Inspection on 06/05/09 for Oaklodge Care Home

This inspection was carried out on 6th May 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oaklodge Care Home 25/02/10

Oaklodge Care Home 23/05/07

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Little Sisters Of The Poor

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Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 10/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Oaklodge Care Home Oaklodge Care Home Stockton Street Haughton le Skerne Darlington Co.Durham DL1 2RY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jean Pegg     Date: 0 6 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Oaklodge Care Home Oaklodge Care Home Stockton Street Haughton le Skerne Darlington Co.Durham DL1 2RY 01325381135 01325381020 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Care Stream Ltd care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Oaklodge Care home provides nursing and residential care to older people. The home is registered for up to 28 service users. The home is spread over three floors the ground floor has 11 bedrooms, one of which is a double bedroom. It also has two bathrooms a lounge and a dining room. The first floor has 10 bedrooms a lounge/dining area and a bathroom. The second floor has a bathroom, one double room and 4 single bedrooms. The home meets those environmental standards required for services in existence prior to April 2002. There is a small patio area to the rear of the property. The home is situated within Haughton Village and is close to the town centre. There are local shops and amenities nearby. Care Homes for Older People Page 4 of 26 Over 65 28 0 Brief description of the care home The current weekly charge for residential care at Oaklodge is three hundred and fifty five pounds. Nursing costs vary. Goods and services not included in that overall charge are, newspapers, toiletries, and transport. There is no standing charge for these and costs vary according to the service users own preference. If the service user wishes, Oaklodge will arrange private chiropody at ten pounds per session. Please contact the manager for details of costs and what they cover. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection for this service was carried out 23 May 2007. In November 2008 Care Stream Ltd. went into administration with Vantis Business Recovery Services being appointed as administrator. Vantis Business Recovery Services have appointed Care Home Management Ltd to act as their managing agents. Oaklodge is continuing to trade as a going concern. This unannounced inspection visit took place on 6 May 2009 and lasted for six hours. To complete this inspection we asked the registered manager to complete an annual quality assurance self assessment document which provides us with information about what has happened in the service during the last twelve months. The manager completed this document and returned it to us before the inspection visit. We also sent out surveys to the people who live and work at the home and to other social and health care professionals who are involved in their care. We received nine surveys back from Care Homes for Older People Page 6 of 26 the people who live at the home, ten back from people who work at the home and none back from the other social and health care professionals. When we visited the home we had a look around the building both outside and inside to see if it was clean and well maintained. We also looked at documents and records held by the home and talked to different people who live and work at the home. What the care home does well: What has improved since the last inspection? What they could do better: Care plans should contain more detail about the type of equipment that is to be used as part of a persons daily care and the manager should make sure that there is always a record of the number of tablets left that are kept in boxes in the home. The manager should make sure that a replacement fridge for the storage of medication is obtained as soon as possible. The manager should continue to provide a staff training programme that will keep staff Care Homes for Older People Page 8 of 26 skills and knowledge up to date. Staff should receive regular refresher training in the Protection of Vulnerable Adults. The registered manager must be sent a copy of the regulation 26 monthly visit report when it has been completed by the managing agent. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information about the home and its Terms and Conditions of Residency are available to people who might be interested in living at the home. Evidence: As we walked around the building we noticed copies of the service user guide in peoples bedrooms. This guide provides information about the home and the people who work there. Our survey that was sent to people who live at the home told us that eight of the people who responded said that they had received enough information about the home to help them decide about moving there. We were told Friends visited before I moved in. and My sister and I liked it. We asked to see copies of the contracts that were provided to people who fund their care privately. We were told that contracts had not been given. When it was pointed out that the regulations said that people should be provided with a contract that outlined the terms and conditions of residency, the manager contacted the Care Homes for Older People Page 11 of 26 Evidence: administrator who is looking after the company and a guarantee was given that contracts would be provided. The Care Quality Commission have been sent a copy of the contract that will now be used in the home. We looked at three care plans to check that pre admission assessments had been completed for people who had been admitted to the home. We found that the correct documentation was in place. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at the home have their health and personal care needs met by the staff who work at the home and other health care professionals. Evidence: The staff survey told us that all ten of the people who responded said that they are given up to date information about the needs of people they care for. We were told We have up to date review on all our residents before we commence our shifts. and I am a new carer and I was shown the care plans on my first day of work. One person told us that Sometimes I would like more detailed information. The survey also told us that communication about the needs of people who use the services of Oaklodge works well. We do a handover so we learn any thing new that may have happened that day. During our visit we checked three care plans. Of the three plans two had up to date reviews completed. One was slightly out of date having last been reviewed on 29 March 2009. The content of the care plans was quite detailed and it was clear when a care need was no longer relevant. To indicate this staff had recorded the date and a statement saying discontinued. This shows that people are having their needs reassessed and are only provided with the care they need. We did recommend Care Homes for Older People Page 13 of 26 Evidence: that the care plans should contain more detail about the type of equipment that is to be used with each person for example pressure relieving equipment. All nine of the people who live at the home who returned surveys to us indicated that they receive the care and support they need including medical support. We were told Staff are easy to approach. I have no difficulty when I need them, and they are easy to talk to. All in all a comfortable home. and The support is always there when you need it. Every time I want one, I get a doctor. and I am very comfortable and my family are pleased with my care. The records held within the care plan showed that people were being visited by a number of different specialist health care professionals. The dentist was also visiting the home the day we were there. The deputy manager showed us how medication is ordered and stored in the home. We could not undertake a stock check for tablets held in a box rather than the nomad system (a monitored dosage system prepared by the pharmacist.) This was because no record had been made of the stock that should have been carried forward. The fridge was not in use as it was leaking. The manager was in the process of trying to locate another fridge to use for medicines. We checked the controlled drugs and found them to be satisfactory. The manager said that they had recently been audited by the Primary Care Trust pharmacist and that this audit had gone alright. We did not witness any disrespectful behaviour to wards the people who live at the home whilst we were there. One person told us I enjoy myself in here. I would have been a goner otherwise. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at the home are provided with choices and stimulation that suits their needs and expectations. Evidence: In our survey we asked people Are there activities arranged by the home that you can take part in.? These are some of the responses made. Go to pub for a pint. and There is activities but I dont always take part for example jumble sales and parties.and There are activities but thankfully not too many. Old folk do seem to need plenty of rest. One person gave us an example of what was on offer. Knitting, walking, games, singing, dancing, gardening. and Dominoes, sing song, board games, quiz. The home has appointed an activities coordinator. They spent some time with us to explain how they carry out their role. We were shown some of the work that people had completed during some of the group sessions and we were told about how one to one activities are carried out. We also saw some of the comments that relatives had made about the new activities programme. Ideas are fresh and appropriate for the people X is dealing with. We particularly like the way they are trying to involve families with the activities. Also all of the residents are being catered for which is essential. and X has not just made suggestions and had ideas.... but put them into practice most successfully. The notices are great and informative and the Care Homes for Older People Page 15 of 26 Evidence: latest idea of a relatives meeting is spot on. In the uncertain future of Oaklodge regarding it being in administration, it can only be of the good that a more happy and active time for the resident bodes well for the home. We observed a meal time and noticed that people were served their meals in a pleasant manner and that those who needed help got it. The menus are prepared by the chef and alternatives to the menu are available on request. The notice board in the dining room advertises this. The annual quality assurance document that the manager had completed for us showed that nutritional screening is carried out but that staff have not received training in malnutrition care and assistance with eating. The manager explained that they were in contact with a training provider who was going to deliver this training once staff had completed their National Vocational Training awards. We looked around the kitchen and checked the food stores. All were satisfactory. The home has been awarded a four star rating by the Tees Valley Food Hygiene Awards. One lady that we spoke to told us that the food was good and that she did not want to leave the home. These are some of the comments made by the people who returned surveys to us. Enjoys all meals They vary, yes I like the food. always nice and always have a choice. No complaints, good food, nothing goes back. Always empty my plate. Good meals and a comfortable atmosphere. Good Food Definitely cant grumble about them. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are responded to and people are protected in the home. Evidence: The annual quality assurance document that the manager completed indicated that there had only been one complaint during the last twelve months. The Care Quality Commission were aware of this complaint had had been sent copies of the investigation and responses. The complaints procedure was out of date regarding names that people should refer to. This procedure was taken out of public view, updated and replaced during our visit. From the staff survey all ten people indicated that they knew what to do if anyone had concerns about the home. I always document and pass on any concerns straight to my matron or nurse in charge. and I refer them to a nurse in charge or our manager. We also asked the people who live at the home Do you know who to speak to if you are not happy. These are some of the responses we got. I will talk to staff members. and There is always someone to help. Matron , nurse in charge A carer or the matron. We also asked Do you know how to make a complaint? all nine people who live at the home said yes. One person commented The home is brilliant. I love the staff all of them and want to stay here. There have been no Adult Protection Referrals or investigations carried out during the last twelve months. The manager told us that the staff had received a twelve week training programme in Protecting Adults but that their training was due to be renewed. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is clean and well maintained. Evidence: We looked around the home and noticed that although some items of furniture were old they had been well cared for. There was evidence of some redecoration work being carried out. The home was lived in but clean and tidy. There were no unpleasant odours noticed during the visit. The grounds were tidy and there were areas for people to sit outside. In our survey, we asked the people who live in the home Is the home fresh and clean. This is what they told us The women never stop cleaning. Well I think so. Staff do their best in here. Comfortable, warm and fresh and clean. Cleaners are in every day and are friendly. Care Homes for Older People Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that has sufficient numbers of qualified and trained staff to meet their needs. Evidence: For the twenty three people that live at the home there are four carers and one nurse on duty from 8am until 4pm, between 4pm and 8pm there is one nurse and three carers and during the night one nurse and 2 carers. In addition the home employs a manager, an administrator, handyman, domestic staff, laundry assistants and kitchen staff. The staff survey indicated that all ten people who responded think that there is always or usually enough staff on duty to meet the individual needs of all the people who use the service. We were told We all work together as a team. We asked the people who live at the home are staff available when you need them.? They replied Usually. adding Staff are busy but always do everything I want.and Cant expect them to do all at once, very busy people on the other hand they are there when you want.and When I ring the bell I always get seen to. Half of the care staff are trained to at least National Vocational Qualification Level 2 in Care. Three more staff are currently studying for the award which will give them 75 of qualified care staff when they complete the award. We selected the file of a new member of staff and checked that all of the relevant Care Homes for Older People Page 19 of 26 Evidence: checks had been completed before they started working at the home. We found that all checks had been carried out and that the documentation was up to date. The staff survey indicated that all ten staff who completed the survey said that their induction covered everything they needed to do the job when they started and that they are given training which is relevant to their role. These are some of the comments they made I would like to do more in house training to understand more. and As a new carer Im just getting used to the residents and learning about their individual needs so I am getting hands on training all the time. The manager admitted that staff training was not as up to date as she would like it to be but that there were plans in place to provide training to staff. On the day of our visit Fire Safety training was taking place and there were plans to provide Focus on Food training and Palliative Care training to staff. The home had also taken part on a training needs analysis exercise carried out by the Primary Care Trust. It is expected that trained nurses at the home will benefit from training as a result of this exercise. Care Homes for Older People Page 20 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is well managed. Evidence: The home is managed by a qualified nurse who has a Nurse Managers Award. The manager has been at the home since 2005. The records we looked at showed that the manager has a system for checking quality in the home and that relatives have been invited to give feedback about the home. We saw these completed surveys which were generally very positive. We were told that the person who is acting on behalf of the responsible individual visits the home regularly. We asked to see copies of the reports of these visits as required by regulation 26 of the registered care homes act. Unfortunately none were available in the home for us to see. The manager showed us a copy of the annual development plan which included continued staff training, refurbishment of the home and social meetings for the people who live at the home. Care Homes for Older People Page 21 of 26 Evidence: We checked the records of the finances held on behalf of two people living at the home and found that these were accurate. The results of the staff survey showed that all ten said that they regularly met with the manager to discuss how they are working. We were told I feel comfortable asking my manager for help or advice if I need to. We were shown an up to date supervision schedule. We checked the maintenance records and service contracts for equipment in the home and found them to be up to date. A health and safety audit was completed by the local authority Environmental Health Department in 2008. Care Homes for Older People Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 33 26 The registered provider 30/06/2009 must provide a copy of the written report to the registered manager on the conduct of the home following their monthly visit. This report must be available in the home for inspection by the Care Quality Commission. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 Care plans should contain more detail about the type of equipment that is to be used as part of a persons daily care. The manager should make sure that a replacement fridge for the storage of medication is obtained as soon as possible. The manager should make sure that accurate stock balances are recorded for medications held outside of the NOMAD system used. 2 9 3 9 Care Homes for Older People Page 24 of 26 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 4 5 18 30 Staff should receive regular refresher training in the Protection of Vulnerable Adults. The manager should continue to implement a staff training programme that will keep staff skills and knowledge up to date. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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