Inspection on 15/11/05 for Oaklea Nursing Home

This inspection was carried out on 15th November 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Oaklea Nursing Home 27/02/07

Oaklea Nursing Home 04/08/05

Oaklea Nursing Home 17/12/04

Oaklea Nursing Home 22/07/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Oaklea Nursing Home 2 - 4 Eastbourne Road Linthorpe Middlesbrough TS5 6QW Lead Inspector Katherine Acheson Unannounced Inspection 15th November 2005 10:30 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 Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 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. Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Oaklea Nursing Home Address 2 - 4 Eastbourne Road Linthorpe Middlesbrough TS5 6QW 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) 01642 819667 01642 819667 Oaklea Nursing Home Ltd Mrs Elaine Bloomer Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability over 65 years of age (0) of places Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named Service User who is under the registered age category may reside at the home. 4th August 2005 Date of last inspection Brief Description of the Service: Oaklea Nursing Home is registered to provide personal and nursing care to twenty residents aged sixty-five and above. The home is situated on Eastbourne Road, Middlesbrough, and is close to Linthorpe Village and other local amenities. The home has been converted from two houses and provides accommodation in the form of fourteen single bedrooms and three double bedrooms. All bedrooms meet with size requirements of National Minimum Standards, however, do not have ensuite facilities. There are two lounge areas and a separate dining room. The home is set in its own grounds and has a large patio/garden area to the front of the property. Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection started at 10:30pm and lasted for six and a half hours. Four residents, two relatives and the Manager were spoken to during the inspection. Staff were spoken to informally. Numerous records including medication, policies/procedures, menus, and staff recruitment and training records were examined. A tour of the home was carried out. Requirements highlighted at the last inspection in August 2005 were re-visited. What the service does well: What has improved since the last inspection? What they could do better: The home’s medication policy requires further development. The Manager must take immediate action to ensure safe dispensing and administration of medication to residents, pre-potting of residents medication must stop with immediate effect. Staff files require to be updated to include a photograph of the staff member and the Manager must ensure that she explores any gaps in employment for prospective staff. The homes induction needs to be updated to include all of the required information. The sluice requires full refurbishment. Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 Page 6 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. Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 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 Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: The above standards were not inspected, however requirements highlighted at the last inspection in August 2005, were re-visited. The home has developed a combined statement of purpose/service user guide that is easy to read, well presented and contains all of the required information. The Manager has also updated the homes statement of terms and conditions/contract. Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 Poor practice in respect of dispensing and administering of medication is taking place and as such residents are not protected. EVIDENCE: The home has a policy/procedure in respect of medication systems that are in place in the home, however this requires to be updated to include new procedure for return/disposal of medication. Appropriate systems were in place for ordering, recording of medication coming into the home and medication dispensed and administered to residents, however the home are not keeping a record of medication returned to licensing company for disposal. It became evident during the inspection that staff at the home are dispensing medication into labelled medication pots for a number of residents at the same time. Staff at the home were informed that this practice must stop immediately and that medication must be dispensed and administered to residents individually. Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 Page 10 Records were examined to confirm that staff at the home take and record the temperature of the medication fridge on a regular basis, however, some recordings were observed to be too warm. The Manager said that at this moment in time there is not any medication in the home that was required to be stored in the fridge, however that she would purchase a new fridge within the next week. It was highlighted at the last inspection that the Manager must carry out an audit of the accident book, highlight any resident at risk and develop a risk assessment. Examination of records confirmed that this had been addressed. Four residents were spoken to during the inspection, all expressed satisfaction with the Manager staff and care received. One resident said, “Matron is a lovely woman, the girls are very good, I couldn’t speak more highly of it”, another said, “The staff are good, they do all they can for you”. Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 Residents in general are happy with the food provided, however, the homes four-week menu plan is very repetitive and as such does not provide variety of food to residents. Liquidized meals are not presented to residents in a manner, which is attractive or appealing. EVIDENCE: The home offers a four-week menu with an alternative choice available at each mealtime. Records were available to confirm that appropriate temperature checks are carried out on fridge, freezers and food. Records of food provided were available for inspection. Three residents were spoken to during the inspection two of which said that they liked the food that is provided, one who said, “The food could be better, it’s the same thing over and over again”. Menus examined did show that there was a four-week menu in place, however, this was very repetitive with the same food being provided a number of times within the four-week cycle. Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 Page 12 Mealtime was observed to be relaxed in pleasant surroundings. A discussion took place with the cook during the inspection regarding the liquidized food that was being provided. Food provided to those residents that required a liquidized diet had all been mixed together and as such did not look appetizing or attractive. The cook said that she would take steps to liquidize each food separately for residents. The food was sampled during the inspection and found to be tasty and well presented. Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 The home provides effective arrangements to ensure that residents are enabled and supported to make any complaint they consider necessary. The home’s adult protection policy/procedure and training that staff have received helps protect residents from abuse. EVIDENCE: The home has a complaints policy/procedure in place. Records examined confirmed that the home have an effective system in place to ensure that complaints are handled efficiently. Complaints received are recorded individually ensuring confidentiality and data protection. Residents spoken to said that they felt able to approach the Manager and staff and make any complaint necessary. The home has an adult protection policy/procedure in place which details action that staff must follow if abuse is suspected. The Manager said that staff at the home have received adult protection training, documentary evidence was available on staff files examined at random to confirm that this was the case. Residents spoken to during the inspection confirmed that they felt safe living at the home. Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26 The home is warm, welcoming and friendly. Re-decoration and replacing the carpet in those areas identified would enhance the home environment for residents. Screening in shared bedrooms is in a poor state of repair; screening is not suitable or safe. The sluice in the home is need of refurbishment to ensure that safe working practice and minimise risk of cross infection. EVIDENCE: A tour of the premises found the home to be warm, welcoming and friendly. Suitable communal space is provided for residents and these areas are decorated in a homely and comfortable manner. Since last inspection the dining room has benefited from re-decoration, new carpet and new dining room furniture. Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 Page 15 Residents’ bedrooms are homely and personalised with many personal belongings being evident, however the carpet in bedroom 8 was worn and required replacement. Bedroom 5 was observed to need the ceiling repairing and painting. Bedrooms have benefited from new curtains and bedding, a number of worn chairs that were identified at the last inspection have also been replaced. A walk round of the home identified that portable screens are being used in shared bedrooms. Screens were observed to be in a poor condition, and presented as a hazard as they could easily be knocked over. The Manager has developed a refurbishment plan for renewal of worn furniture in bedroom areas. The home’s toilets/bathrooms and showers were observed to be of a satisfactory standard, however one toilet on the ground floor requires painting. The Manager said that all showers, sinks and baths in the home environment are temperature regulated and that staff at the home take and record the temperatures on a regular basis to ensure that they are within normal limits. Records were available to confirm that this was the case. The Manager said that the home has one mobile hoist, a number of bath aids, and other specialist equipment available for resident use. On the day of the inspection the home was clean and odour free. One resident spoken to during the inspection said, “My bedroom is lovely, they keep it so clean” another said, “I like my bedroom very much, I can do what I like in my own room. Staff asked me what colour I would like to have it painted”. It was identified at the last inspection that the sluice requires refurbishment, the Manager said that a number of tiles had been replaced, however this was not of a satisfactory standard. A full refurbishment of the sluice is required this must include, flooring, walls and surfaces. The Registered Provider had still not replaced the kitchen flooring, however this is still within timescale for completion of 30th November 2005. Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Staff receive appropriate training to ensure that care needs of residents are met, however, the home’s induction training requires further development. Not all gaps in employment for prospective staff are explored and as such residents are not protected. EVIDENCE: Staff rotas examined during the inspection confirmed that the home is working with the appropriate number of care staff on duty, however it was observed that the Manager does not always get her two supernumerary days per week to carry out managerial duties. Two staff files were examined at random during this inspection. Staff had received appropriate POVA first/Criminal Record Bureau checks, had proof of identification and two references on file. Examination of one staff members file identified that the Manager had not explored possible gaps in employment. Both files did not contain a photograph of the staff member. Staff files examined confirmed that staff had received induction training, however this was basic and requires further development. A discussion took place with the Manager regarding the new induction standards that are to come into force in September of next year. Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 Page 17 Mandatory and other training relevant to the job has been provided to staff. 55 of care staff at the home are trained to NVQ level 2 in care. Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 Appropriate quality assurance systems are in place to ensure that the home is run in the best interest of residents, however, the results/findings of the survey are not made available to residents and their representatives. EVIDENCE: The Manager, Elaine Bloomer is a first level Registered Nurse who has worked in the nursing and social care environment for many years. Elaine also has a NVQ level 4 in Management. Residents spoken to during the inspection spoke highly of the Manager, staff and care that is received. One resident spoken to during the inspection said, “The Manager is top of the bill”. Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 Page 19 The Manager has a quality assurance system in place. A survey/questionnaire is sent out to residents and relatives on a yearly basis asking if they are happy with the care that is being received and other areas relevant to the resident and home. A discussion took place with the Manager regarding publishing the results of the survey. It was highlighted at the last inspection that the home’s fire alarm system must be serviced on a regular basis and that the certificate of the service must be available for inspection. Records were evidenced during this inspection to confirm that the home’s fire alarm system was serviced on 10th August 2005. It was also highlighted at the last inspection that records of fire drills that include evacuation of residents must be kept. The Manager said that she had carried out a further evacuation, however this has still not been documented. The Manager said that she would take immediate action to address the situation. Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 Page 20 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 3 3 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 2 3 2 2 2 2 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X X X X 2 Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP20 Regulation 16, 23 Requirement The flooring in the kitchen must be replaced (Previous timescale for action of 30th June 2005 not met) The sluice requires a full refurbishment, including floor, walls and surfaces (Previous timescale for action of 30th June 2005 not met) Records of fire drills that include evacuation of residents must be kept and include staff signatures as proof as attendance (Previous timescale for action of 30th September 2005 not met) The Manager must keep a record of all medication returned or disposed of Staff at the home must dispense and administer each resident’s medication individually. Potting up of medication must not occur The Manager must obtain a secure fridge in which to store medication The home’s medication DS0000000194.V251004.R01.S.doc Timescale for action 30/11/05 2 OP21 23 30/11/05 3 OP38 23 10/12/05 4 5 OP9 OP9 13 13 30/12/05 15/11/05 6 7 OP9 OP9 13 13 22/11/05 30/12/05 Page 22 Oaklea Nursing Home Version 5.0 8 9 10 11 OP15 OP15 OP21 OP24 16 16 16, 23 16, 23 12 13 14 15 OP24 OP24 OP27 OP29 16, 23 16, 23 18 17 16 17 18 OP29 OP30 OP33 17 18 24 policy/procedure must be updated to include new procedures/guidance for returning of medication Liquidized meals must be presented in a manner which is attractive and appealing The Manager must consult with residents and review the home’s menu The toilet on the ground floor must be painted Shared bedrooms must be provided with suitable screening in order to ensure privacy and safety of residents The carpet in bedroom 8 must be replaced The ceiling in bedroom 5 must be repaired and painted The Manager must be supernumerary 2 days per week The Manager must ensure that all gaps in employment are explored for prospective staff members Staff files must be updated to include a photograph The home’s induction must be updated to include all of the required information The results from the quality assurance survey must be published and made available to residents and their representatives 15/11/05 15/11/05 30/04/05 30/12/05 30/04/05 30/12/05 15/11/05 15/11/05 30/12/05 30/01/06 30/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 Oaklea Nursing Home DS0000000194.V251004.R01.S.doc Version 5.0 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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