Inspection on 29/11/06 for Oakland House Nursing Home

This inspection was carried out on 29th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 House Nursing Home 04/01/06

Oakland House Nursing Home 17/10/05

Oakland House Nursing Home 08/02/05

Oakland House Nursing Home 11/08/04

Oakland House Nursing Home 26/01/04

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Oakland House Nursing Home 290/292 Dickenson Road Longsight Manchester M13 0YL Lead Inspector Sue Henstock Unannounced Inspection 29th November 2006 09:00 Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 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 House Nursing Home DS0000021653.V321360.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 and Care Homes for Adults 18 – 65*. 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 House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakland House Nursing Home Address 290/292 Dickenson Road Longsight Manchester M13 0YL 0161 257 2395 0161 248 0652 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) Beamdouble Limited Lesley Mary Sturgeon Care Home 38 Category(ies) of Dementia - over 65 years of age (13), Mental registration, with number disorder, excluding learning disability or of places dementia (25) Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. A maximum of 38 service users will be accommodated All service users accommodated on the homes ground floor will be aged 60 years or over except where a variation has been granted in respect of age and dementia for a named individual in receipt of nursing care. All service users accommodated on the homes first and second floors will be aged between 18 and 65 years at the time of their admission to the home and require nursing care by reason of mental illness excluding learning disability and dementia. That the home continues to comply with the minimum nursing staffing levels as specified in the Notice of Proposal to register and its attachments, issued under Section 13 (5) of the Care Standards Act 2000 on 16th July 2003. The service should at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 4th January 2006 4. 5. Date of last inspection Brief Description of the Service: Oakland’s House Nursing Home is a care home that provides 24 hour nursing care and accommodation to 38 residents, of whom up to 12 may be above pensionable age. The home provides a service to people with enduring mental health needs. Equilibrium Healthcare Limited owned the premises. The home is situated in a busy residential area in the Longsight district and it is close to public transport routes and within easy reach of Manchester City Centre. The home is close to local facilities, shops, a market and other community facilities. The home consists of a large converted building with a large purpose built extension. The home provides accommodation on three floors for up to 38 residents. There are 12 or 13 residents accommodated on each floor in single bedrooms. None of the rooms has an en-suite facility. Each floor has a nonsmoking lounge, smoking lounge, dining area, communal toilets, one bathroom and one shower room. The home has an off-road parking for approximately 10 vehicles. The entrance to the home is at ground level and is accessible to wheelchair users. A small-enclosed garden area is accessible on the ground floor. Fees range from £454.54 to £1332.09 Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the unannounced site visit to the home as part of the inspection process, which inlcudes a review of all information held by the Commission for Social Care Inspection about the home. The inspection took place on 29 November 2006. The manager was on duty throughout the inspection visit. The opportunity was taken throughout the inspection visit to speak to service users and staff. A selection of care plans, medication records, staff records, and maintenance records were inspected, and a tour of the building was undertaken. A pre-inspection questionnaire, copies of Action Plans and Development Plans were provided by the manager. What the service does well: What has improved since the last inspection? The home had introduced an excellent online training course in the protection of vulnerable adults, which all staff were required to undertake, before completing a questionnaire to test their knowledge. Staff records inspected Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 6 indicated that all staff had completed the training, which was part of the induction programme. There was a comprehensive induction programme for staff, detailed in their files, covering 20 key areas, delivered over a 12 – 13 week period. 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. The summary of this inspection report can be made available in other formats on request. Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. Prospective service users and their relatives had the information they needed to make an informed choice. Their needs were fully assessed to determine the home could meet their needs. There were opportunities for them to visit the home prior to admission. EVIDENCE: The manager described the referral process. On receipt of a referral letter a detailed history was requested and if the home felt it could meet the needs of the prospective service user either the manager or the clinical nurse manager, with the unit team leader visit the person to carry out an assessment. They met with relevant health professionals; (CPN; Psychiatrist; SW; OT;) to gather all relevant information to determine if they could meet the person’ needs. The Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 9 person would then be invited to visit the home, or take a meal or invited for a overnight stay. One service user was staying at the home for three nights per week as part of the assessment process. Those service user files examined contained detailed personal information; an assessment of need; risk assessments; care plans and reviews; personal futures plans; healthcare risk screen; monthly recording charts (BP/ weight / Blood sugars etc); other healthcare professionals’ visits; incident reports; and case file audits. Those assessments seen also included details of the individual’s mental health status. All service users were given a copy of the Service User Guide (SUG) and Statement of Purpose (SOP), and copies were available in the entrance lobby to the home. Service users are provided with replacement copies of the SUG when required. Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 and 10 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. The home involved service users in the assessment and care planning processes. Policies, procedures, and record keeping systems supported and maintained service users’ confidentiality. EVIDENCE: Service users were encouraged to get involved with all aspects of their assessment of needs, care plans and reviews. Where they were unable or unwilling to take part their relatives, advocates, social worker or CPN were involved. In all files reviewed there was a copy of a ‘Personal Futures Plan’, Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 11 written by the service user detailing their views, needs and aspirations, and the home was further developing person centred approaches. The home organised regular service user meetings on each of the three units, and staff encourage them to attend. There was an agreed agenda to prompt discussion on issues relating to the environment; recreational and social activities; menus; bullying and harassment; and any other general issues they may wish to discuss. The chef met with service users’ on a regular basis in order to discuss menus, and surveys were carried out with service users and carer’s to seek their views on the service they receive. A quarterly meal survey was carried out. All records were kept secure, either in nursing stations (service user records) or the main offices (staff records and home management). Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. 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. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 13 12, 13, 15, 16 and 17 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. Service users had the opportunity and were supported to take part in a range of activities, within the home and the local community. The home had an open visiting policy and a family forum to help service users maintain relationships and provide opportunities for involvement in all aspects of the home. EVIDENCE: The home employed two activity workers who met with service users to identify and organise activities they want to do both within the home and in the local community. There was a planned activity programme in each unit, displayed on the notice board. Activity plans were included in service user care plans. Examples of activities included trips to Blackpool; museums; shopping; football matches; TV, DVDs, and visiting relatives and friends. The home also employed a part time Arts & Crafts organiser to support service users. Some service users were able to take part in community activities with no support from staff, and several accessed a local drop in centre, which provided social activities and counselling. Service users and staff described events organised earlier in the year, which involved each unit having themed meals (Italian; Indian; English foods) and a series of BBQs particularly to watch sports events over the summer. Everyone seemed to enjoy these. The chef met with service users and sent a survey out on a regular basis to identify favourite menus. The chef catered for special diets, such as low fat; vegetarian; and diabetic. The chef was able to describe the likes and dislikes of service users, and identified different preferences between the units and a choice of meals is offered. Birthdays, and special occasions were routinely celebrated with special meals / food and parties. In addition to the main kitchen a small kitchen was situation on each unit where service users were able to make snacks whenever they wanted. Staff were always available to support them. A family forum was organised on a quarterly basis and relatives encouraged to take part. The next meeting was due in December. There was an open visiting policy. Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) Service users retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicines. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. Service users’ personal and healthcare needs were appropriately met. EVIDENCE: Key workers were responsible for ensuring service users’ needs were met on a daily basis, supervised by qualified staff. Care plans described what specific support service users required in personal and health care. Staff were observed to treat service users with respect and dignity, and ensuring their privacy, for example, in using bathrooms and toilet areas, and dressing. Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 15 No service user was self medicating at the time of the visit. Service users were supported to attend local GP, dentist, optician and chiropodist clinics. Those unable to attend local clinics, due to their medical conditions, were visited in the home. Details were recorded in care plans. Medication records, storage and administration were all in order. Treatment rooms on each unit were kept locked, with the nurse in charge responsible for holding keys. The clinical nurse Manager for the home oversaw all clinical issues and carried out regular audits on medication and care plans. Information from Age Concern; MIND; an Advocacy Group; and the Roby Centre was made available to service users. Several used the Roby Centre, to access social activities. Mealtimes provided some degree of flexibility, with a continental breakfast available until 10.30 a.m., and in addition to meals delivered from the main kitchen, snacks were available in unit kitchens throughout the day. Service users decided which activities to participate in and staff encouraged and supported them. Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. The home provided a safe environment for service users and there were clear policies in place to protect service users from abuse. EVIDENCE: There had been five complaints recorded in the Complaints Register and Complaint Log since the last inspection (04/01/06). All were dealt with in line with written policy and procedure. The complaint policy was detailed in the Service User Guide, and displayed in each unit and in the entrance to the home. The home had introduced an ‘on- line’ training course in the protection of vulnerable adults, for all staff. Members of staff were required to undertake the training to answer a detailed questionnaire relating to the course. On successful completion, the member of staff received a certificate. The course was comprehensive and all members of staff have undertaken the course, with Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 17 details in their personal files. The course also formed part of the induction training for all staff. Discussions with several members of staff indicated that they had a good understanding of what constituted abuse, and that they were aware policies and procedures were in place. All staff had undertaken the training in protection of vulnerable adults. Discussions with service users indicated that they were aware of how to make a complaint and there was evidence in the Complaints Register / Log of complaints made by service users. There was evidence of action taken following a complaint by a service user and how staff had responded to this complaint and the details of a satisfactory outcome. Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 30 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. The home provided a safe, homely environment for residents, which promoted their independence and privacy. EVIDENCE: A Maintenance Action Plan was available which detailed cyclical repairs and redecoration. There was evidence during the inspection of work in progress, by Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 19 the maintenance team. The kitchen had been refurbished, and flooring in several rooms was being replaced. The manager had a detailed Action Plan, which identified key issues; action to be taken; completion date; and evidence required. The plan covered personal hygiene; diet; staff support; service user activities; management of the home; fire marshal; first aid; staff sickness; expenditure and refurbishment. There was evidence in various files within the home that the Action Plan was a working document. Maintenance logs were evident on each of the three floors. Staff noted work required, which was entered onto a Maintenance Recor, which was then passed to the maintenance team. The manager monitored progress of any work required. The team carried out weekly checks on equipment, fire doors and extinguishers and emergency lighting. The manager organised an annual evacuation drill, and the Fire Marshall carried out risk assessments. The main kitchen was well equipped with separate fridges/freezers for different foods. There was evidence of regular temperature checks. There were three heated food trolleys, one for each unit. Food temperature was checked on arrival on each unit and if it was not hot enough the trolley would be returned to the kitchen. The chef stated this had not been necessary. Kitchen staff were responsible for cleaning the kitchen and a weekly cleaning schedule was in place, which the housekeeper oversees, as part of the overall schedule for the home. Service users’ bedrooms, were simply furnished, although there was evidence of personal possessions in each room, and redecoration was included in the maintenance programme. Each unit had two communal sitting rooms, and an additional one for smokers. Ventilation in the smoking room was adequate. Each unit had a dining area and a small kitchen where service users could make snacks and light meals at any time. Staff were available to provide support and supervision in the kitchens. Communal sitting rooms had been redecorated. Flooring in the dining areas was being replaced. There were no en-suite facilities available, but each floor had adequate bathing and toilet facilities. Shower rooms were currently being upgraded. The manager stated there were no problems in service users being able to access facilities when they wished. Staff were observed to knock on service users’ doors before entering, and to provide support to residents moving around the units. The nurse stations / offices on each unit and treatment rooms were very small, and did not provide sufficient space for any staff discussions or for treatment Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 20 to be carried out. The Manager stated they are looking at how this could be improved but the design of the building would make this difficult. Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36 Quality in this outcome is excellent. This judgement has been made using available evidence including a visit to this service. The home was staffed by experienced and appropriately qualified staff. The staff received regular supervision and had access to a wide range of training opportunities. EVIDENCE: The manager described the recruitment and selection policy and procedures and there was evidence in those staff files seen of application forms, interview questions and scoring, references, Criminal Record Bureau certificates, terms and conditions, and induction details. Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 22 A training schedule for 2006 detailed all available courses and there was evidence in staff supervision files that training courses had been attended, and was ongoing. Training was provided by external training organisations; such as South Trafford College; and internal staff. There was a comprehensive induction programme, which lasted approximately 12 weeks. This included 20 modules, with two modules undertaken each week. At the time of inspection the modules were ‘person centred approaches’ and ‘raising concerns’. The home had introduced an on line training course on Protection Of Vulnerable Adults. Each member of staff was required to undertake the training, and complete a questionnaire before receiving their certificate. All staff files inspected contained evidence of staff attendance and discussions with staff confirmed their understanding of issues relating to this subject. The home was running a course on Equality and Diversity and to date all qualified staff had completed the training and each month a further 12 staff were scheduled to attend. Staff files and discussions with staff provided evidence of training needs and each member of staff had a supervision contract and received monthly supervision. The home had introduced a performance appraisal system, initially focusing on qualified staff, who would then be responsible for appraising care staff. The clinical nurse manager was responsible for overseeing all clinical issues. She provided clinical supervision to qualified staff, who in turn support the care staff. She received external clinical supervision as well as general supervision from the Manager, who has completed the Registered Manager’s award and National Vocational Qualification (NVQ) Level IV. The clinical nurse manager was also undertaking the Registered Manager’s award. Staff were supported to undertake NVQ Levels I, II, III & IV. 10 staff had completed NVQ II, and 13 were due to complete December 2006/January 2007. 4 staff had completed level III, and 4 should complete by January 2007, and two have completed NVQ IV. The head chef provided regular food hygiene training to all staff. Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 24 37, 38, 39, 40, 41, 42, 43 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. The home was run in the best interest of service users, with policies and procedures in place to protect them and there was an ethos of continuous improvement. EVIDENCE: The home carried out quarterly surveys with service users and their carers. The head chef did a quarterly menu survey and met with residents to discuss the menus. Each unit held service users meetings (see Individual Needs & Choices). There was an open visiting policy and a quarterly family forum, although families need encouragement to attend. The clinical nurse manager carried out quarterly audits on care plans, incidents, accidents and medications, in addition to external audits carried out by the Pharmacist. All medication records, storage and administration were in order. All maintenance records were up to date, and the manager carried out weekly spot checks. There were regular meetings covering all aspects of the home: management; operations; qualified staff; support staff; hotel services; service users; and the family forum. There was evidence, in the care plans inspected, that the clinical nurse manager had reviewed them. Copies of policies and procedures were available for staff in the main office and nursing stations. Discussions with staff members indicated they were familiar with policies and procedures and knew where to get information. Each service user had an individual wallet for personal money, kept in locked facilities in the unit. The Activity Co-ordinator was responsible for managing their accounts. All expenditure was noted, with numbered receipts and transactions signed by both the service user and Activity Co-ordinator. Where a service user was unable to sign for their money this was undertaken by a qualified nurse. Accounts were reconciled weekly by the home Administrator, Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 25 and cross checked by the manager. All records inspected were in order. Residents and staff were familiar with the process. Discussions with service users indicated that they received the support they needed and they knew who to talk to if they had any concerns. Each unit was accessed by a keypad entry system and all service users, other than those who had restrictions because of their mental health status, had the key codes so they were free to come and go, as they chose to. The manager had introduced new monitoring systems to ensure the home was run in the best interest of service users. Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 4 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 3 34 4 35 4 36 4 CONDUCT AND MANAGEMENT Standard No Score 37 3 38 4 39 3 40 3 41 3 42 3 43 4 3 3 4 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oakland House Nursing Home Score 3 3 3 X DS0000021653.V321360.R01.S.doc Version 5.2 Page 27 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. 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 OP10 Good Practice Recommendations The manager and owners should explore ways of increasing the amount of space in nurses’ offices and treatment rooms on each unit to provide appropriate facilities to discuss and maintain confidential information. Oakland House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 House Nursing Home DS0000021653.V321360.R01.S.doc Version 5.2 Page 29 - 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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