Inspection on 05/10/05 for Oaklands Residential Home, Barnstaple

This inspection was carried out on 5th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Oaklands Residential Home,... 06/02/07

Oaklands Residential Home,... 23/03/06

Oaklands Residential Home,... 02/03/05

Oaklands Residential Home,... 26/07/04

Oaklands Residential Home,... 03/03/04

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

CARE HOMES FOR OLDER PEOPLE Oaklands Residential Home Oaklands Westfield Avenue Barnstaple EX31 2DY Lead Inspector Adele Adams Announced 5 October 2005 th 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 Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Oaklands Residential Home Address Oaklands, Westfield Avenue, Sticklepath, Barnstaple,Devon, EX31 2DY 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) 01271 374231 As above Mr John Patrick Hall Mrs Ruth Edith Matthews Care Home 25 Category(ies) of Dementia - over 65 years of age (25), Old age, registration, with number not falling within any other category (25) of places Oaklands Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd March 2005 Brief Description of the Service: Oaklands, is a care home found in a residential area on the outskirts of the market town of Barnstaple and provides personal care and accommodation for up to 25 people. The home is registered to provide care for people over 65 years of age who have general care needs and needs associated with a dementia type illness. Care and services are provided in a large extended detached house, close care bungalows have been built in the grounds but the home continues to have some views of the Taw estuary and accessible areas outside for residents. The accommodation at the home includes a large lounge and a large dining room; residents’ rooms are for single use, most of these are on the ground floor. The 3 residents’ rooms on the first floor are reached either by stairs or a stair lift. Oaklands Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission for Social Care Inspection has introduced “Key Standards “ to be inspected over each inspection year. Therefore, unless it is felt necessary by the inspector, some standards will not be inspected. To obtain a full picture of the home it is recommended that previous reports also be taken into consideration. This inspection was announced and began at 9:55 a.m. on 5th October 2005 and ended at 16:40. On the day of inspection, there were 23 residents living at the home. The inspector toured the home, was introduced to residents, observed staff and residents together, read documentation and client records and spoke with residents and staff individually in order to gather information necessary for this inspection, the pre inspection questionnaire completed by the manager and provided before the inspection, and previous inspection reports also informed this inspection. The provider, manager and staff were welcoming, and contributed positively to the inspection; there were no relatives / visitors for the inspector to speak with but feedback has been provided through ‘comment’ cards and has been included in the report. What the service does well: Oaklands has caring staff, who are managed by the registered manager. The staff treat the residents as individuals and respect the residents’ privacy and dignity. Importance is placed on the residents meetings and changes that benefit residents are made as a result of these. Staff are supported to access and attend training, which makes sure that they are up to date and have the opportunity to gain or develop the skills needed to care for the residents at Oaklands. The residents really enjoy the food and said ‘ It is really good – I only have to ask and they bring me what I like’. The food served to residents is of a good quality. Oaklands Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Improvements could be made in the following areas: The Service User Guide and Statement of Purpose – the information provided to people considering Oaklands as a care home for themselves or a member of their family and the contract/ terms and conditions must be improved so that a really clear picture of what living at Oaklands is like and what care and facilities are available for residents. A full and thorough assessment of a potential residents needs must take place before they move into Oaklands, to make sure that the residents needs can be met well by the home. Care needs and how these are to be met must be clearly recorded for each resident in the home. Oaklands Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 Page 7 Not all rooms hold the recommended minimum furnishings – not all bedrooms have 2 comfortable chairs or a table for service users to sit at. Quality assurance systems in the home need to be formalised to clearly show where it is identified improvement is needed and when improvement has been made. Staff should have access to regular two monthly supervision as a way of receiving support and to discuss their development. There is no hand washing facility for residents to use in the bathroom when they have used the toilet. 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 Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 Page 8 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 Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 Page 9 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) 1, 2 , 3 The information and contract made available to residents does not currently provide all of the information that should be available to help people and / or their families decide if Oaklands is a suitable home for them. A full and thorough assessment of a potential residents needs is not undertaken before moving into Oaklands. EVIDENCE: The inspector read the amended Statement of Purpose, Service User Guide and 3 residents Contract / Terms and Conditions and discussed where improvement is necessary with the Registered Manager. The manager advised the inspector that all residents have copies of the current Statement of Purpose and Service User Guide. The inspector read 3 resident records, none had a robust pre inspection assessment in place, however, information when provided by social services is used well. Not all residents are visited and assessed before moving into the home. The records of a privately paying resident were inspected and there is no pre admission needs assessment in place – the manager confirmed that the home must develop one as a matter of priority. Oaklands Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 Page 10 The residents spoken to were not aware of receiving terms and conditions or information about the home – 2 said ‘ My family deal with these things’. No relatives were present to discuss this with. Oaklands Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 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 standard(s) 7, and 9 Residents do have a plan of care but these do not clearly state all health and social care needs or how these needs are to be met. The medication policies, procedures and systems in place make sure that residents if not able do so themselves are supported with their medication needs by staff. EVIDENCE: Three residents care records were read by the inspector – these do not give a clear picture of what each individuals care needs are or how these will be met by staff, some residents had social services information provided before their admission to the home but in one case no formal needs assessment had been undertaken before the resident had moved into the home. The inspector discussed her findings with the manager and deputy manager who are keen to improve the assessment and plans of care. The residents spoken to had no real knowledge of their care plans, however a regular monthly review of care with the residents involvement does now take place and an individual resident profile is being developed with each resident, which provides valuable information. The inspector read the homes medication policies – the home had an inspection by a pharmacist in March 2005. Medication records were also inspected as was the storage and storage facilities – a medication fridge is now Oaklands Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 Page 12 used to store all medication needing cold storage and the temperature of this fridge is recorded appropriately. Two staff were spoken with, one said they do not give medication and wont be able to until they have had the correct training and another told the inspector that they had had medication training and occasional gives medication to residents. The inspector saw evidence that 10 staff attended a medication course in July 2005. One resident told the inspector that they have their medicine brought to them by staff. The manager advised the inspector that no residents are currently taking their medication independently. Oaklands Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 Page 13 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, 13,14 and 15 Residents do exercise choice and control over their lives and are able to maintain contact with family, friends and the local community. Residents enjoy the food at Oaklands. EVIDENCE: The inspector observed residents with staff and residents together and saw choices being made by the residents, residents’ preferences were noted in the resident records inspected. The inspector toured the home and spoke with residents who told the inspector that visitors to the home are welcome – the inspector was present when a visitor was offered a drink on their arrival. A resident described how they enjoy being taken out and spending time with their family. The inspector read minutes of residents meetings and it is clear from the comments made by residents at the meeting that they are able to air their views openly. Changes have been made as a result of these meetings, for example a request was made to have a cooked breakfast occasionally – this has been introduced on a Wednesday morning for those who would like it. The comments also demonstrate the popularity of some activities – ‘Bingo’ in particular was highlighted. There is an activity programme that is followed, on the day of inspection residents were doing gentle exercises / movement to music, a resident told the inspector they choose not to take part in activities, a Oaklands Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 Page 14 member of staff told the inspector they enjoy being able to spend time with the residents doing activities such as manicures. The manager advised the inspector she is going to talk to the residents to see if they would like a regular ‘film’ show and is going to find out about activities for those residents who have communication problems. The inspector observed that some residents only move from their chairs at meal times or to visit the bathroom, the inspector asked the manager to give consideration to the amount of time residents sit for in the same place to see if this is what residents actually want. The inspector spoke to residents and staff about the food at Oaklands – 3 residents comments included ‘the food is really good’, ‘you can have what you want ‘, another resident told the inspector that evening and bedtime drinks and snacks are provided and a new member of staff is impressed with the choice of food available. The dining facilities have been improved and the dining room is no longer also used as a lounge and provides residents with much more easily accessible space. The inspector did not eat with residents during this inspection. Oaklands Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 Page 15 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 An accessible complaints policy and procedure is in place. EVIDENCE: The complaints procedure for the home was read by the inspector, a summary of this was also read in the Statement of Purpose and Service User Guide and a statement about complaints is on display in the entrance of the home. There is a ‘compliments and complaints’ book that is accessible in the hallway of the home. Residents spoken with during the inspection said they felt confidant to approach staff with any concern. Staff spoken with said they would direct any concerns to the manager or deputy manager. Oaklands Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 Page 16 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, 24 and 26 Residents at Oaklands are provided with clean, safe surroundings to which some improvements have been made EVIDENCE: The inspector toured the home, this included viewing residents’ rooms, and the dining room, lounge and bathrooms were also seen. The inspector also asked 3 residents about their rooms and shared space at the home and had discussion with the manager and owner. Recent decoration of some shared areas of the home has taken place; there are new entrance doors and new double-glazing to the residents’ lounge, which makes these areas feel larger and brighter. New carpet has been laid in some areas and parts of the home previously scuffed by wheelchairs have been painted, the lounge and dining room have been rearranged and now provide 2 spacious light rooms for residents to eat and relax in, with more room to move around, providing easier access for residents, visitors and staff. Residents’ rooms are decorated when they are vacated or as required, there is a routine programme of maintenance that is followed. Oaklands Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 Page 17 Residents rooms were seen during a tour of the premises, not all rooms hold the recommended minimum furnishings – not all bedrooms have 2 comfortable chairs and a table for service users to sit at is not provided in all bedrooms. This was discussed with the manager and provider who are to demonstrate through risk assessment why certain furniture is missing and record residents’ views on this matter. The inspector saw evidence of residents being offered lockable storage space in their rooms and the option of being able to lock the door to their room. There is still no hand washing facility in the bathroom where there is a bath and functioning toilet. This toilet is in use and residents cannot was their hands. Oaklands Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 Page 18 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 Residents are cared for by a suitable number of staff that receive training to develop their skills. EVIDENCE: The inspector observed and listened to staff working with residents, spoke with residents, staff and the manager of the home. Residents told the inspector that staff have time to care for them and that they do not feel rushed or hurried. Staff spoken with during the inspection told the inspector that improvements have been made to the numbers of staff which means they have more time to spend caring for residents – staff feel they work hard but are able to enjoy their work. The manager explained the staff changes that have been made at what are the busiest times of the day. The staff rota was also inspected. Oaklands Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 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 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) 33,36 and 38 The interests of the residents at Oaklands are considered but this is an area needing improvement. Staff at Oaklands do not currently receive supervision. Some areas of Health and Safety practice at Oaklands needs to be addressed. EVIDENCE: The inspector spoke with residents, staff and the manager. The inspector read some minutes of residents meetings that are held on occasion, the manager confirmed that no real improvements have been made in this area yet. The inspector spoke with staff and the manager – all confirmed that 2 monthly staff supervision is not in place at Oaklands. Safe working practices were revisited in relation to the previous inspection findings – when a fire door was found wedged open. All doors were closed, fire exits were clear and accessible – the inspector asked that the manager seek advice from the Fire/Officer in relation to an area where an exit that is not a designated fire exit is permanently locked and the opposite exit is hampered by steps. Oaklands Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 Page 20 The home has also had a pharmacy inspection and environmental health inspection - evidence of these together with recommended actions were made available. The fire officer last visited the home on 14/1/05 and stated the home’s fire risk assessment is satisfactory. The manager has sought information in respect of Legionella checks at the home and confirmed that water testing is carried out annually. The emergency call system is serviced annually – last undertaken on 15/9/05. The central heating system is checked by an approved contractor on an annual basis and was last checked on 26/7/05. A COSHH analysis is in place and was seen by the inspector and is due for review in February 2006. Oaklands Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 1 1 1 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x 2 x 2 STAFFING Standard No Score 27 3 28 x 29 x 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 1 x x 2 x 2 Oaklands Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 Page 22 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 1 Regulation 4 (1) and 5 (1) Requirement The registered person shall compile in relation to the care home a written statement (in these Regulations referred to as the statement of purpose) which shall consist of (a) a statement of the aims and objectives of the care home; (b) a statement as to the facilities and services which are to be provided by the registered person for service users; and (c) a statement as to the matters listed in Schedule 1. 5. - (1) The registered person shall produce a written guide to the care home (in these Regulations referred to as the service users guide) which shall include (a) a summary of the statement of purpose; (d) the most recent inspection report; (e) a summary of the complaints procedure established under regulation 22; (f) the address and telephone number of the Commission. Oaklands Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 Page 23 Timescale for action 31st January 2006 2. 2 5 (1) (2) The registered person shall supply a copy of the service users guide to the Commission and each service user. (3) Where a local authority has made arrangements for the provision of accommodation, nursing or personal care to the service user at the care home, the registered person shall supply to the service user a copy of the agreement specifying the arrangements made. (b) the terms and conditions in respect of accommodation to be provided for service users, including as to the amount and method of payment of fees; 31st January 2006 3. 3 14 (c) a standard form of contract for the provision of services and facilities by the registered provider to service users; - (1) The registered person shall 31st not provide accommodation to a January service user at the care home 2006 unless, so far as it shall have been practicable to do so (a) needs of the service user have been assessed by a suitably qualified or suitably trained person; (b) the registered person has obtained a copy of the assessment; (c) there has been appropriate consultation regarding the assessment with the service user or a representative of the service user; (d) the registered person has confirmed in writing to the service user that having regard to the assessment the care home is suitable for the purpose of Oaklands Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 Page 24 meeting the service users needs in respect of his health and welfare. (2) The registered person shall ensure that the assessment of the service users needs is (a) kept under review; and (b) revised at any time when it is necessary to do so having regard to any change of circumstances. (1) Unless it is impracticable to 31st carry out such consultation, the January registered person shall, after 2006 consultation with the service user, or a representative of his, prepare a written plan (the service users plan) as to how the service users needs in respect of his health and welfare are to be met. (2) The registered person shall (a) make the service users plan available to the service user; 5. 33 24 The registered person must establish and maintain a system for reviewing at appropriate intervals and improving the quality of care provided in the care home. The registered person must supply to the Commission a report in respect of any review conducted by him for the purposes of paragraph (1), and make a copy of the report available to service users. The system referred to in Paragraph (1) must provide for consultation with service users and their representatives. This refers to the need to ensure that quality assurance systems are put in place. This requirement is carried forward from the previous D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc 4. 7 15 31st January 2006 Oaklands Residential Home Version 1.40 Page 25 inspection. 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 24 Good Practice Recommendations In the absence of service users’ own provision, furnishings for individual rooms are provided to a minimum as follows: · A clean comfortable bed, minimum 900mm wide, at a suitable safe height for the service user, and bed linen · Curtains or blind · Mirror · Overhead and bedside lighting · Comfortable seating for 2 people · A table to sit at and a bed -side table. This recommendation is carried forward from the previous inspection. Handwashing facilities should be prominently sited where infected material or clinical waste are being handled. This refers to the lack of handwashing facilities for residents in the bathroon. The registered person should ensure that care staff receive formal supervision at least six times a year.This recommendation is carried forward from the previous inspection. 2. 26 3. 36 4. Oaklands Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Residential Home D54-D07 S57690 Oaklands Residential Home V242271 051005 Stage 4.doc Version 1.40 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!