Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 30 Are there any outstanding requirements from the last inspection? NO 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 OP9 Regulation Reg 13(2) Requirement The registered person is required to ensure that MAR sheets are recorded by the member of staff administering medication, at the time of administration. The home’s policy and procedure must be adhered to. The registered person is required to ensure that the storage of COSHH chemicals is a locked environment. Timescale for action 31/03/07 2. OP38 Reg 13(4) 31/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. Extracts may not be used or reproduced without the express permission of CSCI Oakland Grange DS0000011767.V325671.R01.S.doc Version 5.2 Page 32 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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