CARE HOMES FOR OLDER PEOPLE
Oaklands Forest Glade Dunton Hills Laindon Essex SS16 6SX Lead Inspector
Valerie Buckle Unannounced 8 September 2005
th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Oaklands I56-I06 S18110 Oaklands V236630 080905 Stage 4.doc Version 1.40 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 Southern Cross Healthcare Services Ltd Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) CRH 55 Category(ies) of OP Old Age 55 registration, with number of places Oaklands I56-I06 S18110 Oaklands V236630 080905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 23rd November 2004 Brief Description of the Service: Oaklands 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 th 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 I56-I06 S18110 Oaklands V236630 080905 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over four hours, in the home. Not all the standards have been inspected at this inspection. Standards not covered at this inspection will be inspected at the next inspection. Records, practices, policies and procedures have only been sampled. At future inspections other issues may come to light when different items are sampled or different people spoken to. There was a tour of the premises, and inspection of records and documentation. Five members of staff were spoken to and seven residents spoke about their life at the home. The manager assisted in the process of the inspection. Thirteen of the fourteen requirements and all of the ten good practice recommendations had been met. What the service does well: What has improved since the last inspection? What they could do better:
The home must continue shampooing carpets in three residents rooms and replace the carpeting and mattresses if required. The home must replace the universal locking system with individual Yale locks and keys on resident’s rooms.
Oaklands I56-I06 S18110 Oaklands V236630 080905 Stage 4.doc Version 1.40 Page 6 It would be desirable to include key workers photographs in resident’s rooms. The home should forward to the C.S.C.I. a short report on the outcomes of the quality assurance questionnaires. The home should forward to the C.S.C.I. a copy of the report completed each month by the operational manager. The manager must ensure that the new system that is being implemented for night staff which involves the completion of individual forms placed in residents rooms which details the regularity of the times of the night checks carried out on residents, is put into operation and monitored. 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. Oaklands I56-I06 S18110 Oaklands V236630 080905 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Oaklands I56-I06 S18110 Oaklands V236630 080905 Stage 4.doc Version 1.40 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3,4 Each resident has a contract and statement of terms and conditions with the home. Detailed assessments are made before residents are admitted to the home. EVIDENCE: Resident’s contracts and statement of terms and conditions are kept in their individual rooms, this information is also displayed on their wall with the name of their key worker. Initial assessments of new residents which include relevant professionals, the resident and their family plus a planned admission ensures that the new residents needs and wishes are properly assessed before moving in the home. Oaklands I56-I06 S18110 Oaklands V236630 080905 Stage 4.doc Version 1.40 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10,11 Resident’s health and personal care needs are appropriately met. Care plans in place at the home were detailed and covered all areas of residents needs. Residents are treated with dignity and respect. EVIDENCE: The care planning system is currently being revised – the old system and the new system are detailed and include all aspects of the resident’s life. Four care plans were examined on the day of the inspection, these were seen to be comprehensive and the information was easily accessible to staff. Resident’s last wishes are recorded in their care plan. Staff members were observed to be respectful to residents and knocked on bedroom doors before entering. Residents use their own rooms for visiting professionals and visitors if they wish to speak in private. Oaklands I56-I06 S18110 Oaklands V236630 080905 Stage 4.doc Version 1.40 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,14,15 Routines in the home are flexible and residents are encouraged to make choices. Various activities are made available and day trips. The menu is well balanced, and interesting and offers a variety of choices. EVIDENCE: Residents are involved in making decisions and choices about their daily routines. A variety of activities are provided and an activities board is displayed in the corridor. Residents choose and request daily activities, these include: fish and chips supper, quizzes, bingo, shopping, arts and crafts, sitting in the garden, socialising, keep fit, hairdressing and chiropody. The home has recently interviewed a part-time activities co-ordinator who will work with small groups of residents and individuals engaging them in activities of their choice. Residents spoken with gave examples of how staff encourage them to be involved and exercise choice, one resident said the staff are very friendly and caring and encourage me to be involved in activities, but I prefer the comfort of my own room and choose to relax, read and watch television instead. The menu was seen to be varied and nutritious, residents are asked daily which foods they would like to eat and records are kept of their choice of meals. These are kept at the back of the menu book and in individual
Oaklands I56-I06 S18110 Oaklands V236630 080905 Stage 4.doc Version 1.40 Page 11 residents files. Residents were very complimentary about the choices of food they are offered. During the inspection, residents were seen enjoying their lunch, most were in the dining room, some ate in their own rooms, lunch provided was pork and celery pie or lamb hot pot with alternatives of ham egg and chips or an omelette. Pudding was either arctic roll or strawberry gateau. A family visitor at the home expressed that she was very happy with the care and support which was provided to her mother, and that she was always made welcome and staff were very friendly. Oaklands I56-I06 S18110 Oaklands V236630 080905 Stage 4.doc Version 1.40 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 The home has a detailed complaints procedure which is accessible to the residents. Arrangements are in place for protecting residents and responding to their concerns. All staff are aware of the issues relating to the protection of vulnerable adults. Regular training is provided in areas relevant to meet staff and residents needs. EVIDENCE: All residents have a copy of the complaints procedure in their room, residents spoken to said they feel comfortable in approaching the manager or staff if any issues arise. Complaints recorded were investigated appropriately and the outcomes forwarded to the C.S.C.I. Five staff spoken to were aware of the procedures relating to the protection of vulnerable adults, training for all staff on the Protection of Vulnerable Adults is planned for November 2005. A buzzer system is installed in each residents room, and three buzzer/call systems are available in each lounge, this enables less mobile residents to call staff is need arises. The staff on duty at night check the less able resident at least two hourly, throughout the night, more often than that depending on individual needs. The manager said that she is implementing a new system of night inspections at least once a month by herself and the Operational Manager of the home, also each residents room will have a record of times they are checked by night staff held in their room.
Oaklands I56-I06 S18110 Oaklands V236630 080905 Stage 4.doc Version 1.40 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,22,24,26 The home provides the residents with a homely, comfortable environment. EVIDENCE: Oaklands is well maintained and suited to residents needs. It is clean and fresh, decorated and furnished to a standard that creates a homely, comfortable environment. All residents’ rooms that were seen were decorated and furnished in a homely way; residents are able to bring items and possessions with them which creates their own personal style. Most of the areas of the home smelt fresh and pleasant, with the exception of three residents rooms, although clean all had an odorous smell from the carpets. The manager said that these carpets are shampooed regularly, but said she would increase shampooing to daily and if the smell remains, the carpets and mattresses would be replaced. Oaklands I56-I06 S18110 Oaklands V236630 080905 Stage 4.doc Version 1.40 Page 14 During the inspection process it was noted that the majority of the residents rooms had a universal locking system in place. An issue was raised that this system could be abused, as access could be gained to all the rooms with the same key. The manager was advised and agreed to install new individual Yale locks and keys to the residents who had requested locks to their rooms and a master key to this system would be kept in her office. Oaklands I56-I06 S18110 Oaklands V236630 080905 Stage 4.doc Version 1.40 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28,29 The vetting and recruitment of staff is good and protects the residents. Staff at the home are well trained and supported, and employed in sufficient numbers to meet the residents needs. EVIDENCE: At the time of the inspection there were adequate staff on duty to meet the needs of the residents. The rota showed that there is a sufficient mix of staff skills and abilities on duty. Four staff files were examined and these evidenced that a thorough recruitment was being followed which protects the residents. The five staff members spoken to commented that they were happy with the support and guidance they receive from the new manager of the home and the training that is available to them. Oaklands I56-I06 S18110 Oaklands V236630 080905 Stage 4.doc Version 1.40 Page 16 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35 The home is well managed and the manager is competent and committed to providing a good service for the residents. EVIDENCE: The manager is experienced and trained and has applied to do the Registered Managers Award. Currently she is awaiting registration with the C.S.C.I. and has forwarded all the appropriate documentation. Staff members spoken to said they found the manager very approachable and supportive. Residents families provide personal allowances and these are kept safe with records of expenditure. Any valuables of residents are labelled and kept in the safe. Oaklands I56-I06 S18110 Oaklands V236630 080905 Stage 4.doc Version 1.40 Page 17 A system of quality monitoring is in place, regular services of the quality of care are carried out regularly, resident and family meetings are in place and the responsible individual visits the home monthly and monitors the management and quality of care provided at the home. Oaklands I56-I06 S18110 Oaklands V236630 080905 Stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 x 3 x 3 3 2 STAFFING Standard No Score 27 x 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 3 3 x x x x Oaklands I56-I06 S18110 Oaklands V236630 080905 Stage 4.doc Version 1.40 Page 19 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. 4. 5. Standard OP26 OP24.5 OP33 OP33.4 OP18.1 26 Regulation 16(2) (K) Requirement The premises to be kept free from offensive odours. Residents individual bedrooms must have a yale lock and key fitted. Report of unannounced visits by responsible individual to be forwarded to C.S.C.I. Report of quality assurance audit to be forwarded to C.S.C.I. Ensure that the system of checking residents safety throughout the management takes place and records kept. The management must contact the C.S.C.I. to arrange an interview date for registration. Timescale for action 9.10.05 Immediate 9.10.05 Annually Immediate 6. OP31 (9)(1)(2) Immediate 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. 2. 3. 4.
Oaklands I56-I06 S18110 Oaklands V236630 080905 Stage 4.doc Version 1.40 Page 20 Refer to Standard Good Practice Recommendations 5. Oaklands I56-I06 S18110 Oaklands V236630 080905 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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