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Inspection on 18/07/05 for Oaklands Nursing Home

Also see our care home review for Oaklands Nursing Home for more information

This inspection was carried out on 18th July 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Prospective residents are assessed prior to admission to ensure that the home can meet their needs. An individual plan of care is drawn up in consultation with the resident and/or their representative that sets out what action the home`s staff will take to help the resident meet those needs. Staffing levels ensure that these plans of care can be followed. Residents` health care needs are particularly well met by a team of experienced nurses. Residents are treated with respect and their privacy and dignity are maintained. Catering is of a high standard. One resident said the food was `marvellous`. There is an well publicised complaints procedure to reassure residents that any concerns will be taken seriously. The home`s recruitment procedures afford protection for residents.One visitor, whose mother had been in the home for thirty years, said she had always been happy with the care and had no complaints. Another said the staff were very nice and encouraged his relative with his rehabilitation following a stroke.

What has improved since the last inspection?

Some bedrooms have been redecorated and work has been carried out to make the grounds more attractive. There has been a stable staff team since the last inspection, affording a better continuity of care for residents. Supervision records now identify agreed actions on the part of the supervisor or supervisee.

What the care home could do better:

There needs to be some consultation with residents about the programme of activities available and arrangements made for more social and recreational stimulation.

CARE HOMES FOR OLDER PEOPLE Oaklands Nursing Home 10 Tarvin Road Littleton Chester CH3 7DG Lead Inspector Gill Matthewson Unannounced 18 July 2005 09:30 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 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 F51 F01 S18812 Oaklands NH V238362 180705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Oaklands Nursing Home Address 10 Tarvin Road Littleton Chester CH3 7DG 01244 335060 01244 335076 Telephone number Fax number Email 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 Roberts-Hounsell Care home with nursing 40 Category(ies) of Old age, not falling within any other category registration, with number (OP) 40, Physical disability (PD) 4 of places Oaklands Nursing Home F51 F01 S18812 Oaklands NH V238362 180705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 26 November 2004 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 en-suite 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 F51 F01 S18812 Oaklands NH V238362 180705 Stage 4.doc Version 1.40 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. Since the last inspection an additional visit was made to the home because there was an allegation that a member of staff had been verbally abusive towards residents on one occasion. This was investigated by the registered manager and appropriate action was taken. The inspection took place over six hours and included a tour of the building, inspection of records, observation of staff handover and discussion with six residents, three relatives, the registered manager, three staff and the transitional care team. Feedback was given to the registered manager immediately following the inspection. What the service does well: Prospective residents are assessed prior to admission to ensure that the home can meet their needs. An individual plan of care is drawn up in consultation with the resident and/or their representative that sets out what action the home’s staff will take to help the resident meet those needs. Staffing levels ensure that these plans of care can be followed. Residents’ health care needs are particularly well met by a team of experienced nurses. Residents are treated with respect and their privacy and dignity are maintained. Catering is of a high standard. One resident said the food was ‘marvellous’. There is an well publicised complaints procedure to reassure residents that any concerns will be taken seriously. The home’s recruitment procedures afford protection for residents. Oaklands Nursing Home F51 F01 S18812 Oaklands NH V238362 180705 Stage 4.doc Version 1.40 Page 6 One visitor, whose mother had been in the home for thirty years, said she had always been happy with the care and had no complaints. Another said the staff were very nice and encouraged his relative with his rehabilitation following a stroke. 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 F51 F01 S18812 Oaklands NH V238362 180705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Oaklands Nursing Home F51 F01 S18812 Oaklands NH V238362 180705 Stage 4.doc Version 1.40 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 standard(s) 3 & 4. A robust admissions procedure ensures that all prospective residents have their needs assessed, and are assured that the home has the capacity to meet their needs, prior to admission. EVIDENCE: Case tracking was carried out for 3 residents. All had undergone a full needs assessment by the manager prior to admission. Care plans were drawn up and these demonstrated that the home had the capacity to meet individuals’ assessed needs. The home was staffed by an experienced team of first level registered general nurses at all times. Oaklands Nursing Home F51 F01 S18812 Oaklands NH V238362 180705 Stage 4.doc Version 1.40 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 standard(s) 7, 8 & 10. Individual plans of care ensure that residents’ health and personal care needs are met. Residents feel they are treated with respect. EVIDENCE: All residents had an individual plan of care in place. All relevant information was conveyed at the staff handover at 2p.m. The care plans examined on the day had been reviewed and updated as appropriate, but did not contain any documentary evidence that residents were consulted. The registered nurses said that they discussed the care plans with residents and relatives and this was confirmed by the residents spoken with during the inspection. See Recommendation 1. Case files demonstrated that residents were assessed on a regular basis for their needs in relation to oral hygiene, risk of pressure sores, continence and nutrition and plans of care were drawn up to address any identified needs. These also contained evidence that residents were referred to appropriate health services such as GP, optician, dentist, chiropodist, physiotherapist and tissue viability nurse, according to need. A transitional care meeting was being held during the inspection and the nurse manager of the transitional care team said that she was ‘very pleased with Oaklands’. Oaklands Nursing Home F51 F01 S18812 Oaklands NH V238362 180705 Stage 4.doc Version 1.40 Page 10 Staff had induction training instructing them on how to treat residents with respect at all times. All the residents interviewed as part of the tracking system felt that they were treated with dignity and respect and that all staff were aware of their needs. Other residents and visitors stated that they had good relationships with the staff. Two residents said they enjoyed having a laugh and a joke with staff and one said ‘ I really appreciate everything they do for me.’ Signs were hung on bedroom doors stating ‘care being given do not enter’ and privacy screens were provided in double rooms. Oaklands Nursing Home F51 F01 S18812 Oaklands NH V238362 180705 Stage 4.doc Version 1.40 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 standard(s) 12 & 15. The activity programme is limited and provides little stimulation for residents. However, meals are nutritious and balanced and provide a tasty and varied diet for the residents. EVIDENCE: The weekly Holy Communion took place during the inspection. An activity programme was displayed on a white board in the corridor, but this had not changed since the previous inspection. When questioned, staff said that most of the activities displayed were still available, but did not always take place as set out in the programme. These included hairdressing, flower arranging, beauty therapy, poetry readings, aromatherapy massage, bingo and sewing. There was no dedicated member of staff responsible for activities and residents were not aware of a planned activity programme. See Requirement 1. There was a four week menu cycle, which was varied and well balanced. Residents could choose from two main courses for lunch, with a dessert and at teatime could have soup, a sandwich or hot snack and a choice of two desserts. Other alternatives were available if a resident did not like any of the choices on the menu that day. Residents confirmed that they were offered choices and were very complimentary about the food. One said ‘the food is really good’ and another said it was ‘marvellous’. Oaklands Nursing Home F51 F01 S18812 Oaklands NH V238362 180705 Stage 4.doc Version 1.40 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Residents know how to complain and are confident that any concerns will be taken seriously. EVIDENCE: The home had a satisfactory complaints procedure that was displayed in reception and included in the service user guide. Complaints forms were also available in reception. Residents confirmed that they were aware of the complaints procedure and that the manager was very approachable. No complaints had been made since the last inspection. Oaklands Nursing Home F51 F01 S18812 Oaklands NH V238362 180705 Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for 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 home was clean, hygienic and free from offensive odours. Oaklands Nursing Home F51 F01 S18812 Oaklands NH V238362 180705 Stage 4.doc Version 1.40 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 29 Residents are protected by the home’s recruitment procedures and the skill mix and numbers of staff ensure that residents’ needs can be met. EVIDENCE: There were 39 residents accommodated on the day of inspection. The home provided two registered nurses at all times. In addition, there were 6 or 7 care staff on duty in the morning, 5 in the afternoon and 3 at night. This was adequate for the needs of the residents accommodated. Three staff files were reviewed. These consisted of one registered nurse and two care assistants recruited from overseas. In all cases the required information and documentation had been obtained prior to the offer of a position in the home. Oaklands Nursing Home F51 F01 S18812 Oaklands NH V238362 180705 Stage 4.doc Version 1.40 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 Staff are appropriately supervised to ensure that their practice is in accordance with the home’s stated aims and objectives. EVIDENCE: The registered manager was responsible for the supervision of the registered nurses. Supervision of care assistants was delegated to the registered nurses. Annual appraisals of all staff were carried out and the home had adequate arrangements in place to enable all staff to receive formal supervision on a regular basis. Oaklands Nursing Home F51 F01 S18812 Oaklands NH V238362 180705 Stage 4.doc Version 1.40 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 4 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x 3 x x Oaklands Nursing Home F51 F01 S18812 Oaklands NH V238362 180705 Stage 4.doc Version 1.40 Page 17 NO Are there any outstanding requirements from the last inspection? 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 OP12 Regulation 16(2) (m&n) Requirement The registered person must consult residents about their social interests and devise an appropriate programme of activities to meet residents social needs. Timescale for action 1.11.05 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 OP7 Good Practice Recommendations Residents and/or their representatives should be encouraged to sign the care plans to indicate they agree with them. Oaklands Nursing Home F51 F01 S18812 Oaklands NH V238362 180705 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich Cheshire, 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 F51 F01 S18812 Oaklands NH V238362 180705 Stage 4.doc Version 1.40 Page 19 - 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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