CARE HOMES FOR OLDER PEOPLE
Oaklands Nursing Home 43 Bodenham Road Hereford HR1 2TP Lead Inspector
Sandra J Bromige Unannounced Inspection 16th January 2006 10:45 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 DS0000059478.V278982.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 Nursing Home DS0000059478.V278982.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Oaklands Nursing Home Address 43 Bodenham Road Hereford HR1 2TP 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) 01432 272775 01432 351596 Oaklands Care Services Limited Mrs Pamela Ann Newman Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30), Physical disability over 65 years of age of places (30) Oaklands Nursing Home DS0000059478.V278982.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Conditions of Registration 1. Oakland Care Services Limited will carry out a review of the heating, surface temperatures of radiators and pipes, water temperature controls and legionella precautions in Oaklands Nursing Home. The review, together with an action plan to rectify any deficits identified, will be submitted to the Commission for Social Care Inspection within 3 months of the date of registration. 2. Oakland Care Services Limited will increase the amount of day space provided for service users and will fit a new passenger lift to replace the undersized lift within 2 years of the date of registration. 3. Oakland Care Services Limited will provide a set of architects plans for Oaklands Nursing Home to the Commission for Social Care Inspection within 6 months of the date of registration. Date of last inspection 28th July 2005 Brief Description of the Service: Oaklands is registered to provide nursing care for up to 30 people whose needs arise from the ageing process, from a dementia illness or from a physical disability. The home was taken over by new providers Oaklands Care Services in May 2004. Oaklands is a large Victorian house with 2 modern, purpose built extensions. The accommodation is on four floors and there are 2 shaft lifts and 1 platform lift to access these. Oaklands is situated in an established residential area less than a mile from the centre of Hereford city, where the majority of local facilities are based. There are 14 single bedrooms and 8 shared bedrooms. On the ground floor there are 3 lounges and 1 dining area for communal use. The gardens are large and some areas are accessible to the service users Oaklands Nursing Home DS0000059478.V278982.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on the 16th January 2006 from 10.45 – 17.45 hrs. Following the last inspection in July 2005 the findings were shared with the other multi-agencies responsible for the care of the residents in the Home and a decision was made to allow the Home to admit residents once again as the standards of care were satisfactory. The Primary Care Trust made a decision not to admit for a further 3 months, as this was their policy, although they are now admitting residents to the Home. The Pharmacy Inspector has carried out a recent follow up Pharmacy Inspection. The Homes management of medication was good and only one recommendation was made. Information contained in this report has been obtained by the Inspector looking around parts of the building and a number of records were inspected. Residents, the manager, staff, relatives and 3 visiting professionals were spoken with during this visit. There has been one complaint received by the Commission since the last inspection. The complaint was about care practice and choice of meals. The complaint was referred to the owner to investigate and two elements of the complaint were not upheld and one was unresolved. What the service does well:
Residents are able to live in a Home that is close to the centre of the City of Hereford, making it very accessible for visitors and close to the shops and amenities of Hereford. The staff are very pleasant, friendly and cheerful and there is a welcoming atmosphere in the Home. Residents said that the staff are ‘very helpful and nice’. Visitors are made very welcome and appear to be well known by the manager and staff. The manager keeps the individual relatives next of kin very well informed about their health, phoning them to let them know the outcome of the Doctors visits when they are unwell. Residents were all well groomed and their clothes were nicely laundered. Residents and relatives spoken with all indicated that they were satisfied with the care being provided. Visiting professionals commented that they were also very pleased with the care provided and that the staff carry out their instructions for their patients. Oaklands Nursing Home DS0000059478.V278982.R01.S.doc Version 5.1 Page 6 The premises are bright, homely and nicely decorated and furnished. The tables in the dining room are nicely laid for meals with linen cloths, salt & pepper and table decorations and residents are able to sit in groups of up to four people per table to enable mealtimes to be a social occasion. Residents are able to invite their visitors for lunch and a separate slightly more private table is provided in the dining room for them and their guests. A wholesome and varied menu is provided, residents have a choice of meals and specialist diets are catered for. Residents have the choice to eat in their rooms. Residents said that the food ‘is very good on the whole’; ‘sometimes there is more choice than others’. The Home is clean and there are no bad smells. There is plenty of equipment provided for moving and transferring residents such as hoists, slide sheets, handling belts, and wheelchairs. Staff were transporting residents in the wheelchairs safety with both footrests in place and reminding residents to keep their arms tucked in so that they did not get knocked when going through doorways. The dining room chairs all have arms to support the residents when sitting and have gliders on the legs to make it easy for staff to position the chairs at the table. The manager continues to report all significant incidents that take place in the Home to the Commission as required through legislation. What has improved since the last inspection? What they could do better:
The Inspector has been unable to assess the adequacy of the Homes contract as a copy has been requested and at the time of writing the report has not been provided by the owner. Residents must be consulted about their hobbies and interests and the activities they would like to see being provided in the Home. A programme of activities must be provided including the opportunity for residents to exercise. Staff need more training about Adult Protection and Whistle Blowing. Oaklands Nursing Home DS0000059478.V278982.R01.S.doc Version 5.1 Page 7 There were a number of concerns relating to health & safety that needed to be addressed very quickly. These included the need to consider the risk to residents from falling down the stairs to the basement floor as staff were not using the coded lock, radiators in two identified bedrooms were not guarded or of a guaranteed low surface temperature to prevent burns if a resident falls against them and is unable to get up, the use of an unguarded portable heater in a residents bedroom because the radiator was not working properly and the use of a broken piece of equipment in the kitchen. For all of these concerns an immediate requirement notice was issued on the day of the inspection and given to the manager. A risk assessment must be carried out by the owner to make sure that the residents; staff and visitors to the Home are not at risk from Legionella. The owner and manager must review the numbers of care staff provided in the daytime to ensure that there are enough staff to give the physical and social care that is needed. Employment references must be obtained for all staff prior to them starting work at the Home. A policy and induction training programme must be developed for new staff employed to ensure that the care & safety of residents and the staff is promoted. When staff start work at the Home they must be allocated to work with a more experienced carer who has the experience and ability to supervise the new member of staff. A policy and procedure must be written so that the Home can monitor the standard of the service given by the Home. Care staff must receive formal supervision from a senior member of staff at least six times each year. The owner must visit the Home at least once a month and write a report of the findings. The report must be given to the manager and a copy sent to the Commission. The following concerns in addition to the ones above all relate to health & safety and need to be addressed as a matter of urgency: - staff must receive manual handling training, a first aider must be on duty in the Home at all times, staff working in the kitchen must undertake a food hygiene course, the safety, adequacy & suitability of the kitchen surfaces, storage facilities, equipment and appliances must be reviewed, the temperatures of the fridges and freezers must be checked and recorded daily, raw and cooked meat must not be stored on the same shelf in the fridge and they must be dated when opened, the risk to staff of injuring themselves when lifting and changing the milk purgal must be assessed and documented, safety data sheets for the chemicals used in the kitchen must be available to staff in case of an emergency, all portable electrical equipment must be tested before use and at
Oaklands Nursing Home DS0000059478.V278982.R01.S.doc Version 5.1 Page 8 the required intervals, electrical equipment brought into the Home and used by staff must not be used until it has been tested by a trained person and the health & safety poster must be completed and prominently displayed. This report also made 5 recommendations. The Home should provide homemade soup on a daily basis and not just once a week. Staff when assisting residents to eat their meals should make it a social occasion by sitting down with the resident and talking to them. The manager should be given allocated time during her working week to carry out managerial duties such as developing policies, staff induction & supervision. The ‘bug killer’ in the kitchen should be fixed to the wall as at the moment it is stood on a shelf. Staff should not be permitted to bring their own electrical equipment into the Home to be used as part of their day-to-day work. 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 DS0000059478.V278982.R01.S.doc Version 5.1 Page 9 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 DS0000059478.V278982.R01.S.doc Version 5.1 Page 10 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: A copy of the Homes current contract was requested from the Provider at the time of the inspection and it was agreed that this would be forwarded to the Commission the next day. This document has not been received at the time of writing this report, so the requirement has been brought forward. Oaklands Nursing Home DS0000059478.V278982.R01.S.doc Version 5.1 Page 11 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 There is a comprehensive care planning system in place to provide staff with the information they need to meet residents care needs. The social care plans need further development to ensure that the social care needs of residents are met. EVIDENCE: A number of care records were seen. The plans of care are developed from the pre-admission assessment. They contain detailed information about the care needs of the resident and are being reviewed on a monthly basis. Parts of the care records are held in the residents’ rooms such as the information about personal care needs and the residents’ mobility. This is good practice. All residents seen appeared very comfortable, and were well groomed. All residents spoken with expressed their satisfaction with the standard of care that they received by the staff at the Home. Relatives were satisfied with the care given and 3 General Practitioners spoken with all expressed their satisfaction with the care provided at the Home. The care records contain personal profiles for residents. Some of these had been partly completed.
Oaklands Nursing Home DS0000059478.V278982.R01.S.doc Version 5.1 Page 12 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 & 15 There is a lack of planned social opportunities in the Home which is needed to provide stimulation and interest for the people living at the Home. The Home is well visited by friends and family enabling the residents to maintain contact with their families and the local community. A varied and wholesome diet is provided. EVIDENCE: The residents were receiving visitors at intervals throughout the day. visitors’ book shows that the Home is well visited. The There was no information on display in the Home indicating a planned programme of activities for the residents to choose from. The manager confirmed that this is an area that needs development and there is a meeting planned with a number of relatives and residents to discuss the provision of activities in the Home. Residents were watching television in the privacy of their rooms or listening to the radio. Televisions are provided in both of the sitting rooms downstairs. Some residents choose to spend most of their time in their rooms, only coming down for lunch with the other residents. Evidence was seen that an identified resident was being given the choice to move to another room on the ground floor.
Oaklands Nursing Home DS0000059478.V278982.R01.S.doc Version 5.1 Page 13 Residents are offered a choice of meals each day. A good choice of breakfast is available including a cooked breakfast upon request. Breakfast is served to the residents in their rooms. A 4-week menu is provided showing a choice of meals. On the day of the inspection lunch was breaded fish or chicken scallops, served with parsley sauce, mashed potato and fresh carrots followed by a desert of semolina. The cook confirmed that fresh fruit & yoghurt were also available as a choice of desert. The meals are served from the hotplate in the dining room by the cook and are individually portioned according to residents’ appetites. Residents were given assistance with their meals in the dining room by one of the care staff in a discreet and sensitive manner. Residents needing assistance to eat their meals who are in their bedrooms are served first by the care staff. Three staff were observed feeding residents in their bedrooms, two were in bed and one sat in the chair. All three of the staff were stood up over the resident feeding them. This is not good practice, as meals should be made a social occasion and not just be task orientated. Cold drinks were accessible to all residents at all times throughout the day and hot drinks are served between meals with either a snack of a biscuit or cake. Records are kept of the amount that residents eat and drink. Supper consists of soup and sandwiches or a hot choice and a desert. The soup is mostly made up from a packet, although the cook confirmed that it was homemade once a week. Residents spoken with all expressed their satisfaction with the food provided and that they had a choice of meals. Oaklands Nursing Home DS0000059478.V278982.R01.S.doc Version 5.1 Page 14 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 Training is needed for staff in Adult Protection issues to ensure that the Home provides a safe environment to protect residents from abuse. EVIDENCE: Protection of Vulnerable Adults training is programmed for the end of February 2006 as the previous session was postponed. Oaklands Nursing Home DS0000059478.V278982.R01.S.doc Version 5.1 Page 15 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 & 25 Recent investment has significantly improved the appearance of this Home creating a comfortable and safer environment for those living there and visiting. Further investment is needed to enhance the comfort and facilities of the Home for residents and staff. Systems and procedures for managing the safety of hot surfaces and the control of Legionella need urgent attention to ensure that residents safety is maintained at all times. EVIDENCE: The Home has been undergoing a programme of refurbishment since the new Provider was registered in May 2004. The priority for refurbishment has been given to the residents’ individual and communal accommodation and facilities. All these areas have been redecorated, with new furniture, curtains and carpets. Some structural work has been carried out in the dining room to enlarge this area and provide space for residents to entertain guests at mealtimes. The Home is now looking homely and well cared for and the facilities are much improved for the residents and people visiting the Home. Further upgrading work is needed to sluice areas and staff facilities and toilets and the kitchen, as these areas are looking very tired in appearance.
Oaklands Nursing Home DS0000059478.V278982.R01.S.doc Version 5.1 Page 16 At the point of registration, conditions were imposed by the Commission and agreed by the Provider, that within 2 years of registration the Provider will increase the amount of day space for residents and replace the undersized shaft lift in the Home. This work has not been commenced. The Commission intends to write to the Provider through separate correspondence. The coded lock was not in use on the door opening onto the stairs to the lower ground floor leaving it accessible to residents. Two identified bedrooms had radiators that were not guarded or have guaranteed low temperature surfaces. An identified resident was using a potable heater, which was not guarded, as the radiator in that room was not working. A new boiler has been installed and a new water tank. The Provider has confirmed that the water temperatures are checked each week, although they do not have a risk assessment in place for the management of Legionella. The bath/shower water temperatures are checked and recorded by care staff. Oaklands Nursing Home DS0000059478.V278982.R01.S.doc Version 5.1 Page 17 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 The numbers of care staff provided during the daytime each day are not always sufficient to ensure that residents’ receive consistent care. The procedures for employment of staff have improved but are not sufficiently robust and do not offer protection for the people living at the Home. An induction policy & programme if not in place for newly appointed staff to ensure the safety of residents and staff. EVIDENCE: On the day of the inspection there were 27 residents in the Home. The manager was on duty and was the registered nurse in charge of the shift. A further registered nurse was on duty and as it was her first day in the Home she was working with the care staff and not carrying out trained nurse duties. Four care staff were on duty and a further carer has got with a resident to a hospital appointment and returned later that morning. It was the also the first day of working in the Home for one of the care staff. Ancillary staff included a cook, kitchen assistant, laundry assistant and a cleaner. The rota for the previous week based on the current numbers of residents in the Home at the time of the inspection show that there were 3 mornings shifts and all of the afternoon shifts of that week when there were not sufficient staff on duty for the numbers of residents. There was sufficient staff on duty at the time of the inspection, although it was not good planning to have two staff on duty when it was their first day of work at the Home, and the Home was very busy. Oaklands Nursing Home DS0000059478.V278982.R01.S.doc Version 5.1 Page 18 The recruitment files of two newly appointed staff were seen. There was no evidence of an employment reference for one employee and there were gaps in the employment history of both employees that had not been explored at interview. There is no formalised induction policy and programme for new staff and this needs to be addressed as a matter of urgency. Oaklands Nursing Home DS0000059478.V278982.R01.S.doc Version 5.1 Page 19 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): 30, 33, 36 & 38 The manager has a good understanding of the areas in which the Home needs to improve, although managerial time needs to be set aside to enable the improvements to be implemented. Systems for the review of the quality of the service including consultation with residents, relatives and visiting professionals need to be implemented, sought and acted upon. A system for the supervision of care staff must be implemented to ensure that the staff have the skills and competencies to meet residents care needs. Systems are not in place to protect the health & safety of the residents living and the staff working in the Home. EVIDENCE: The manager has been approved and registered by the Commission since the last inspection. She is only responsible for the management of this Home. She is very experienced and has put considerable effort into raising the standard of care practice at the Home. The manager is currently working almost full time as the registered nurse in charge of the Home when she is on duty. To enable policies and procedures to be implemented such as staff
Oaklands Nursing Home DS0000059478.V278982.R01.S.doc Version 5.1 Page 20 training, induction & supervision and to enable herself to attend training courses to update her knowledge base, the manager needs to be given time each week whereby she is solely there to manager the Home and not be in charge of the day to day care of the residents. As part of the Home’s quality audit they have recently engaged an independent person to carry out an inspection of the Home in line with the National Minimum Standards for older people. A copy of this report has been sent to the Commission. Policies & procedures are not in place to enable the Home to measure the quality of the service in a structured manner. This must be given urgent priority by the owner and manager. Monthly written reports are not being given to the manager of the Home by the Owner and are not being sent to the Commission in line with regulation. A policy and programme for supervision of staff is not in place. The Home has a trained manual handling trainer. None of the staff spoken with on the day of the inspection had received any manual handling training since being employed at the Home. The Owner has confirmed in writing that weekly fire checks are being carried out and that the equipment has been serviced. Not all staff spoken with at the time of the inspection had received fire training since starting work at the Home. The manager confirmed that there was no qualified first aider on duty. There was no liquid soap of paper towels in the laundry room. The cook has a current food hygiene certificate; although neither of the two kitchen staff seen on the day of the inspection has a food hygiene certificate. The kitchen appears tired and would benefit from being upgraded as not all of the work surfaces are stainless steel, they were badly stained and some of the shelving in the kitchen and washing up area has exposed wood that may be a contamination risk. The temperature of the one fridge could not be checked each day, as the fridge did not have a thermometer. The cleaning schedule had not been completed since the 2nd January 2006. An open packet of meat was being stored on the same shelf as an open packet of cooked meat. This is poor practice. The ‘bug killer’ was not wall mounted and was sat on a shelf adjacent to the microwave. A piece of plastic or matchstick was being used to move the safety switch on the blender, as this was broken. A milk purgal is in use although there was no manual handling assessment regarding the safety of staff when changing the purgal. Oaklands Nursing Home DS0000059478.V278982.R01.S.doc Version 5.1 Page 21 There were no chemical safety data sheets in the kitchen for the chemicals in use. The health & safety poster was not completed and was not mounted on the wall. Portable appliances in the kitchen have not been tested including the two kettles that are being used to provide hot water for drinks and cooking. The one kettle had been brought in by a member of staff and was not provided by the Home. Oaklands Nursing Home DS0000059478.V278982.R01.S.doc Version 5.1 Page 22 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 2 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 2 X X X X X 1 X STAFFING Standard No Score 27 2 28 X 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 1 X X 1 X 1 Oaklands Nursing Home DS0000059478.V278982.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP2 Regulation 5 Requirement The Statement of Terms and Conditions of Residence must specify the amount of the nursing contribution as detailed in the Care Homes (Amendment No. 2) Regulations 2003. Brought forward. Social care needs of individual residents must be identified and a plan of care put into place in consultation with the resident. Brought forward, not met. Residents must be consulted about their social interests and a programme of activities must be arranged on a group and individual basis. All residents must be given the opportunity to exercise. All staff must receive training on Adult Protection and Whistle Blowing, including the Herefordshire multi-agency procedures for the Protection of Vulnerable Adults. Brought forward, timescale of 31/10/05 not met. A risk assessment must be written regarding the
DS0000059478.V278982.R01.S.doc Timescale for action 30/11/04 2. OP7 15 31/03/06 3 OP12 16 31/03/06 4 5. OP12 OP18 16 12 31/03/06 31/03/06 6 OP19 13 17/01/06 Oaklands Nursing Home Version 5.1 Page 24 7 OP25 13 8 OP25 13 9 OP25 13 10 11 OP27 OP29 18 19 12 OP30 18 13 OP30 18 accessibility of the lower ground floor to residents. An immediate requirement notice was issued. All radiators in the Home where residents have access must be of a ‘low surface temperature’ type or must be covered to prevent burns. An immediate requirement notice was issued. A risk assessment must be carried out for the use of the portable heater the bedroom fire risk assessment must be reviewed. An immediate requirement notice was issued. A risk assessment must be carried out with regard to the prevention of legionella. Appropriate action must be taken based on the findings of the risk assessment. Brought forward as timescale of 30/11/04 not met. The Home must review the numbers of care staff on duty during the daytime. An employment reference relating to the persons last period of employment must be obtained for all staff prior to commencement of employment at the Home. All staff must receive induction training to TOPSS (Training Organisation for Personal Social Services) specification within six weeks of the commencement of employment. Brought forward, not met. For the duration of new employees induction training a member of staff who is appropriately qualified & experienced must be appointed to supervise the new employee.
DS0000059478.V278982.R01.S.doc 23/01/06 16/01/06 28/02/06 28/02/06 31/01/06 31/01/06 31/01/06 Oaklands Nursing Home Version 5.1 Page 25 14 OP33 24 15 OP36 18 16 17 OP37 OP38 26 13 18 OP38 13 19 20 21 OP38 OP38 OP38 13 13 13 22 23 24 OP38 OP38 OP38 13 13 13 25 OP38 13 The staff member must be on duty at the same time as the new employee. Policies & procedures must be established to enable the Home to audit all aspects of the standard of the service provided. The Registered Person must ensure that care staff receive formal supervision at least six times a year. Brought forward, timescale of 31/03/05 not met. The Provider must forward to the Commission monthly monitoring reports. Staff must receive manual handling training upon employment and this training must be updated annually. All staff must receive fire training upon employment and training must be updated at intervals throughout the year. A first aider must be on duty at all times. All staff working in the kitchen must undertake a basic food hygiene course. The safety, adequacy and suitability of the kitchen surfaces, storage facilities, equipment and appliances must be reviewed. The temperature of all the fridges and freezers must be checked and recorded every day. Raw and cooked meat must be stored on separate shelves and must be dated when opened. The blender must be taken out of use. An immediate requirement notice was issued. A manual handling risk assessment must be carried out regarding the lifting and
DS0000059478.V278982.R01.S.doc 31/03/06 30/04/06 31/01/06 28/02/06 28/02/06 28/02/06 28/02/06 31/01/06 31/01/06 31/01/06 16/01/06 31/01/06 Oaklands Nursing Home Version 5.1 Page 26 26 27 OP38 OP38 13 13 28 29 OP38 OP38 13 13 changing of the milk purgal in the kitchen. Chemical safety data sheets must be provided in the kitchen for all chemicals in use. The health & safety poster must be put up in a prominent place in a staff area and completed with the details required for staff. All portable appliances in the Home must be tested at the required frequency. Electrical equipment brought into the Home by staff must not be used until it has had a Portable Appliance Test. 31/01/06 31/10/06 28/02/06 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP15 OP15 Good Practice Recommendations The Home should provide homemade soup on a daily basis. It is strongly recommended that staff when assisting residents to eat their meals in their bedrooms make it more of a social occasion by sitting down with the resident and talking to them. It is strongly recommended that the manager is given allocated time during her working week to carry out managerial duties in the Home. The ‘bug killer’ should be fixed on the wall on the kitchen. It is strongly recommended that staff should not be permitted to bring their own electrical equipment into the Home to be used as part of their day-to-day work. 3 4 5 OP31 OP38 OP38 Oaklands Nursing Home DS0000059478.V278982.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Hereford Office 178 Widemarsh St Hereford Herefordshire HR4 9HN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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