Inspection on 10/07/07 for Oaklands

This inspection was carried out on 10th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Oaklands 16/12/08

Oaklands 09/01/08

Oaklands 08/02/07

Oaklands 01/06/06

Oaklands 09/02/06

Oaklands 08/09/05

Oaklands 23/11/04

Oaklands 17/06/04

Oaklands 16/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Oaklands Forest Glade Dunton Hills Laindon Essex SS16 6SX Lead Inspector Carolyn Delaney Unannounced Inspection 10th July 2007 07:45 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 Oaklands DS0000018110.V338774.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. Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oaklands Address Forest Glade Dunton Hills Laindon Essex SS16 6SX 01268 491491 01268 543045 oaklands@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Healthcare Services Limited 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) Sallyanne Green Care Home 55 Category(ies) of Old age, not falling within any other category registration, with number (55) of places Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may admit one person who is over the age of fifty-five years and under the age of sixty-four years whose name is known to the Commission. 8th February 2007 Date of last inspection Brief Description of the Service: Oakland’s is a large detached, purpose built home on two floors, providing residential accommodation for up to 55 elderly residents. The home is situated in the middle of a modern housing estate. A large attractive garden is located at the rear of the property. There is a rooftop patio on the first floor of the home. Access to facilities in the area can be made by private or public transport. Parking is available to the front of the home. . Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced Key inspection carried out on 10th July 2007. It took place over eleven and a half hours between 07.45 am and 6.45 pm and I was accompanied by inspector Michelle Love. As part of the inspection process the relatives of a random sample of residents and the general practitioners who have patients living at the home were contacted by post and given the opportunity to make comment about the home. At the time of this inspection four relatives and two general practitioners had returned completed questionnaires. Each person had been offered the opportunity to speak with the inspector, and one person chose to speak with the inspector. The comments and views of residents and those people who responded to questionnaires have been used in conjunction with the findings of the inspection visit so as to make a judgement about the level of services provided by the home and have been included throughout the report. Records including assessments, care plans, daily care notes, and medication records, risk assessment documents and accident records in respect of a number of people living at the home were examined. Members of staff and the homes manager, and the homes owner were spoken with and a number of records including duty rotas and staff recruitment files were examined. A tour of the premises was carried out. Key standards as identified in the intended outcomes sections of this report are inspected at each key inspection. Key standards are identified for each section of the report. Where other standards have not been assessed these will have been assessed at previous inspections. Reports in respect of previous inspections may be accessed via the Commissions website www.csci.org.uk. The judgements made in this report are based upon the information collected during the site visit, the information provided by residents relatives and other relevant individuals, and other information received by the Commission from the home and other parties. Below is a brief summary of the findings of the inspection. More detail is contained within the main body of the report. Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Information must be made available to staff working in the home at any time an a pre- admission assessment is carried out by a member of Southern Cross staff who does not work at Oaklands and the assessment documents must be completed fully. A plan of care must be developed for each person living at the home. The information within each persons care plan must kept up to date and changed at any time where there are changes to the persons condition or the level of care the person needs. Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 7 Staff working at the home must ensure that where there are identified risks to the health and safety of a person living at the home that these risks are managed and that staff take all appropriate action so as to minimise risks of injury or ill health. More could be done so as to provide a lifestyle, which suits the people living in the home. More opportunities for activities and keeping residents stimulated and occupied could be provided and staff must treat residents with more respect such as referring to the person according to their preferred term of address and not referring to people according to the number of the room they occupy. Some residents could be better supported at mealtimes. The routines and staff practices in the home must be reviewed so that they are suited to the needs of residents. Residents should have access to communal areas in the home such as the lounge area and the dining rooms. More could be done so as to keep the home free from unpleasant odours. Where the home employs agency staff checks should be made when these staff arrive at the home so as to confirm the person’s identity and wherever it is possible agency staff should be supported by the homes permanent staff so that residents receive a consistent level of care and support. There are some areas where the homes management could improve. More must be done so as to ensure that all the equipment and systems in the home are checked regularly and that certificates to evidence checks and maintenance are kept and made available for inspection upon request. Domestic and cleaning staff must ensure that cleaning materials are stored in accordance with the homes policy when not in use and that these items are not left unattended. The home must develop a system to monitor and improve the quality of service it provides. 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. Oaklands DS0000018110.V338774.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 Oaklands DS0000018110.V338774.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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People’s needs are not always assessed in a consistent way in line with the homes policy and procedure so as to ensure that the home will be suitable for the person. EVIDENCE: The home has documents, which should be completed by staff when an assessment of a persons needs is carried out before a decision is made to offer the person a place at the home. These documents were examined for three people who had moved into the home since the last key inspection, which was carried out in February 2007. There was evidence that an assessment had been carried for each person. However a member of staff working at another Southern Cross home had carried out the assessment for one person. This assessment document had not Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 10 been forwarded to the home until after the person had moved into the home. Staff working at the home did not have the relevant information about the person so as to be able to plan for and provide individualised care for the person. In addition it was noted that important information provided in respect of one persons needs as recorded by social services in their assessment document had not been incorporated into the assessment carried out by staff. This information was in respect of the person’s difficulty in swallowing and the measures to be employed regarding the consumption of fluids so as to minimise this risk. Staff working at the home must be provided with information about a person to be admitted to the home where the assessment has been carried out by staff from another Southern Cross home. Other sections of the pre- admission assessment documents for the three residents were not fully completed. The section of the assessment pertaining to the resident’s ability to eat and drink was not completed for one person and the continence assessment was not completed for another person. It is the policy of the organisation that staff complete a ‘pre-admission draft care plan’ for people to be admitted to the home. This document contains relevant information about the persons care needs until a detailed plan of care is developed. However these documents were not completed consistently for those people whose documents were examined on the day of the inspection. Oaklands does not provide intermediate or rehabilitative care. Oaklands DS0000018110.V338774.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 poor. This judgement has been made using available evidence including a visit to this service. Information about residents needs is not always recorded or available for staff to act upon. Risks to resident’s health & safety are not managed in a way, which minimises the risks. EVIDENCE: During the day of the inspection the care plans, risk assessments and general assessment documents for six people living at the home were sampled and examined. Since the last inspection an audit in respect of the information recorded about residents, their care needs and the type and level of support they need had been carried out an in a number of care plans there were notes made as to what information was missing. There was some improvement noted in some residents care plans particularly in respect of some residents preferences for meals, the times they wish to get Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 12 up and go to bed etc. However there were number of issues identified about the way in which staff record information about residents care needs and the level of assistance they require from staff. It is noted that staff had not developed a plan of care for one resident and that there was very little information available as to how staff were to provide care and support for this person. Shortly after their admission to the home this person fell and sustained an injury, which necessitated their admission to hospital. Staff working at the home had identified this person, as being at high risk of falls but there was no plan developed so as to minimise this risk. Other care plans were not always kept up to date when there were changes to a person’s condition. One person had been admitted to the home and there was clear information in the assessment as carried out by the social worker about specific risks to the persons health in respect of swallowing and the measures to be taken so as to minimise this risk. There was no evidence that staff working at the home had carried out an assessment in respect of this risk, or that they had sought the advice of healthcare professionals regarding this. It was noted that the measures to minimise risks to the resident had not been implemented. Where specific risks to a person’s health and safety had been identified it was not always clear that these risks were being managed in a way, which minimised the risks involved. It was recorded in one persons care plan that their bed was not suitable and risks were identified. There was no evidence as to what action staff at the home had taken to provide a more suitable bed. This was discussed at the inspection and staff were advised that this must be dealt with as a matter of urgency. However one week following the inspection no action had been taken so as to address. This matter. A number of people living at the home are at risk of injury as a result of their tendency to fall. The care plans for two people for whom it was identified that the level of risks is high were examined. Both these people had a number of falls in the weeks and months prior to this inspection visit. Despite the frequency in falls the care plans and risk management plans had not been reviewed and amended and there was no evidence that staff had monitored the person’s condition following a fall in accordance with the organisations policy and procedure. For example when one person fell it was recorded in that person’s care notes that the person ‘claims to have hurt their hip’. There was no evidence that staff had offered any pain relief or that they had checked on the person after the fall so as to assess whether the person had been injured. Two of the resident’s general practitioner completed surveys. Both said that they could see their patients in private; one of the two said that there is not always a senior member of staff available to confer with when they visit the Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 13 home and one said that more could be done so as to bring patients to the surgery for routine check-ups. Four residents relatives completed ‘Have your say about’ surveys. One person commented that residents should be shown how to use wheelchairs when it becomes necessary to use them. People living in the home rely upon staff to ensure that they receive the medicines, which have been prescribed for them as part of their treatment. It was positive to note that the majority of staff who are responsible for the safe handling and administration of medicines had undertaken advanced level training and that staff undertook a period of supervision until they were deemed to be competent. The arrangements for storing and administering medicines were observed to be appropriate and staff completed residents Medication Administration Records (MAR) to evidence when medicine have been administered. A statutory Requirement notice was issued to the home in respect of the failure of the provider to ensure that residents have a plan of care and that risks to a persons health and safety are managed. Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 14 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 poor. This judgement has been made using available evidence including a visit to this service. The routines within the home and staff practices do not ensure that people living in the home receive the level of support they need in respect of daily life and the participation in meaningful occupational and recreational activities. EVIDENCE: On the day of the inspection residents on the ground floor did not have access to the homes communal lounge as this area was being used for staff training, instead residents were seated in the homes reception area. It was also noted that a number of residents were provided with their breakfast in the reception area and residents were not offered the opportunity to have breakfast in the homes dining room. When residents were asked as to why they did not go into the dining room, one resident told the inspector ‘I think the cook has training today’. Residents did not have access to tables on which to place cups and plates and one resident who was sitting in a wheelchair appeared to be struggling to manage their tea and toast. Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 15 On arrival to the home one inspector asked a member of staff who was the newest person to have recently moved into the home. The staff member could not provide the name of the resident and instead referred to the person as ‘room 4’. When asked who the person in room 4 was? The member of staff said they ‘were not sure as they had been off for a few days.’ It had been identified at a previous inspection that staff referred to residents by their bedroom number rather than their name or the term of address by which they would wish to prefer to be called. Throughout the day there were no opportunities for activities provided for those residents who were sitting in the reception area. Some residents spent some time sitting in the garden with their relatives. Two relatives who were spoken with during the inspection said that ‘things had gone downhill’ since their relatives had moved into the home some years previously and that there ‘was little for residents to do during the day’. It was recorded in one persons care plan that they were to attend a local day care centre and activities in a local church hall each week. There was no evidence that the person was attending these arranged activities. The homes temporary manager said that the resident had ‘refused to go’ however there were no records made in respect of any discussions with the resident or their refusal to attend these activities. It had also been identified earlier in the year that one resident may benefit from attending a local club. However there was no evidence that any action had been taken so as to make arrangements for the person to attend. The serving of the lunchtime meal was observed in both dining rooms. Some residents in the first floor dining room complained that the room was very stuffy and uncomfortable. Most residents were provided with their meal and offered support in a manner, which suited their needs. Staff were observed to ask if residents had finished before taking their plates away. None of the residents were asked if they would like more food and one resident complained that they are never offered more and they should be. One inspector observed the serving of the lunchtime meal in the dining room on the ground floor. One member of staff was observed to place meals in front of residents without saying anything to the residents. Meals were served according to a list of names, which meant that a number of people seated together did not get their meals simultaneously. One resident said to another seated next to her ‘ I wont wait for you otherwise it will go cold’ Five people were overheard to say that they did not like the meal. Only one person was asked if they would like an alternative. Two residents said that the food is often not good and that the particular meal served (lamb cobbler) was ‘not nice’ Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 16 One resident told the inspector ‘ they (staff) are more attentive today because you are here’. It was noted that two agency members of staff, one of whom had not worked in the home previously, served the evening meal in the ground floor dining room. As one of the two did not know residents or the level of support that they needed. A number of residents had to ask on more that one occasion for more food and one resident in particular appeared to be quite distressed at having to wait for their meal to be served. It was not clear as to why two agency staff were left to work together and that they were not supported by the homes permanent staff. Following this inspection a Statutory Requirement Notice was served to providers for their failure to ensure that people living in the home are treated in a way which respects their rights to receive care in a manner which is suited to them and that they are treated with respect and dignity. Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 17 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 adequate. This judgement has been made using available evidence including a visit to this service. Complaints are not always responded to in line with the homes / organisations policy and procedure. EVIDENCE: Oaklands has a policy and procedure for dealing with complaints. Of the four residents relatives who completed a ‘Have say about’ survey two said that they knew how to make a complaint about the home if they needed to. Of the two who confirmed that they were aware of the homes complaints process one said that the home responded appropriately when concerns were raised. The other person commented that ‘they do not always respond to letters’. Records, which were examined on the day of the inspection, indicate that there have been seven complaints made to the home since the last key inspection, which was carried out in February 2007. Three complaints were made in respect of personal care provided to residents, two were regarding health care provided to residents, one was regarding staffing levels and one was regarding the maintenance of the homes garden. There was evidence that these complaints had been investigated however the outcomes as to whether the complaints had been upheld was not recorded or clear and there was not always evidence that the complainant had received a response to the complaint. Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 18 There has been one complaint since the last, which was referred to the local Adult Protection Safeguards unit for investigation. The referral was made when the complainant said that staff at the home had failed to contact the district nurse and G.P. however following the investigation it was found that staff at the home had acted appropriately. Records indicate that 97 of staff working at the home have received training in respect of protecting vulnerable people from abuse and harm. Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents do not always have access to communal areas of the home. EVIDENCE: Oaklands is a purpose built home comprising of two floors both of which have communal dining and seating area. Residents have access to a well-maintained garden and a number of residents were observed to sit in the garden throughout the day of the inspection, as the weather was good. It was disappointing to observe that the homes lounge area was not available to residents as staff were using this room for training. There was evidence that the lounge area is regularly used for staff training. Some residents were seated in the homes reception area for the most of the day and some people had breakfast there instead of the dining room. Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 20 While it was evident that the problem with unpleasant odours had been dealt with in one area of the home there were still persistent odours in some parts of the home and more must be done so as to eliminate these. On the day of the inspection on of the members of domestic/ cleaning staff left the trolley with cleaning materials unattended in the corridor. This practice is unsafe and not in line with the organisations policy and procedure for dealing with substances which may be hazardous to a person’s health. Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The deployment of staff in the home does not always ensure that people who live there are supported in accordance to their needs. EVIDENCE: The minimum staffing levels for the home are two senior care staff and five care staff for the morning shift, two seniors and four care staff for the afternoon and one senior and three care staff at night. The duty rotas for the five weeks prior to the day of the inspection were examined and it was noted that these minimum levels have been maintained. A number of people who were spoken with during the inspection commented about staff in the home. One person said ‘they (staff) are always so busy’ On occasions the home uses temporary staff from a local agency. It is recommended as good practice that where agency staff are used that the home obtains evidence from the agency in respect of the checks including Criminal Records Bureau (CRB) disclosures / PoVA First checks and details of the skills and experience in respect of these staff and this information was available for agency staff who had recently worked at the home. Any agency staff who have not previously worked in the home should be given an induction including a tour of the building noting fire exits etc however there was little evidence that this is carried out in a consistent way. Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 22 It was noted that the night prior to the inspection that agency staff had been used. However the person supplied by the agency was not the person who’s named had been provided when the booking was made. Staff on duty at the time when the person had arrived to work at the home had failed to check the identity of the person. During the morning of the inspection a number of residents were over heard by inspectors to ask for their mid morning cup of tea. One member of staff commented that the tea was late due to staff training, which was being carried out that morning. When questioned about this the homes temporary manager said that there were sufficient numbers of staff on duty in the morning s as to provide residents with their tea. However it then transpired that a number of staff had taken their morning break at this time. On the day of the inspection two agency staff were employed on the ground floor. One of the two had worked in the home previously and had some knowledge of residents needs. However the second person had not worked at the home previously. At teatime both of these agency staff were left to support residents in the dining room on the ground floor. This impacted upon the delivery of support to residents and it was not clear as to why two agency staff were working together and not teamed with permanent staff. There have been six new staff recruited to work in the home since the last inspection. These files were examined and it was positive to note that there have been improvements made in the way that staff are recruited to work in the home. There was evidence that the previous employment history for all but one person had been explored and that references had been obtained and interviews carried out prior to a person being offered a job in the home. There were references on file for each person however references had not been sought and obtained from previous employers for each person. There was evidence that PoVA First checks had been carried out for each person before they had commenced work in the home and that CRB disclosures had been applied for. However these had not been obtained for all staff prior to them commencing work at the home and there was no evidence that staff had been supervised until such time as the CRB disclosure had been obtained. There was proof of identity and eligibility to live and work in the United Kingdom (where applicable) for each person. There were records in respect of the induction undertaken by new staff however this induction is not in line with the recommended ‘Skills for Care’ induction. Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 23 There was up to date information in respect of the training provided for staff working in the home. From the records available it was noted that the majority of staff working in the home had received up to date training in respect of their roles within the home. For example 97 of staff had received training in respect of safe moving & handling, fire safety, protecting vulnerable people from abuse or harm and dealing with substances, which may be hazardous to health. 92 of staff had received training in respect of the safe handling and administration of medicines and 66 of staff had received training for managing aggressive behaviour and dementia awareness. It is the policy of the home that following on from the training that staff complete an assessment of learning and that these are assessed by one of the organisations trainers. However a number of these assessments were examined and it was noted that some of the answers were incorrect and the person assessing the papers had corrected some. However it was not clear that where staff had answered incorrectly that this had been discussed with the individual or that further training needs had been identified. Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 24 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, 32, 33, 36 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There have been some improvements in the management of the home however more needs to be done so as to ensure that the home is managed in the interests of the people who live there. EVIDENCE: The homes registered manager has not worked at the home for some months and a manager from one of the organisations other homes has been providing management support until such time as more permanent management arrangements have been implemented in the home. The staff rota must be amended as it still indicates that the previous manager is working at the home. Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 25 There was evidence of some improvements in the way the home is managed and a number of staff working in the home said that the home is more organised. However there are still areas, which need to be improved upon as identified within this report and the home needs a permanent manager so as to be able to maintain these improvements. One relative said that they ‘do not always know what is going on and that the home has been poorly managed for a considerable length of time which means that staff are not supported’ The temporary manager has carried out some audits in respect of documentation, staff recruitment and training and the provision of activities within the home. This audit is in respect of the compliance against the homes and organisations policies and procedures. During June two audits were carried out and in terms of documentation and care planning the home scored between 48 and 54 . Staff recruitment scored between 62.5 and 75 and staff training rose from 75 to 100 . It was recorded that staff supervision also rose from 75 to 87.5 and this was evident in the records maintained in respect of staff supervision. The result for activities provision was judged to be 75 overall. At the time of the inspection there was no evidence that there is a system for regularly reviewing, maintaining and improving where necessary the quality of care and services provided which includes the views of residents, their relatives and other stakeholders such as health and social care professionals. Where monies are held on behalf of residents at the home there were records available as to the receipt and expenditure of money and those records and monies, which were checked, were satisfactory. A number of records in respect of maintenance of equipment in the home were out of date and there was no evidence that the due period checks in respect of the homes passenger lift and electrical equipment and installations had been carried out. Other records were available in respect of hot water and fire safety checks and there was evidence that staff undertake regular fire safety exercises and drills. Oaklands DS0000018110.V338774.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 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 2 2 X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 2 14 2 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 1 X X X X X X 2 STAFFING Standard No Score 27 1 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 3 X 2 Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 15(1) (2) Requirement Timescale for action 22/08/07 2. OP8 13(4) (c) Staff working at the home must develop a care plan for each person living in the home as soon as a need is identified. Staff working at the home must 22/08/07 carry out an assessment of the risks to resident’s health, safety and welfare, implement a plan so as to minimise the risks of injury or harm to the residents, act in accordance with the plan of care to minimise risks of harm and / or injury to resident and review and revise the plan to minimise risks where there is a change to the level of risk or the existing plan is not effective. Staff working at the home must treat the people living there in a manner, which promotes the persons dignity, and consult residents about the way they receive care support and so far as it is possible provide support according to the residents wishes. The people living at the home must be consulted about their DS0000018110.V338774.R01.S.doc 3. OP12 12 (4) (a) (b) 22/08/07 4. OP12 16(2) (m) (n) 30/09/07 Oaklands Version 5.2 Page 28 wishes for recreation and social interests and arrange a programme of activities taking into consideration the wishes of residents. (Previous timescales following the last two inspections including the timescales of 20/07/06, 30/12/06 & 30/05/07 have not been met.) 5. OP19 3(4) (b) (c) Staff must ensure that any hazards to a person’s health and safety are minimised and that cleaning products re stored safely when not in use. So far as is possible the home must be maintained free from unpleasant odours and that measures are implemented so as to dispel odours as they occur. (Previous timescales following the last two inspections including the timescales of 30/07/06, 30/12/06 & 30/05/07 have not been met.) 7. OP27 18 (1) (b) Where agency staff are 30/09/07 employed in the home measures should be implemented so that these staff are supported and that their employment does not detract from the level of care and support provided to residents living in the home. People must only be recruited to 30/09/07 work at the home once all of the checks as required by regulation for the protection of people living at the home have been carried out. (Previous timescales following the last two key inspections including the timescales of 20/07/06, 30/12/06 & 30/05/07 Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 29 30/08/07 6. OP26 16(2) (k) 30/10/07 8. OP29 19 have not been met.) 9. OP33 24 A system must be developed and 30/10/07 implemented for periodically reviewing and improving the level of services provided by the home taking into account the views of residents, their relatives and other stakeholders such as health & social care professionals. All equipment and systems in the 30/09/07 home must be checked periodically as per manufacturers guidelines etc and records maintained in respect of these checks. 10. OP38 23(2) (b) (c) 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 OP3 Good Practice Recommendations Assessments of persons needs should be more detailed so as to evidence that taking into account this information and the resources available that the home will be able to meet the needs of the person to be admitted to the home. Care plans should be more detailed so as to provide staff working at the home up to date and accurate information about the needs of residents. More could be done so as to ensure that the more dependent people receive an acceptable level of care in respect of personal hygiene. More could be done so as to allow people living at the home to exercise more control over their daily lives. 2. OP7 3. OP10 4. OP14 Oaklands DS0000018110.V338774.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!