Inspection on 23/04/07 for Oaklands Nursing Home

This inspection was carried out on 23rd April 2007.

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 13/12/05

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 Unannounced Inspection 23rd April 2007 09:45 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 DS0000018812.V329831.R01.S.doc Version 5.2 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.V329831.R01.S.doc Version 5.2 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.V329831.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th December 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. Fees range from £389 to £500 per week plus NHS funding for those who require nursing care. Additional charges are made for hairdressing, chiropody, newspapers and outings. Oaklands Nursing Home DS0000018812.V329831.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on the 23rd April 2007 and lasted seven hours. This visit was just one part of the inspection. Before the visit the home manager was asked to complete a questionnaire to provide up to date information about services in the home. Questionnaires were also made available for residents, families and health and social care professionals to find out their views. Other information received since the last key inspection was also reviewed. During the visit various records and the premises were looked at. A number of residents and relatives were spoken with and they gave their views about the home. 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. Visitors are encouraged and residents are helped to exercise choice and control over their lives. Catering is of a high standard. There is an well publicised complaints procedure to reassure residents that any concerns will be taken seriously and residents are protected from abuse. 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. The management of the home is based on openness and respect. The manager is extremely competent and regularly seeks the views of the residents and Oaklands Nursing Home DS0000018812.V329831.R01.S.doc Version 5.2 Page 6 their families. Records are maintained in such a way as to protect the confidentiality of residents’ and staff’s personal information. 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. The summary of this inspection report can be made available in other formats on request. Oaklands Nursing Home DS0000018812.V329831.R01.S.doc Version 5.2 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.V329831.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 deputy manager prior to admission. Two other residents confirmed that the deputy manager had been to visit them before admission. Following assessment a key worker was allocated and the manager made sure the key worker was on duty on the residents’ day of admission. Care plans were drawn up and these demonstrated that the home had the capacity to Oaklands Nursing Home DS0000018812.V329831.R01.S.doc Version 5.2 Page 9 meet individuals’ assessed needs. The home was staffed by an experienced team of first level registered general nurses at all times. One comment card received said ‘ we find Oaklands Nursing Home very capable in caring for our mother.’ Oaklands Nursing Home DS0000018812.V329831.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual plans of care ensure that residents’ health and personal care needs are met. Residents are treated with respect. EVIDENCE: All residents had an individual plan of care in place. All relevant information was conveyed at the staff handover when the shifts changed. The care plans examined on the day had been reviewed and updated as appropriate, and contained documentary evidence that residents and/or their representatives 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. Oaklands Nursing Home DS0000018812.V329831.R01.S.doc Version 5.2 Page 11 Case files demonstrated that residents were assessed on a regular basis for their needs in relation to oral hygiene, risk of pressure sores and falls, 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. Medicine storage arrangements were satisfactory. 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. Arrangements for controlled drugs were also satisfactory. However, one resident’s heart medication was being disguised in their food, on the instruction of the GP because the resident had dementia and was refusing to take it. There was no evidence that this had been discussed with the resident’s representative or social worker. Another resident was prescribed two pain killers twice a day. These weren’t always administered and sometimes the resident was only given one at their request. The deputy manager said this was because the resident did not always need them. The deputy manager was advised to discuss this with the GP and have them prescribed ‘one or two tablets when required’ rather than two tablets twice a day. 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 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 ‘staff are responsive to residents’ individual needs.’ Signs were hung on bedroom doors stating ‘care being given do not enter’ and privacy screens were provided in double rooms. Residents were also able to put ‘do not disturb’ signs on their doors. Oaklands Nursing Home DS0000018812.V329831.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to have visitors at any reasonable time and the home encourages residents to exercise choice and control over their lives. EVIDENCE: 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 was maintained. There were activities for residents to take part in on most days. These included manicures, hand massages, board games, music therapy, arts and crafts, flower arranging, exercise sessions and bingo. A staff member from Chester Grosvenor Museum visited the home on a monthly basis to bring various artefacts to stimulate discussion of times gone by. A hairdresser visited on a regular basis. A local minister provided Holy Communion monthly for any Oaklands Nursing Home DS0000018812.V329831.R01.S.doc Version 5.2 Page 13 residents that wished to participate. Large print and talking books were available for the visually impaired and visual communication aids were available for those with communication difficulties. The home was decorated with Easter decorations that some of the residents had helped to make. There had been a clothes sale and a Caribbean themed weekend was planned. A visitor commented ‘The care staff have great patience and spend quality time with their residents in a sociable atmosphere.’ One resident was planning a holiday to America with their spouse. Two staff from the home were accompanying them to provide care and assistance. 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. 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. Several said ‘the food is really good’. Oaklands Nursing Home DS0000018812.V329831.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents know how to complain and are confident that any concerns will be taken seriously. Robust systems are in place to protect residents from harm. 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. 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.V329831.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides safe, pleasant and comfortable surroundings for residents to live in. EVIDENCE: The home was comfortable and homely and some bedrooms and the small lounge at the front had been redecorated since the last inspection. They were also in the process of replacing the window frames on the first floor. The grounds were well maintained and there was a pleasant garden with patio furniture, which was easily accessible to residents. New dining furniture was on order. Oaklands Nursing Home DS0000018812.V329831.R01.S.doc Version 5.2 Page 16 Residents were given choice regarding rooms. One married couple were in single rooms opposite each other and said the manager had arranged for a vacant double room to be refurbished for them. The home was clean, hygienic and free from offensive odours. Oaklands Nursing Home DS0000018812.V329831.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The skill mix and numbers of staff, together with a comprehensive staff training programme, ensure that residents’ needs are met. EVIDENCE: There were 32 residents accommodated on the day of inspection. The home provided two registered nurses during the day and one at night. 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. Three staff files were reviewed. These consisted of two care assistants and one cleaner recruited from overseas. In all cases the required information and documentation had been obtained prior to the offer of a position in the home. Eighty percent of the care assistants were trained to NVQ Level 2 or equivalent. Oaklands Nursing Home DS0000018812.V329831.R01.S.doc Version 5.2 Page 18 The home employed a training coordinator for 20 hours a week. Staff training in the previous twelve months had included training in medication management, mentorship and clinical supervision, venepuncture, dementia care, management of challenging behaviour, assessment and care planning, confirmation of death, wound care and risk assessment. Two of the nurses were undertaking a palliative care course. The home was a member of the Cheshire Nursing Homes Training Partnership and had been accredited as achieving the standard for the Investors in People Award. A visitor commented ‘Friendly staff, responsive to residents’ needs.’ Another said ‘We are impressed particularly with the sympathetic care of the nurses.’ A resident said ‘Nothing is too much trouble. If there is anything wrong they put it right straight away.’ One resident, who had been in hospital recently, said he was glad to be back at Oaklands. Oaklands Nursing Home DS0000018812.V329831.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 & 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 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 Oaklands Nursing Home DS0000018812.V329831.R01.S.doc Version 5.2 Page 20 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 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. To seek people’s views about the home, customer satisfaction surveys had been distributed to residents and relatives before Christmas, as well as resident and staff meetings and interviews with residents. The Care Development Manager had collated the results and produced an action plan. She had sent out a newsletter to residents and relatives in February informing them about the results of the survey and the future plans for the home. The home looked after two residents’ monies at the time of the inspection. Appropriate procedures were followed and the residents were provided with regular statements. 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. Four staff were qualified first aiders, four of the registered nurses had 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 high for one resident but there was an appropriate risk assessment and control measures in place. The home audited the accidents on a monthly basis. All equipment was checked and serviced at the required intervals. Oaklands Nursing Home DS0000018812.V329831.R01.S.doc Version 5.2 Page 21 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 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 4 X 3 X 3 3 Oaklands Nursing Home DS0000018812.V329831.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action 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 OP9 Good Practice Recommendations If consideration is being given to covertly administering medication to a resident who does not have mental capacity, this should be discussed with the resident’s representative, GP and social worker, who must all agree that it is in the resident’s best interest. Oaklands Nursing Home DS0000018812.V329831.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V329831.R01.S.doc Version 5.2 Page 24 - 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. 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