Inspection on 30/01/06 for Oaklands House Residential Home

This inspection was carried out on 30th January 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 House Residential Home 04/04/07

Oaklands House Residential Home 08/08/05

Oaklands House Residential Home 05/01/05

Oaklands House Residential Home 02/06/04

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 House Residential Home Blackwater Covert Reydon Southwold Suffolk IP18 6RD Lead Inspector Jane Offord Unannounced Inspection 30th January 2006 09:30 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 House Residential Home DS0000024463.V282069.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 House Residential Home DS0000024463.V282069.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Oaklands House Residential Home Address Blackwater Covert Reydon Southwold Suffolk IP18 6RD 01502 724955 01502 724955 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) Pri-Med Group Ltd. Mrs Aileen Janice Bond Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Oaklands House Residential Home DS0000024463.V282069.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th August 2005 Brief Description of the Service: Oaklands is a large detached property, and stands in wooded grounds within the Suffolk village of Reydon. The home has been adapted to meet the needs of older people in a hotel style setting and is registered to provide care and support for up to 29 service users. Oaklands is part of the Pri-Med Group of care and nursing homes, which was founded in 1976. Oaklands has a choice of attractive ground floor communal lounges, large conservatory and a spacious dining room. Good views are available of the landscaped grounds. The accommodation is on three floors with 6 bedrooms on the ground floor, 13 bedrooms on the first floor and 10 bedrooms on the second floor. There are two shaft lifts, which provide access to the first floor bedroom area, with one serving the second floor bedrooms. All rooms are single occupancy and spacious, with en suite facilities. In all bar three of the en suite rooms this includes a bath or shower as well as the standard toilet and hand washbasin. The home has its own minibus transport enabling service users access to local shops, arranged entertainment events or day trips out. The minibus also provides access to Southwold and Lowestoft, for shopping. Oaklands House Residential Home DS0000024463.V282069.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on a weekday between 9.30 and 15.45. The registered manager was present throughout and the Operations Director of the Pri-Med group was in the home as well. For the manager it was the first shift after a holiday so there were a number of calls on their time during the day, nevertheless they were very helpful in supporting the inspection process. Three residents’ files and care plans, three staff files, the complaints log, the staffing rotas and the medication policy were seen in the course of the day. The manager offered a conducted tour of the establishment and then the inspector had the freedom to wander at liberty. The kitchens, the laundry, all the communal rooms and a number of residents’ private rooms were seen. Part of a medication administration round was observed and a random check was made on the controlled drugs (CD) register and stock. The manager explained the system used to manage residents’ personal money if a resident was unable or unwilling to manage their money themselves. During the day a number of residents, several staff including the chef and a visitor were spoken with. Menus, the activities programme and the policy folder were all inspected. On the day of inspection the home was clean, bright and welcoming. Most residents spoke very highly of the care offered and the atmosphere in the home. Staff spoken with had mainly been working at the home for a number of years and enjoyed the work and the environment. Documentary evidence showed a commitment to a well-trained workforce and staff confirmed that training was a high priority. What the service does well: The environment and furnishings are maintained to a high standard. The décor throughout the communal parts of the building is attractive with attention to detail in the form of fresh flowers and plants around the building. Residents’ rooms are personalised with their own furniture and soft furnishings. There is a strong commitment to the staff team in recruiting the correct people and then offering wide training opportunities. Oaklands House Residential Home DS0000024463.V282069.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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 House Residential Home DS0000024463.V282069.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 House Residential Home DS0000024463.V282069.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): 5, 6 People who use this service can expect to be offered a trial period prior to making a final decision about living in the home. The service does not offer intermediate care. EVIDENCE: The policy manual makes provision for a prospective resident to have a trial period in the home to ensure they are happy with the service and that the service can meet their needs. One resident spoken with said they had had a month’s trial and had decided they would like to remain and have been in the home a year now. Other residents said that they knew of the service prior to admission because they had other family members in the home or visited residents who were friends. The file of one resident recorded that they had been admitted to the home for a month’s trial and has now been there for a number of months as they found the service to their liking. Oaklands House Residential Home DS0000024463.V282069.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, 8, 9, 10, 11 People who use this service can expect to have a plan of care compiled to show how to meet their health needs and to be treated with respect, however, they cannot be assured that the present medication administration procedures will protect them or that there is adequate detail in their files for staff to know their final wishes. EVIDENCE: Three residents’ files were examined during the inspection. There was provision for recording initial assessment findings to generate a plan of care in all three files. Many of the assessments were not completed, with no evidence that they did not apply to that resident or they had not been addressed at all. One resident was admitted with a very low body weight but the nutritional assessment and weighs were not completed. Some risk assessments for moving and handling, falls and bathing alone were completed. The care plans seen addressed areas such as mobility, communication, sleep, personal hygiene, elimination, expressing sexuality, eating and drinking and safe environment. Individual areas of care that were recorded included allergies, self-medication and hobbies and interests. Oaklands House Residential Home DS0000024463.V282069.R01.S.doc Version 5.1 Page 10 There was evidence that all care plans were reviewed regularly and updated as required. Often there was evidence that the resident was included in the reviews. Progress notes were completed in appropriate language and recorded some of the activities the residents had participated in such as, ‘attended the hairdressers’, ‘went on a shopping trip with a carer’, ‘came down for exercises this morning’. All the files seen had a record of the resident’s next of kin, the relationship to the resident and their contact details. However, only one file seen had any details of the resident’s final wishes. It is recognised that this is a sensitive area of care but to offer holistic care to residents ways to address it and record preferences should be explored. The files contained evidence of health professionals involved with the residents. There were out patient appointments at the hospital, visits by the GP and community nurse and, in one case, an appointment at the audiology department. One file recorded that the resident had had a fall and the treatment given by the GP and subsequently a visit to the hospital and X-ray department. Residents spoken with confirmed that they had access to health care and professionals any time they needed. Part of a medication administration round was followed at lunchtime. The carer undertaking the round had recently done the recognised medication administration training and was being observed and supervised by a more experienced carer. Medication was dispensed and offered to the residents correctly. Drinks to help with swallowing tablets were readily available and the carer respectfully assisted where necessary. The trolley was secured whenever the carer left it with medication stowed away. The medication administration records (MAR sheets) were examined and no gaps were observed in signature boxes. Some medication prescribed on an ‘as required’ (PRN) basis which offered a choice of dose i.e. one tablet or two, or 5mls or 10mls, was not always recorded with the amount given so an audit trail would not exist. On one occasion a PRN medication was dispensed, pre-wrapped, from its’ container and offered to the resident. The resident did not require the medication at that time so the carer returned the medication to box. This constitutes unsafe practice and double dispensing. The medication policy was seen and was comprehensive. It had procedures for allowing residents to self medicate, for the management of covert administration and ‘homely’ remedies. One resident spoken with self medicates and has a lockable drawer in their room to keep medication safe. Oaklands House Residential Home DS0000024463.V282069.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): 12, 13, 15 People who use this service can expect to be offered a range of activities and outings, be encouraged to maintain contact with their family and friends and have the choice of a well-balanced menu. EVIDENCE: Residents spoken with said they were able to choose how they spent their time. One resident said they had taken responsibility for delivering the post to each resident’s room daily. They also tended some plant pots on a patio outside their room. Other residents said they were quite content with their own company reading or watching television in their room. One resident said that although their room was one of the smaller ones they loved the outlook and would not change even if offered a larger room. One resident said they had moved from another part of the country to be nearer their family. They were visited a couple of times a week now and had seen a lot of family members over the Christmas period. Another resident said they had entered the home a number of years ago with their spouse. There was already a sibling and their spouse in the home unfortunately both spouses died. The siblings saw each other daily now. Oaklands House Residential Home DS0000024463.V282069.R01.S.doc Version 5.1 Page 12 In one of the resident’s files was a list of proposed visits and outings for the next month or so. One resident showed the inspector the same list that they had a copy of in their room. They said they were going on a trip to a garden centre for afternoon tea that day, and looking forward to it. Other proposed trips included Fritton Lake and a picnic, Lowestoft Air show, Great Yarmouth sea life centre, a river trip and various outings for lunch or afternoon tea. Residents spoken with were very clear that attendance or non-attendance for any of the trips was entirely the choice of the individual. Residents had a choice of where they preferred to eat their meals. A number of them chose to eat lunch in the dining room. Tables were attractively set with fresh flowers and a selection of fruit juices, squashes and water available. The meal served looked well presented and hot. Most residents cleared their plate and when asked later agreed that they had enjoyed the meal. In the kitchens the cupboards and refrigerators were stocked with a wide selection of fresh local produce. The chef said there is always a choice of two main hot dishes for lunch and the evening meal. Salads and omelettes are always available. There is a hot dessert offered and a choice of cold desserts from the trolley at both meals. There is a roast dinner on the menu twice a week. Oaklands House Residential Home DS0000024463.V282069.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16. People who use this service can expect to have any complaints taken seriously and investigated. EVIDENCE: A number of residents were spoken with in the course of the day only one had had cause to make a complaint but the others were all confident they could speak to the manager if they had any concerns. The complaints log was examined. Since the last inspection there were four complaints recorded. There was evidence that they had all been investigated and the complainant given a response. Two complaints related to ‘lost/misplaced’ personal items. One complaint was regarding staff clearing a dining table before residents had finished their meal and the other complaint was about lack of cleaning in residents’ rooms over a weekend. The final complaint was raised with the manager who said there had been a temporary difficulty with weekend cover in the domestic team, which was now resolved. If there was a crisis in the future the carers had been instructed to undertake basic room cleaning in addition to their duties. Oaklands House Residential Home DS0000024463.V282069.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24, 26 People who use this service can expect to live in a safe, comfortable and well maintained home with their own possessions around them, however they cannot be assured that adequate provision is made for the control of the spread of infection. EVIDENCE: The building is an attractive old house that has been thoughtfully adapted and extended to meet it’s purpose. The communal rooms downstairs are large, light and airy with views over the mature gardens. A large conservatory and balcony have fairly recently been added to the building and these are accessible from the dining room and the two lounges. There is level access to the gardens and walkways that can accommodate wheelchairs. The residents own rooms varied in size and layout but all had garden views and pleasant décor. A number of residents expressed their satisfaction with their own room and enjoyed the time they spent there. All rooms have ensuite facilities. Oaklands House Residential Home DS0000024463.V282069.R01.S.doc Version 5.1 Page 15 The rooms in the newer extension are called apartments and have a sitting/dining area separated from the sleeping space. They also have a small kitchenette to facilitate the preparation of snacks and hot drinks. This allows for the entertainment of guests without relying on provision from the main kitchen. On the day of inspection one apartment was empty and being prepared for a new occupant. One of the domestics was steam cleaning and re-hanging the curtains. The manager said they had a rolling programme of re-decoration for the home. The home has one assisted bathroom on the first floor. On the day of inspection the bathroom was clean and tidy and it was noted that there was liquid soap available for hand washing but only a cloth towel to dry hands. In the toilet nearby the situation was the same. The laundry had a paper towel dispenser but it was empty. Oaklands House Residential Home DS0000024463.V282069.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29, 30 People who use this service can expect to be cared for by a correctly recruited and well-trained staff team that is rostered in adequate numbers to meet their needs. EVIDENCE: The files for three recently recruited members of staff were examined during the inspection. Each one contained evidence of identification documents that had been seen. There were records of POVA 1st checks and enhanced criminal records bureau (CRB) checks being done before employment commenced. All the staff had had three references supplied. There was evidence of induction training that covered fire awareness, health and safety, POVA, moving and handling and safe food handling. One of the carers spoken with had only recently joined the staff team and confirmed that they were doing their induction under supervision at the time. Staff and residents spoken with all felt there were enough staff rostered to meet the needs of the residents. The staff rota was seen and showed there were four carers and the manager on the early shift, three carers on a late shift and two covering night duty. In the week prior to the inspection there had been two late shifts covered by agency and the same person had done both shifts. Oaklands House Residential Home DS0000024463.V282069.R01.S.doc Version 5.1 Page 17 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): 35, 36, 38 People who use this service can expect that their financial interests will be protected, that the staff will be properly supervised and that safe working practices will be in place to protect the health and safety of staff and residents. EVIDENCE: The manager explained the system used for managing the finances of residents who did not manage their own affairs. The recording of transactions and the evidence kept was safe and would allow an audit trail. Individual wallets were kept in the safe with the balance of residents’ money in them. Three wallets were randomly checked and the amounts tallied with the records. A member of the domestic staff was spoken with and they were able to explain the infection control policy in relation to cleaning using coloured cloths for different tasks. Oaklands House Residential Home DS0000024463.V282069.R01.S.doc Version 5.1 Page 18 The member of the domestic staff said they had yearly updated training in moving and handling, health and safety, COSHH, fire awareness, food hygiene and POVA. There was adequate protective clothing such as aprons and gloves to do their work. Their trolley was locked away when not used and not left unattended. In the kitchen records were seen of the temperatures recorded for the refrigerators and freezers and were all within safe limits for food storage. The chef said they had had all mandatory training including POVA. All three staff files seen had records of supervision meetings taking place regularly. Staff spoken with confirmed that they receive regular supervision. Oaklands House Residential Home DS0000024463.V282069.R01.S.doc Version 5.1 Page 19 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 x 3 3 X X X 3 X 2 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 3 X 3 Oaklands House Residential Home DS0000024463.V282069.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? NONE 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) Requirement Completed assessments of residents’ needs must be used to generate a plan of care for the resident. As required (PRN) medication that gives a choice of dose i.e. one tablet or two must have the number or amount recorded that is given each time. Medication that has been dispensed must be destroyed if the resident refuses to take it. Hand washing equipment of liquid soap and paper towels must be available in communal bathrooms and toilets. Timescale for action 31/03/06 2. OP9 13 (2) 30/01/06 3. 4. OP9 OP26 13 (2) 13 (3) 30/01/06 31/03/06 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 House Residential Home DS0000024463.V282069.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 House Residential Home DS0000024463.V282069.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. 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