Inspection on 07/02/06 for Oaklands Court Nursing Home

This inspection was carried out on 7th February 2006.

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 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 14/11/06

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 Unannounced Inspection 7th February 2006 12:00 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.V283062.R01.S.doc Version 5.1 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.V283062.R01.S.doc Version 5.1 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.V283062.R01.S.doc Version 5.1 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 June 2005 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, and individuals with physical disabilities. 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.V283062.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second statutory inspection of the year and should be read in conjunction with the first inspection that was carried out on the 13th June 2005, to give an overview of all the standards assessed during this period. The requirements recorded in the previous inspection report were used to develop the plan for this unannounced inspection. The aims were to assess if the home had met the requirements, identify aspects of the service that have been improved and how the service could be developed for the benefit of residents. Oaklands Court is under new management, and the registered providers have been assessing the services offered at the home since their registration in September 2005. The inspection was carried out on the 7th February over five hours from 12.00pm and included a tour of the home, an examination of care plans, medicine administration records (MAR sheets), personnel files, policies and procedures, activity programmes, menus and staff training. The reader should be aware that the Care Standards Act 2000 and the Care Homes Regulation 2001 use the term service user to describe those living in care home settings, however for the purpose of this report those living at Oaklands Court will be referred to as residents. The manager, deputy manager, activity person, two members of staff, 18 residents and three visitors were spoken with during the inspection. What the service does well: What has improved since the last inspection? Oaklands Court Nursing Home DS0000065197.V283062.R01.S.doc Version 5.1 Page 6 The requirements from the previous inspection have been met. The care plans have been reviewed to include details of the involvement of residents and relatives, and appropriate risk assessments. The policies and procedures regarding Adult Protection have been reviewed and are being updated to include all the relevant information, with staff training in place to ensure staff have a good knowledge of abuse and adult protection. The recruitment procedures have been reviewed and now ensure the safety of residents with POVA/CRB checks and two references. A system of formal supervision has been developed and 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. Oaklands Court Nursing Home DS0000065197.V283062.R01.S.doc Version 5.1 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.V283062.R01.S.doc Version 5.1 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 the following standard(s): EVIDENCE: Standards not assessed during this inspection. Oaklands Court Nursing Home DS0000065197.V283062.R01.S.doc Version 5.1 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 the following standard(s): 7 and 9 The care planning system does not provide staff with the information they need to satisfactorily meet the residents’ needs. The systems for the administration and storage of medication are poor and potentially place residents at risk. EVIDENCE: The manager confirmed that the care plans have been reviewed, risk assessments updated and the involvement of residents or their representatives were part of this process. However it was noted that the care plans had not been reviewed since December. The manager explained that this may be due to changes in management at the home, her role has changed and a nurse has recently been appointed as the Deputy Manager. She will take responsibility for clinical issues when she has completed the induction programme, with the expectation that the concerns identified during this inspection will be addressed. Oaklands Court Nursing Home DS0000065197.V283062.R01.S.doc Version 5.1 Page 10 Policies and procedures for the administration and storage of medication are in place, but it was noted during the inspection that the registered nurses are not following these. MAR sheets were not completed appropriately, gaps were noted although there are clear guidelines to follow if medicines are not required or refused. MAR sheets are designed to show clearly the date and time of the administration of medicines on a daily basis and when they are completed they should be replaced. However the practice in the home is to repeat the prescriptions in spaces left on the chart. This should be reviewed to ensure the safety of residents. The contents page in the controlled drugs book was full, residents no longer receiving medicines were still listed, and some residents who were receiving prescribed medicines were not. This is not an acceptable practice and increases the risk of mistakes. Medicine was found in the controlled drugs cupboard that was not labelled and there was no indication which resident this medicine had been prescribed for. An immediate requirement was left regarding the administration and storage of medicines. Oaklands Court Nursing Home DS0000065197.V283062.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Standards not assessed during this inspection. Oaklands Court Nursing Home DS0000065197.V283062.R01.S.doc Version 5.1 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 the following standard(s): 18 Staff demonstrated a good knowledge and understanding of Adult Protection issues, which protects residents from abuse. EVIDENCE: The manager confirmed that the policies and procedures concerning Adult Protection are being reviewed to give clear guidelines for staff if they suspect an incident of abuse, to include information regarding social services taking lead responsibility. Training in Adult Protection is provided for all staff. Those spoken with were able to demonstrate an understanding of abuse, adult protection and what action they should take if they have any concerns. Residents who expressed an opinion said that ‘the staff look after us very well’ and ‘know what help we need.’ They were positive about the support they receive and ‘felt safe and comfortable’ in the home. Oaklands Court Nursing Home DS0000065197.V283062.R01.S.doc Version 5.1 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 the following standard(s): EVIDENCE: Standard not assessed during this inspection. Oaklands Court Nursing Home DS0000065197.V283062.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 29 The staffing levels and skill mix may not provide a satisfactory level of care for residents. Thorough recruitment procedures help to ensure the safety and protection of residents. EVIDENCE: The manager advised that there were sufficient numbers of staff on duty, although this was not noted during the inspection. The role of the staff in the home was discussed and the concern raised was that staff are working on the basis that they have to complete tasks rather than offering residents choice and encouraging them to participate in the support and care provided in the home. It was noted that the call bells, the tone of which changes if they are not answered within a certain time, were not responded to as quickly as expected, and when touring the building talking to residents and visitors no staff were observed. Residents and visitors mentioned that the staff were very busy and they have to ‘wait a while for anyone to come’ when they use the call bell. Part of the inspection was to sit in the lounge on the ground floor during the activity programme, twelve residents were joining in bingo and domino’s. They were clearly enjoying themselves, with some winning small prizes. But there were no care staff apparent until approximately 16.30pm, when they assisted Oaklands Court Nursing Home DS0000065197.V283062.R01.S.doc Version 5.1 Page 15 residents to get ready for skittles. The staff spoken with explained that they were getting residents ready for supper and making them comfortable. Staff spoken with said they enjoyed working at the home, they felt that residents were given appropriate care and support, and were able to make decisions about whether to stay in their rooms or use the lounges. However the indication given by staff, and noted during the inspection, was that the care provided is task based, with resident’s opportunities to make choices dependent on what work the staff have to do. The importance of enabling residents to make choices about all aspects of their day-to-day lives was discussed during the inspection. The personnel files for new members of staff were viewed. References and POVA/CRB checks were completed prior to employment at the home. Oaklands Court Nursing Home DS0000065197.V283062.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35, 36 and 38. A programme of supervision has been developed and is being introduced to ensure that staff are appropriately supported to provide appropriate care for residents. The practice of propping doors open puts the health and safety of residents at risk. EVIDENCE: The quality assurance and monitoring system, which includes yearly questionnaires and audits, is being reviewed so that it meets the requirements of the new owners of the home. Residents and relatives said that they feel they are asked about the care that is provided ‘the staff are very good.’ The homes policy is that it does not take responsibility for resident’s finances. Some residents have a small amount of money kept locked in the Oaklands Court Nursing Home DS0000065197.V283062.R01.S.doc Version 5.1 Page 17 administrators office. Records and receipts are kept of any payments made from this money for hairdressing, chiropody or shopping, and if appropriate are signed by the resident or their representative. The manager has started to introduce formal supervision with the trained staff and the plan is to continue this with the carers over the next few months. Responsibility for the supervision of staff will then be delegated to senior staff, when they have completed the appropriate training. During the tour of the home it was noted that wedges, stools, scales are used to prop open doors in the home, including the lounges, bathrooms and store cupboards. The residents do not use these rooms without assistance and therefore the doors are propped open for the convenience of staff. This practice is not acceptable and an immediate requirement was completed regarding this. Oaklands Court Nursing Home DS0000065197.V283062.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 2 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 3 X 2 Oaklands Court Nursing Home DS0000065197.V283062.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? NO Oaklands Court Nursing Home DS0000065197.V283062.R01.S.doc Version 5.1 Page 20 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 Requirement Timescale for action 27/03/06 2. OP9 13 (2) 3. OP27 18 15 (1) 13 (4)(c) 4. OP38 Care plans are to be reviewed on a monthly basis to ensure that the reflect the assessed care needs of residents. Staff to follow the homes policies 07/02/06 and procedures regarding the administration and storage of medicines. Appropriate training to be provided for staff. Staffing levels and skill mix to be 27/03/06 reviewed and changes made where necessary to meet the assessed needs of residents. Advice to be sought from the 07/02/06 Fire Service regarding a safe system for keeping doors open in the home. 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.V283062.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 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.V283062.R01.S.doc Version 5.1 Page 22 - 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!