Inspection on 13/12/05 for Oaklands Nursing Home

This inspection was carried out on 13th December 2005.

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 Nursing Home 23/04/07

Oaklands Nursing Home 18/07/05

Oaklands Nursing Home 26/11/04

Oaklands Nursing Home 27/04/04

Oaklands Nursing Home 31/01/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Oaklands Nursing Home 10 Tarvin Road Littleton Chester Cheshire CH3 7DG Lead Inspector A Gillian Matthewson Announced Inspection 09:30 13 December 2005 th 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 Nursing Home DS0000018812.V264569.R01.S.doc Version 5.0 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 Nursing Home DS0000018812.V264569.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Oaklands Nursing Home Address 10 Tarvin Road Littleton Chester Cheshire CH3 7DG 01244 335060 01244 335076 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) Dr V. K. Trehan Charmaine Vivienne Roberts-Hounsell Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (4) of places Oaklands Nursing Home DS0000018812.V264569.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th July 2005 Brief Description of the Service: Oaklands Nursing Home is a care home providing nursing care and accommodation for 40 people. The majority of service users are older people, although the home is registered to provide a service for up to 4 adults with physical disabilities. Oaklands is owned by Dr V Trehan and is located in Littleton on the outskirts of the city of Chester, close to the village of Christleton, and benefits from the amenities provided by both these centres.The home is a three storey building with access to all levels being provided by a passenger lift. There are 32 single rooms, 30 of which have ensuite facilities, and 4 double rooms. In addition there are communal assisted bathing facilities. Day space consists of three lounges, an interview room and a separate dining room. There is a large garden to the front and side of the property and parking at the rear. Oaklands Nursing Home DS0000018812.V264569.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The lead inspector spent two hours planning the inspection by reviewing previous inspection reports and the service history over the last twelve months. The inspection took place over seven hours and included a tour of the building, inspection of records, observation of staff and discussion with five residents, six relatives, the registered manager and three staff. A comment card was also received from a social worker. Feedback was given to the registered manager immediately following the inspection. What the service does well: Residents are treated with respect and their privacy and dignity are maintained. Visitors are encouraged and residents are helped to exercise choice and control over their lives. The home is well staffed to ensure that residents’ needs can be met. Robust systems of staff recruitment and training assist in the promotion of residents’ health, safety and welfare and in their protection from abuse. Residents are provided with a homely environment that is clean and wellmaintained. Records are maintained in such a way as to protect the confidentiality of residents’ and staff’s personal information. One resident, who had previously lived alone, said he really enjoyed living at Oaklands and another resident who had lived there for a few years said all the staff were very kind. Two visitors said they were delighted with the care and had no complaints. Others said the staff were very caring and welcoming. The social worker said that residents’ care was managed very well and the home maintained good relationships with relatives. Oaklands Nursing Home DS0000018812.V264569.R01.S.doc Version 5.0 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 Nursing Home DS0000018812.V264569.R01.S.doc Version 5.0 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 Nursing Home DS0000018812.V264569.R01.S.doc Version 5.0 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: None of these standards were assessed at this inspection. Standards 3 and 4 were assessed as meeting the standard at the last inspection and Standard 6 is not applicable because the home does not provide intermediate care. Oaklands Nursing Home DS0000018812.V264569.R01.S.doc Version 5.0 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): 9 & 10. In the main medicines are well managed and residents receive their prescribed medication. Residents feel they are treated with respect. EVIDENCE: Standards 7 & 8 were assessed as being met at the previous inspection. Medicine storage arrangements were satisfactory apart from those medicines that were required to be kept in a fridge. These included eye drops, antibiotic oral suspension and a food supplement. All have a limited shelf life once opened and should be marked with the date of opening. This had not been done. See Requirement 1. A sample of medication administration record sheets were reviewed. All were completed accurately, including the amount of each medication received into the home, detailed instruction for administration, when medication was administered and any reason for non-administration. Staff had induction training instructing them on how to treat residents with respect at all times. All the residents interviewed felt that they were treated Oaklands Nursing Home DS0000018812.V264569.R01.S.doc Version 5.0 Page 10 with dignity and respect and that all staff were aware of their needs. Visitors stated that they had good relationships with the staff. One visitor said ‘the staff are lovely, they have been absolutely wonderful with both Mum and I.’ Signs were hung on bedroom doors stating ‘care being given do not enter’ and privacy screens were provided in double rooms. Oaklands Nursing Home DS0000018812.V264569.R01.S.doc Version 5.0 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 & 14. The opportunities for recreational activity have increased. Residents are able to have visitors at any reasonable time and the home encourages residents to exercise choice and control over their lives. EVIDENCE: At the previous inspection the home’s activity programme was deemed to be rather limited. Since then all residents had been consulted about their interests and hobbies and this information was recorded. A residents’ meeting had been held and residents had made suggestions for the type of activities they would like to be able to participate in. A record of activities provided and participants had been commenced. In the last six weeks there had been a Halloween supper, a bonfire party, a special commemoration on Remembrance Sunday and an afternoon of Daniel O’Donnell’s music. In addition there was a poetry reading every week, flower arranging most weeks and regular film afternoons. Residents could attend a church service in the home on a monthly basis. The hairdresser was in the home on the day of inspection and residents could arrange for massage or reflexology from a qualified therapist. Arrangements for Christmas were well underway. Residents had been involved in decorating the Christmas trees and some had been out to see the Christmas lights in Chester. A Christmas party was planned for 17th December, and a visitor said that she had been invited to have Christmas dinner at the home with her relative on Christmas Day. Oaklands Nursing Home DS0000018812.V264569.R01.S.doc Version 5.0 Page 12 Residents confirmed that they were able to have visitors at any reasonable time. This was also stated in the service user guide. Visitors confirmed they could visit residents in private and were made to feel welcome by management and staff. Residents interviewed stated that they had opportunities to exercise choice in relation to routines of daily living, meals, leisure and social activities. Residents were able to manage their own financial affairs. The home referred to Age Concern advocacy service if any resident did not have a representative to act on their behalf. Standard 15 was assessed as being met at the previous inspection. Oaklands Nursing Home DS0000018812.V264569.R01.S.doc Version 5.0 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): 18 Robust systems are in place to protect residents from harm. EVIDENCE: Standard 16 was assessed as being met at the previous inspection. The home had satisfactory policies and procedures on the protection of vulnerable adults and whistle blowing. All staff received training in these areas on induction. Staff had criminal records checks prior to employment and were also required to have two satisfactory references, including one from the previous employer. Oaklands Nursing Home DS0000018812.V264569.R01.S.doc Version 5.0 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 & 26. The home provides safe, pleasant and comfortable surroundings for residents to live in. EVIDENCE: The home was comfortable and homely and some bedrooms had been redecorated since the last inspection. The grounds were well maintained and there was a pleasant garden with patio furniture, which was easily accessible to residents. The exterior paintwork was flaking in places but the manager said this would be addressed in the spring. The home was clean, hygienic and free from offensive odours. Oaklands Nursing Home DS0000018812.V264569.R01.S.doc Version 5.0 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 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, 28 & 30. The skill mix and numbers of staff, together with a comprehensive staff training programme, ensure that residents’ needs can be met. EVIDENCE: There were 34 residents accommodated on the day of inspection. The home provided two registered nurses at all times. In addition, there were 5 or 6 care staff on duty in the morning, 4 in the afternoon and 2 or 3 at night. This was adequate for the needs of the residents accommodated. The manager discussed the possibility of only having one registered nurse on duty at night with 2 care assistants. This was agreed. Sixty two percent of the care assistants were trained to NVQ Level 2 or equivalent. The home employed a training coordinator for 20 hours a week. Staff training in the previous twelve months had included training in tissue viability, nutrition, gastrostomy feeding, mentorship, Parkinson’s Disease, oral hygiene, confirmation of death, rehabilitation, falls prevention, assessment and care planning, chronic obstructive pulmonary disease, clinical supervision, continence promotion and catheter care, pressure sore risk assessment. Further training was planned in palliative care, diabetes and the management of medicines. Oaklands Nursing Home DS0000018812.V264569.R01.S.doc Version 5.0 Page 16 The home was a member of the Cheshire Nursing Homes Training Parnership and had been accredited the day before as achieving the standard for the Investors in People Award. Standard 29 was assessed as being met at the previous inspection. Oaklands Nursing Home DS0000018812.V264569.R01.S.doc Version 5.0 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): 31, 32, 33, 35, 37 & 38. The manager provides leadership, guidance and direction to staff. This ensures that residents receive consistent, quality care and that their health, safety and welfare are promoted. EVIDENCE: The home was run and managed by a person who was fit to be in charge, of good character and able to discharge her responsibilities fully. The registered manager was very experienced in care home management and undertook periodic training to update her knowledge, skills and competence whilst managing the home. At the time of the inspection she was undertaking the Registered Managers’ Award. There were clear lines of accountability within the home. The processes of managing and running the home were open and transparent. This was evidenced by interviews with residents, staff and relatives. All spoke very Oaklands Nursing Home DS0000018812.V264569.R01.S.doc Version 5.0 Page 18 highly of the manager and said they were fully consulted on all matters affecting them. The staff team appeared stable and well managed and the atmosphere within the home was considered to be cheerful and positive. The registered provider had a business development plan in place. Customer satisfaction surveys had been distributed to residents and relatives prior to the inspection. So far, only four responses had been received, which were all positive. A care management consultant visited the home on a monthly basis on behalf of the registered provider. Copies of his reports were submitted to CSCI. However, the focus of the reports appeared to be on the premises, rather than reviewing the quality of care. There was also little evidence of consultation with residents and relatives. See Recommendation 1. The home did not look after any residents’ monies at the time of the inspection. However, there were appropriate policies and procedures in place for the management of residents’ personal property and finances should the need arise. The home had satisfactory policies and procedures on access to files, confidentiality and disclosure of information. Staff were trained in these areas on induction and records were stored appropriately. All mandatory training in safe working practices such as fire safety, moving and handling, food hygiene and infection control was up to date. Two staff were qualified first aiders, four of the registered nurses had recently completed training in the treatment of anaphylaxis, and all other staff had watched a video on emergency first aid. Fire safety systems were tested and serviced at the required intervals. A fire risk assessment was in place and regular fire drills were held. Accident records for the previous three months were reviewed. The incidence was not high and there were no patterns. The home audited the accidents on a monthly basis. Oaklands Nursing Home DS0000018812.V264569.R01.S.doc Version 5.0 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 X 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 2 X 3 X 3 3 Oaklands Nursing Home DS0000018812.V264569.R01.S.doc Version 5.0 Page 20 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. 1 Standard OP9 Regulation 13(2) Requirement The registered person must ensure that medicines with a limited shelf life are dated on opening. Timescale for action 13/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP33 Good Practice Recommendations Reports of Regulation 26 visits should include evidence of consultation with residents and relatives. Oaklands Nursing Home DS0000018812.V264569.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Nursing Home DS0000018812.V264569.R01.S.doc Version 5.0 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. 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