Inspection on 14/11/06 for Oaklands Court Nursing Home

This inspection was carried out on 14th November 2006.

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

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

Other inspections for this house

Oaklands Court Nursing Home 07/02/06

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Oaklands Court Nursing Home Vines Cross Road Horam East Sussex TN21 0HD Lead Inspector Kathy Flynn Key Unannounced Inspection 14th November 2006 12:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Oaklands Court Nursing Home DS0000065197.V317369.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 Court Nursing Home DS0000065197.V317369.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oaklands Court Nursing Home Address Vines Cross Road Horam East Sussex TN21 0HD 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) 0208 5430705 Chanctonbury Healthcare Limited Maureen Taylor Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44) of places Oaklands Court Nursing Home DS0000065197.V317369.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is fortyfour (44). Service users will be sixty-five (65) years or over on admission. Service users may have a physical disability. Date of last inspection 7th February 2006 Brief Description of the Service: Oaklands Court is registered to provide nursing care for up to 44 residents, older people over 65 years of age. The home is purpose built with 42 single rooms and one double room, which may be used by a couple or people choosing to share. Located near the centre of Horam it is within walking distance of local amenities and bus services. There are parking areas within the grounds, which are landscaped and attractive, accessible to wheelchair users, and used by residents when weather permits. There is a large lounge on the ground floor that is used for activities and a smaller communal room on the first floor. A shaft lift enables residents to access all parts of the home. Oaklands Court Nursing Home DS0000065197.V317369.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was carried out over 10 hours on the 14th and 17th November. A pre-inspection questionnaire and residents survey forms were sent to the home prior to the inspection. The pre-inspection questionnaire was returned to the Commission and 7 residents surveys were completed. The inspection included a tour of the home, an examination of care plans, staff files, training records, accident records, menus and activity records. There were 41 residents at the home during the inspection, 30 residents and a visitor were spoken with. Those who expressed an opinion were very positive about the support they receive at the home, ‘very good nursing home’ and ‘a very good atmosphere and always ready to help and very happy staff’. The manager, clinical nurse manager, registered nurses, care staff, cook and activity person were happy to discuss the care they provide for residents. The reader should be aware that the Care Standards Act 2000 and the Care Homes Regulations 2001 uses the terms service user to describe those living in care home settings, for the purpose of this report those living at care homes will be referred to as residents. What the service does well: What has improved since the last inspection? Oaklands Court Nursing Home DS0000065197.V317369.R01.S.doc Version 5.2 Page 6 An effective quality assurance and monitoring system has been introduced. Directly linked to the National Minimum Standards it addresses each aspect of the services provided by the home. As part of this process feedback is sought from residents, relatives and staff, to ensure that residents receive the support and care they need, with any issues dealt with as they arise. The management structure at the home has been reviewed, with the manager and clinical nurse manager working together to develop the service. All staff are aware of their roles and responsibilities; there are clear lines of accountability at the home; and residents and relatives are aware of who their key worker is and find this reassuring. The requirements listed in the last report have been addressed. The care planning system has improved, with registered nurses and key workers involved in ensuring all relevant information is recorded. Medication procedures have been reviewed and staff training has been provided to ensure the registered nurses follow the home policies. A safe system of keeping doors open has been introduced. 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. Oaklands Court Nursing Home DS0000065197.V317369.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Oaklands Court Nursing Home DS0000065197.V317369.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An appropriate pre-admission assessment is used prior to the offer of a room to ensure the home can meet prospective residents needs. EVIDENCE: Pre-admission assessments are completed for all prospective residents to ensure that the home can meet their needs. Some residents explained that they chose to come to this home, they had heard about Oaklands Court from friends and relatives, or they knew someone who had lived here, and were pleased that a room was available. Oaklands Court Nursing Home DS0000065197.V317369.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care planning system is clear and consistent and provides staff with the information they need to satisfactorily meet residents’ needs. The systems for the administration of medicines are good with clear and comprehensive arrangements in place to ensure residents’ medication needs are met. The staff have a good understanding of the residents support needs. This is clear from the positive relationships, which have been formed between the staff and residents. EVIDENCE: The care plans have been updated and show evidence of the involvement of residents and their relatives, if appropriate. The information available to staff is based on the pre-admission assessments, they include appropriate risk Oaklands Court Nursing Home DS0000065197.V317369.R01.S.doc Version 5.2 Page 10 assessments and a daily record of the care provided. Registered nurses, and care staff as key workers, are expected to record all relevant information on a daily basis. Residents spoken with said they know who their key worker is and find this reassuring, ‘I know who to talk to if I need something’. Nutritional screening is carried out and monthly weights are recorded. It was noted that one resident has lost weight over a short period but there was no record in the care plan of any action taken to address this. Food and fluid charts were evident for other residents at risk. Residents who expressed an opinion said ‘the staff are helpful’, ‘I’m quite happy here, and my family know I am well looked after’, it is ‘very comfortable’ and ‘very nice here’. Residents are registered with GP’s and are referred to allied health professionals including physiotherapists, dentists and chiropodists. Policies and procedures are in place for ordering, storage, administration and disposal of medication, with medicine administration charts completed appropriately. A resident is responsible for administering some medication, staff confirmed that this has been assessed as appropriate. This information should be included in the care plan and reviewed on a regular basis as part of the care package provided. It was noted that the relationship between staff and residents is friendly and relaxed, residents are treated with respect and staff spend time in the lounge with the residents, including having their meals there. Residents said ‘staff are good, look after me very well’, and their privacy is protected when they need help with personal care. Oaklands Court Nursing Home DS0000065197.V317369.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents benefit from an extensive programme of activities. The routines at the home are flexible this enables the residents to have control over their lives and encourages them to make choices about all aspects of their day to day living. Dietary needs of residents are well catered for with a balanced and varied selection of food available that meets residents’ tastes and choices. EVIDENCE: A programme of activities has been developed by the activity co-ordinator and includes word games, bingo, as well as art and craft sessions. Residents who take part in the activities spoke very positively about them, ‘I can continue to do things I like’. There is open visiting at the home and relatives and friends are encouraged to be involved in the care and support provided for residents. They are invited to Oaklands Court Nursing Home DS0000065197.V317369.R01.S.doc Version 5.2 Page 12 residents meetings and the quarterly general meeting. Feedback from the inspection and surveys was positive, ‘we are very happy with the home’. Residents are encouraged to decide how they spend their time, some prefer to remain in their rooms while others join the activities in the lounges. Meals are taken in the dining room or residents rooms depending on what the residents want to do. Those who expressed an opinion said that they can decide what they want to do, and staff are ‘always ready to help and are very happy’, staff stated that ‘this is their home’. A choice is offered at all meals, and snacks and drinks are available throughout the day. Residents said ‘the food is good’, they are ‘able to choose what we want’, and the cook confirmed that they she will make whatever they want. The chef and cook have recently started at Oaklands Court and the manager explained that a review of the meals will be undertaken over the next few weeks to see if any improvements can be made. Oaklands Court Nursing Home DS0000065197.V317369.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system, with evidence that residents feel their views are listened to and acted upon. Staff have good knowledge and understanding of Adult Protection issues which protects residents from abuse. EVIDENCE: There have been no complaints since the last inspection and the manager confirmed appropriate policies and procedures are in place. Residents who expressed an opinion stated that they are able to make choices about all aspects of their day-to-day life. Some attend the residents meetings to ‘find out what is happening’ while others feel they can talk to staff at any time if they ‘need anything’. Training in adult protection and whistle blowing is provided for all staff at the home. Staff were able to demonstrate a good understanding of adult protection and what action to take if they have any concerns. Oaklands Court Nursing Home DS0000065197.V317369.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within this home is good providing residents with an attractive and homely place to live. All parts of the home are safe and accessible with satisfactory infection control systems in place to protect residents and staff. EVIDENCE: Oaklands Court provides comfortable and homely individual and communal space for residents. There is a large lounge on the ground floor, with a separate dining room, and a smaller lounge on the first floor, both lounges are used for activities. The home is well maintained and there is a programme of ongoing improvement. Oaklands Court Nursing Home DS0000065197.V317369.R01.S.doc Version 5.2 Page 15 Hoists and additional aids, including walking frames, assisted baths and toilets are provided to ensure that residents have access to all parts of the home and are able to use all the facilities. Residents are able to bring personal possessions to the home if they wish and many have personalised their rooms with pictures, ornaments and small pieces of furniture. Residents said they were ‘comfortable’ and their rooms are ‘very nice’, some were relaxing in bed while others were reading or watching the TV. The home was clean at the time of the inspection and there are systems in place to prevent the spread of infection. Staff demonstrated a clear understanding of the use of gloves and aprons as part of this process. Oaklands Court Nursing Home DS0000065197.V317369.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff morale is high resulting in an enthusiastic workforce that work positively with residents to improve their whole quality of life. There are sufficient trained and competent staff on duty at all times to meet the assessed needs of residents. Robust recruitment procedures are in place to ensure the protection of service users. The arrangements for the induction of staff are satisfactory, enabling staff to provide appropriate levels of support and care for residents. EVIDENCE: There is a dedicated team of staff working at the home, they have a range of skills and the manager confirmed that there are sufficient numbers to meet the needs of residents. Staff who were spoken with said that they were able to provide the care and support residents need, ‘it is their home’ we work with them to ensure they are as independent as possible, and make choices about what they do’. Oaklands Court Nursing Home DS0000065197.V317369.R01.S.doc Version 5.2 Page 17 Staff felt that the key worker system is a good way of ensuring that residents and relatives are involved in the services provided, ‘both know who the key worker is so they know who to talk to’. The manager explained that all new members of staff receive induction training in line with Skills for Care, and staff are also encouraged to work towards NVQ Level 2 and 3. There are currently under 50 with NVQ Level 2 or equivalent. The homes recruitment policies are followed and appropriate checks are completed prior to an offer of employment. The manager explained that the advice she has received stated that POVA/CRB are not completed for new staff from abroad until they have worked at Oaklands Court for 1 year, because checks are carried out by the agency who recruit the staff. Advice is to be sought to ensure that this is the correct procedure. Oaklands Court Nursing Home DS0000065197.V317369.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management approach at the home is open and inclusive. Staff, residents and relatives are encouraged to be involved in any decisions about changes to the support and care provided. The home regularly reviews aspects of its performance through a good programme of self-review and consultations, which include seeking the views of residents, staff and relatives. The manager is supported well by staff in providing clear leadership throughout the home with staff demonstrating an awareness of their roles. Oaklands Court Nursing Home DS0000065197.V317369.R01.S.doc Version 5.2 Page 19 EVIDENCE: The management approach at Oaklands Court is open and inclusive, there are clear lines of accountability and staff are able to demonstrate an understanding of their responsibilities. A quality assurance and monitoring system has been developed and introduced which looks at all aspects of the services provided by the home. It is linked to the National Minimum Standards but also includes feedback from the monthly residents and staff meetings and the quarterly general meeting, residents and relatives are encouraged to attend these. The managers of the two homes in this group visit each others home to review the services provided, in addition to the monthly visits from the Operations Manager of the company that owns the homes. Residents who expressed an opinion said that they were consulted about all aspects of the care they receive, and were encouraged by the staff to make decisions with them about the support they need. The home does not take responsibility for the finances of residents, although some money is kept to pay for some additional costs, including hairdressing and chiropody. Receipts are kept and copies are sent to the residents’ representatives. Mandatory training is provided for staff and includes moving and handling, fire training, infection control and food hygiene. The manager confirmed that a safe system for keeping doors open in the home is now in place. Oaklands Court Nursing Home DS0000065197.V317369.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 4 Oaklands Court Nursing Home DS0000065197.V317369.R01.S.doc Version 5.2 Page 21 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. Refer to Standard Good Practice Recommendations Oaklands Court Nursing Home DS0000065197.V317369.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Oaklands Court Nursing Home DS0000065197.V317369.R01.S.doc Version 5.2 Page 23 - 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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