Inspection on 04/10/07 for Oaklands Rest Home

This inspection was carried out on 4th October 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 Rest Home 13/12/06

Oaklands Rest Home 06/12/05

Oaklands Rest Home 04/08/05

Oaklands Rest Home 16/11/04

Oaklands Rest Home 01/07/04

Oaklands Rest Home 29/04/04

Oaklands Rest Home 09/03/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Oaklands Rest Home 216 Stakes Hill Road Waterlooville Portsmouth Hampshire PO7 5UJ Lead Inspector Pat Griffiths Unannounced Inspection 4th October 2007 10:00 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 Rest Home DS0000011786.V347663.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 Rest Home DS0000011786.V347663.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oaklands Rest Home Address 216 Stakes Hill Road Waterlooville Portsmouth Hampshire PO7 5UJ 023 9226 6343 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) marilyn_803@hotmail.com Mr Timothy Maloney Marilyn Collins Care Home 25 Category(ies) of Dementia - over 65 years of age (14), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (9), Old age, not falling within any other category (25) Oaklands Rest Home DS0000011786.V347663.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th December 2006 Brief Description of the Service: Oaklands Care Home is a large detached house situated at the southern end of Waterlooville, near Portsmouth, and is close to local shops and the main bus route. On the day of this visit Oaklands Care Home was registered to provide personal care for up to twenty-five older people. At the end of October the number was increased and in future the home will be able to accommodate and provide personal care for thirty older people who have a diagnosis of dementia related behaviours, but do not need specialist care or support. There will be twenty-two single and four shared bedrooms. Eleven of the single rooms have en-suite facilities. The home will have a new reception area with seating for the residents, a new large lounge and a dining room. There is a passenger lift to provide access to all floors. There is a secure back garden and a patio area, with car parking spaces at the front of the home. The manager informed us that the current weekly fees are £400 – 650, depending on care needs and accommodation. Fees for hairdressing or chiropody are billed separately. Oaklands Rest Home DS0000011786.V347663.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The evidence used to write this report was gained from a review of the information the provider sent to the Commission for Social Care Inspection (CSCI) and an unannounced visit to the home on 4th October 2007. The information provided included an Annual Quality Assurance Audit [AQAA], which had been completed by the manager and returned to us and other information that has been provided since the last inspection, such as accident reports. During the site visit we spoke with ten residents, six visitors, the manager, the provider, the care and domestic staff on duty and the cook. We were able to see different parts of the home, such as the kitchen, dining room, bathrooms and some of the bedrooms, we were also able to see the new bedrooms in the extension. Documents relating to the residents, staff, policies and procedures and documents regarding the running of the home were seen during the visit. What the service does well: What has improved since the last inspection? The care plans have been improved and now contain records of the care given to each resident. The procedure for ordering medication has been reviewed and there are clear records of all medication ordered. The extension has been completed and shortly a large, light and airy sitting room and five extra bedrooms will be available. Oaklands Rest Home DS0000011786.V347663.R01.S.doc Version 5.2 Page 6 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 Rest Home DS0000011786.V347663.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 Rest Home DS0000011786.V347663.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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. People wishing to use this service benefit from a comprehensive pre-admission assessment of their needs before moving into the home. The home does not provide intermediate care. EVIDENCE: The home has recently seen the completion of some building works, which will shortly provide an extra five bedrooms and a new large lounge. During the reregistration process the provider has decided to amend the registration category for the home. The home will provide social or personal care for people who have a diagnosis of dementia related behaviours, but do not need specialist care or support, so the home will be registered just in the older people [OP] category. Oaklands Rest Home DS0000011786.V347663.R01.S.doc Version 5.2 Page 9 The statement of purpose and service users guide are currently being amended to reflect the proposed change in registration, which will explain that the assessed care needs of potential residents will indicate a primary need for personal and social care, with possibly some low-level dementia related needs. The home does not provide nursing care and or specialist dementia care. The manager said that she visits all potential residents in hospital or in their own home prior to admission and completes a thorough assessment of their needs. The personal care records that were seen indicated that the assessments were detailed and included a family history. Care management assessments are also sought as part of the pre-admission assessment and they also provide information that is used in the care planning process. The manager said that friends and relatives are encouraged to help in the assessment process to ensure that as much information as possible is gathered and is up to date. The home does not provide intermediate care Oaklands Rest Home DS0000011786.V347663.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning ensures residents have all their needs met. Medication administration practices protect the residents EVIDENCE: As part of the inspection process the care plans of three residents were looked at to assess the information provided about how the staff planned to meet the individual needs of the people living there. Everyone living in the home had care plans in place, those looked at by the inspector were seen to contain information about personal hygiene, mobility, continence, dementia care needs, any equipment needed, communication, risk of falls and moving and handling assessments. The care plans ensure a person-centred care plan that provides information about the type of support given with personal care on a daily basis. A separate page was used by the visiting GP or other healthcare professional to record their visits. The need for more in-depth nutritional assessments was discussed and the manager said that she has recently Oaklands Rest Home DS0000011786.V347663.R01.S.doc Version 5.2 Page 11 obtained new assessment information and guidelines, which she will be implementing shortly. Risk assessments for the residents have been constantly reviewed during the homes building work and the manager said that new ones would shortly be in place now that the new bedrooms and sitting room were being used. The home has medication policies and procedures in place for the receipt, storage, return and administration of medication, which are followed by the staff. An action point raised at the last visit indicated that the procedure for ordering medications or repeat prescription needed to be revised, this has been completed and is now working well. None of the residents administer their own medication. The home has a homely medicines guidelines signed by the GP, which allows staff to give certain over the counter medications that have not been prescribed, such as paracetamol for a headache. A sample of medication administration record [MAR] sheets were looked at and no gaps in recording were seen. These are the records that are kept of all medication received into the home and are also a signed record of when medication is given to a resident. It is clearly documented when a resident has not take the medication and the reason why the medication has not been taken. The manager told us that staff receive medication administration training from an external trainer, which includes a theory workbook, questionnaires and evaluation by the trainer. The manager is a registered nurse and carries out the in-house practical supervision for the staff. People living in the home and their visitors said that they were happy with the care provided at the home and that the staff were very helpful and friendly. They felt they were always treated with dignity and respect and their right to privacy was upheld – ‘ nothing is too much trouble’ ‘excellent care’ Oaklands Rest Home DS0000011786.V347663.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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have good quality food and their diverse needs are generally well supported. EVIDENCE: Information in the AQAA indicates that the home provides a variety of entertainment which is enjoyed and appreciated bt the people living there. The home employs an activities organiser who works in the home every afternoon. Activities that have been organised recently include armchair exercises such as ball games, musical afternoons, reminescence sessions with daily games and sing-song sessions. Communion is held monthly in the home and ladies from the church also provide ‘Bright Hour’ sessions, which are christian meetings. The hairdresser visits regularly and was in the home on the day of the visit so that everyone could have their hair done for the garden party and ‘open day’ at the weekend, which was a party to celebrate the completion of the building work in the home. The manager said that families and support agencies had Oaklands Rest Home DS0000011786.V347663.R01.S.doc Version 5.2 Page 13 also been invited to the party so that they could see the improved facilities that would be available. The manager told us that there is an open visiting policy, residents families and friends are free to visit as they wish and meals can be provided on request. She also said that there are virtually no rules for the residents as it is their home, however for security reasons visitors wishing to attend after 8pm are requested to inform staff. The cook has worked at the home for many years and said that the menus are based on the known likes and dislikes of the people living in the home. The meals are planned to be appetising, nutritious and suitable for the residents, such as those who need their food pureed because of swallowing difficulties. Choices are available at each meal, but often the residents do not remember what they have chosen. The residents now use the new sitting room, which has ensured there is now more room available in the dining room. Meals are not plated-up in the kitchen but are served from the sideboard in the dining room, so that the residents can say exactly what they want to eat and how much. The inspector was invited to join the residents for lunch and was able to sample home made steak and kidney pie, which was enjoyed by all the residents. Oaklands Rest Home DS0000011786.V347663.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff training in adult protection, and the knowledge that all complaints are dealt with appropriately usually safeguard the people who use this service. EVIDENCE: Visitors that spoke to us said that they knew they could talk to the staff or the manager if they had any concerns and complaints and they felt confident that the matter would be responded to appropriately. A copy of the complaints procedure is prominently displayed within the home and is also contained in the service users guide and statement of purpose. No complaints have been received at the home since the last inspection. Polices and procedures are in place regarding the protection of vulnerable adults and the action to be taken in the case of suspected abuse. The AQAA indicates that staff have a clear understanding of adult protection and their ongoing training ensures that the residents are protected. Discussions with staff indicated that they have a good understanding of abuse and will know the correct action to take if they suspect abusive practices have happened in the home. Oaklands Rest Home DS0000011786.V347663.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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service live in a safe, well maintained, clean, and hygienic home EVIDENCE: The home has a warm and welcoming atmosphere, but was dusty in parts and disorganised on the day of the visit because the building work had just been completed and the site was being cleared and cleaned up. Risk assessments of the environment have been completed to ensure that people living in the home are protected from risks associated with the building and environment of the home. Oaklands Rest Home DS0000011786.V347663.R01.S.doc Version 5.2 Page 16 The residents are accommodated in a warm and clean environment, with no malodours. Accommodation is provided on two floors with a passenger lift and stairs giving access to all areas of the home. The AQAA indicates that the home has a policy of continual assessment of the fabric of the buildings and the grounds. Management meetings highlight areas of concern and a programme is drawn-up for issues which arise in this area which includes a policy of continual tree trimming as many trees grow very close to the buildings, which shuts out natural sunlight. The new extension will provide five extra bedrooms and a large sitting room for the residents. A new washing machine has been installed in the laundry and it is planned that a separate room will now be used for the clean laundry. The building work will also provide a reception area and new store rooms for the kitchen stores and cleaning materials. The manager told us that ‘sun-pipes’ have been installed to provide more sunlight in the sitting room and corridors and a new condensing boiler has been installed for all central heating and hot water needs. We were told that the garden will be landscaped later in the year. We saw the kitchen, laundry, communal areas and some of the bedrooms, which the residents had personalised with their own possessions, such as photographs, pictures and ornaments. Information and training on infection control was available to staff and observation during the day indicated that staff were aware of this and used protective equipment, such as gloves and aprons, when necessary. Oaklands Rest Home DS0000011786.V347663.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Robust recruitment practices and staff training protect people who use this service. EVIDENCE: The AQAA indicates that the home employs the appropriate skill-mix of staff to meet the needs of the residents. The staff rota seeks to provide a balanced skill-mix for each shift by taking into account the experience and leadership qualities of individuals. There is a strong management team in place, which leads from the front providing supervision which is positive but sensitive. The home employs sixteen care staff, thirteen full-time and two part-time, who are supported by seven ancillary staff. The roster indicates that there are usually five staff on duty in the morning, three in the afternoon/evening and three at night. The manager said that the staffing numbers would be assessed to ensure they could meet the needs of the new residents when they are admitted. The manager told us that staff do the Skills for Care induction programme as well as the in-house induction training when they first start work in the home. Staff training records show that training has included health and safety, manual handling, medication administration, dementia awareness and fire Oaklands Rest Home DS0000011786.V347663.R01.S.doc Version 5.2 Page 18 safety. Training booked for the weeks following the inspection included manual handling and fire safety. The manager told us that ten of the staff have competed a National Vocational Qualification [NVQ] in social care and three more were currently on the course. This exceeds the national expectation that at least 50 of all care staff in a home will have an NVQ at level 2. Staff told us that the dementia training has helped them, giving a better understanding of the needs of the residents. They also said that they are happy working in the home as the manager is very supportive and the resident’s families are friendly. Observations made during the day by the inspector confirmed that the residents and staff have developed good relationship together and staff were seen to treat the residents with dignity and respect, speaking to them quietly and knocking on doors and waiting for a response before entering The home has recruitment polices and procedures in place. The three staff files that were seen indicated that these procedures were followed. All the statutory checks required, such as a reference from a previous employer and a satisfactory Criminal Records Bureau [CRB] disclosure where obtained before employment started in the home. Oaklands Rest Home DS0000011786.V347663.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, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service are usually safeguarded by good management EVIDENCE: The manager is a registered nurse and has the experience and skills to manage the home, having worked in senior positions in other care homes. She has completed her NVQ 4 and the registered manager’s award (RMA). She continues to undertake further training to develop her professional and clinical practice and is able to support and encourage staff to provide very good care. Staff said the manager open and approachable, welcoming comments and suggestions from residents, staff and relatives. Oaklands Rest Home DS0000011786.V347663.R01.S.doc Version 5.2 Page 20 The home had a large number of comprehensive policies and procedures, which are available and accessible to the staff. The manager has developed a quality assurance system and sends out questionnaires to relatives, residents and other healthcare professionals. The results of these questionnaires are being collated and will be made available to all interested parties. Friends and relatives, who were visiting the home on the day of the visit were very positive about the staff and the management of the home, saying ‘it’s a lovely place,’ ‘staff are lovely – warm and friendly’ ‘my Mum is well looked after, everyone is friendly’ Records indicated that staff attended regular and compulsory fire and other health and safety training, a new fire alarm panel has been installed recently and emergency plans were in place. The manager said there had been many false alarms and fire drills during the building work and the usual fire alarm checks had not been recorded every week on the correct page. There was a fire risk assessment for the premises and regular risk assessments of the premises were undertaken. There were also up-to-date certificates for the homes fixed electrical wiring, portable appliance testing and for gas safety. No outstanding health and safety issues were observed during the inspection visit and records showed that all equipment was regularly serviced. The manager told us that a new storeroom has been built to store all hazardous cleaning materials and there is a lock on the sluice room door. Oaklands Rest Home DS0000011786.V347663.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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 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 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Oaklands Rest Home DS0000011786.V347663.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. Refer to Standard Good Practice Recommendations Oaklands Rest Home DS0000011786.V347663.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Rest Home DS0000011786.V347663.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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