Inspection on 12/09/06 for Oaklodge Nursing Home

This inspection was carried out on 12th September 2006.

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

Oaklodge Nursing Home 17/10/05

Oaklodge Nursing Home 21/12/04

Oaklodge Nursing Home 22/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Oaklodge Nursing Home 2 Silverdale Road Burgess Hill West Sussex RH15 OEF Lead Inspector June Hough Key Unannounced Inspection 12th September 2006 09:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Oaklodge Nursing Home DS0000024188.V309346.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. Oaklodge Nursing Home DS0000024188.V309346.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oaklodge Nursing Home Address 2 Silverdale Road Burgess Hill West Sussex RH15 OEF 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) 01444 243788 Dr Dhananjay Dalmond Dr Dhananjay Dalmond Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Oaklodge Nursing Home DS0000024188.V309346.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 17th October 2005 Brief Description of the Service: Oaklodge is a care home providing nursing care and registered to accommodate up to twenty-five service users in the category OP (persons over 65 years). It is a detached property located in the town of Burgess Hill, close to shops and transport networks. The accommodation is arranged over three floors, which are all served by a passenger lift. Most of the private accommodation is for single occupancy although there are four shared bedrooms. There are two communal sitting rooms with patio doors leading to the garden and a dining room. Oaklodge Nursing Home DS0000024188.V309346.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over 6 hours and the registered manager/proprietor Dr Dalmond was present at the inspection and provided the information required. Some documents were requested prior to the inspection that also provided evidence for this inspection report. A tour of the premises took place and staff, residents and visitors were spoken with. Records were examined in relation to resident’s assessments and care plans, medication records, complaints log, staff recruitment files, policies and procedures and maintenance records. There were 20 permanent residents and one resident on respite care accommodated in the home on the day of inspection. This was a key inspection and the key standards were assessed. There were no requirements made as a result of this visit. The current scales of fees are from £525.00 to £650.00 per week. What the service does well: The home has a relaxed and homely atmosphere and was well maintained. Residents and relatives feedback was positive about the services offered by the home. Staff have the skills and experience individually and collectively to deliver the care required. The residents appeared well cared for and content in their surroundings. Comments from residents said the staff were very kind and caring and didn’t mind what they did for you. Residents were able to choose how they spent their day, and were encouraged to pursue their own hobbies and interests as part of the home’s activities programme. Visiting arrangements are open and relatives can receive visitors in their own rooms or in communal areas. Meals were varied and well balanced and residents commented that the food was good and there was always plenty to eat. Oaklodge Nursing Home DS0000024188.V309346.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Oaklodge Nursing Home DS0000024188.V309346.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 Oaklodge Nursing Home DS0000024188.V309346.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6. Quality in this outcome is good. This judgement has been made using available evidence including a site visit to this service. A pre-admission assessment is carried out on all residents wishing to move into the home, to ensure the home is able to provide the individual care residents need. The home does not provide intermediate care. EVIDENCE: The manager or senior nurse will assess the needs of all new residents prior to admission, to ensure the home is able to provide the care required. Residents referred through Care Management arrangements also have an assessment carried out by health and social services. The home does not provide intermediate care. Oaklodge Nursing Home DS0000024188.V309346.R01.S.doc Version 5.2 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): 7,8,9,10 Quality in this outcome is good. This judgement has been made using available evidence including a site visit to this service. The care planning system in the home ensures that resident’s needs are fully met. The medication procedures for the home ensure safe practice in the administration of medicines to residents. EVIDENCE: Two care plans and assessments were read as part of case tracking of residents. Care plans were detailed in outlining the individual needs of the residents. Risk assessments and nutritional assessments including the monitoring of resident’s weight were fully completed and updated monthly. There was evidence on care plans that the resident or relatives had read the plan and agreed with its contents. Oaklodge Nursing Home DS0000024188.V309346.R01.S.doc Version 5.2 Page 10 Pressure relieving equipment such as mattresses and cushions were available in the home for residents identified as being a high risk of developing pressure sores. Evidence of consent for the use of cot sides was seen written in care notes. The home provides a portable hoist on each floor. The home had purchased several hospital beds since the last inspection and on touring the premises only a few divan beds were still in use for those residents who were mobile. Access to specialist services such as dentists, opticians and chiropodist are arranged either by appointment or by the specialist visiting the home. The chiropodist visits the home routinely every 6 weeks. Residents register with a GP of their choice within the catchment area of the home. The medication administration records were read and were accurately completed. Pain charts were now being completed for residents where appropriate. None of the present residents were able to administer their own medicines but the manager confirmed that if residents expressed a wish to self medicate and were capable a risk assessment would be carried out. The Controlled drugs register was read and all entries were correct. Controlled drugs were stored and handled satisfactorily. All medicines disposed of were recorded in a book and signed by the clinical waste company on collection. Residents spoken with said that the staff were always courteous and caring and respected their privacy. Staff knocked on bedroom doors before entering resident’s rooms and personal care was provided in private at all times. Oaklodge Nursing Home DS0000024188.V309346.R01.S.doc Version 5.2 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): 12,13,14,15 Quality in this outcome is good. This judgement has been made using available evidence including a site visit to this service. Residents are able to make choices about how they are cared for and how they spend their day. The residents are offered a choice of well- balanced and nutritious meals. EVIDENCE: Activities take place with the activities organiser for one hour on Monday, Wednesday and Friday afternoons. The care staff provided the activities on the other days. There was a wide range of activities that took place taking into account resident’s interests and wishes. Each resident had an activities chart that showed what he or she had participated in on a daily basis. Activities were given in groups or on a one to one basis. Outings had been arranged in the past, but due to the present lack of interest and the poor health of some of the resident’s outings had not taken place lately. Oaklodge Nursing Home DS0000024188.V309346.R01.S.doc Version 5.2 Page 12 Residents expressed satisfaction with what was on offer in the way of activities and said they could choose whether they joined in or not. Residents were given opportunities to make decisions about what they liked to do during the day, and the home as far as practicable, meets resident’s preferences with regard to times for getting up and going to bed. The visiting arrangements for the home are open and visitors can visit at any reasonable time. The home has a policy not to get involved with the finances of residents. Where residents are not able to manage their own finances advocacy information is given on request. Residents are able to bring their own personal possessions into the home with prior arrangement with the manager, and some rooms were seen furnished with resident’s small items of furniture. Menus run for three weeks and are changed every season. Menus were developed taking into account the resident’s likes and dislikes in food. Special diets were catered for and pureed diets being served were well presented. Residents were asked the day before to select their choice of food for the following day. Residents can choose where they eat their meals, and some used the dining area and others ate in the lounge or in their own rooms. Lunchtime was observed, and staff were seen giving assistance to some residents with their eating and drinking in a dignified and caring manner. There was a calm atmosphere during lunch and residents were given plenty of time to eat and enjoy their food. Residents spoken with thought the food was good and there was plenty to eat. Oaklodge Nursing Home DS0000024188.V309346.R01.S.doc Version 5.2 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 Quality in this outcome is good. This judgement has been made using available evidence including a site visit to this service. The home has a clear complaints procedure and takes all complaints seriously. The policies and procedures in the home protect the resident’s from harm. EVIDENCE: The home has a clear complaints procedure that is displayed in the home. The complaints log was seen and there were two concerns/ complaints recorded since the last inspection in October 2005 that had both been satisfactorily resolved. The Commission investigated a complaint last year that resulted in the complaint not being upheld. However the complaint remains ongoing and due to the frequency of complaints these are recorded in the resident’s personal care notes. The home is working closely with Social Services and the GP who are kept informed of the issues raised. Oaklodge Nursing Home DS0000024188.V309346.R01.S.doc Version 5.2 Page 14 Residents spoken with said they would not hesitate to speak with the manager on any matters of concern. On reading the home’s guidelines for the protection of vulnerable adults it was noted that some information was omitted with regard to contacting the Adult Protection team at Social Services, in line with the West Sussex Adult Protection Procedures. This matter was discussed with the manager/proprietor who confirmed that a review of the guidelines would take place. Staff were provided with training on Adult Abuse as part of their induction training and updated at appropriate intervals. Oaklodge Nursing Home DS0000024188.V309346.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome is good. This judgement has been made using available evidence including a site visit to this service. The residents live in a comfortable, clean and safe environment. EVIDENCE: A tour of the premises took place and all areas of the home were found to be fresh and clean on the day. Residents spoken with said the home was always kept clean and presentable. The general décor and furnishings were satisfactory and some new items of furniture had recently been purchased. Some of the resident’s rooms and communal areas had been decorated and new carpets fitted. The laundry area was seen and a new washing machine had recently been purchased. The home washes the resident’s personal laundry and bed linen is sent out for washing. Red bags are used for soiled linen and staff were Oaklodge Nursing Home DS0000024188.V309346.R01.S.doc Version 5.2 Page 16 observed following the correct infection control procedures when providing personal care and handling laundry. Hand washing facilities were available in the laundry area. The home complies with the requirements of the local fire service following a fire safety assessment carried out in January 2006. Oaklodge Nursing Home DS0000024188.V309346.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome is good. This judgement has been made using available evidence including a site visit to this service. The staffing levels in the home are adequate. Staff have the experience and skills required to meet the needs of residents. Residents are supported and protected by the home’s recruitment policies and practices. EVIDENCE: Staff rota’s showed that there were one to two trained nurses plus four care assistants working in the mornings and one trained nurse plus three care assistants in the afternoon and evening. At night there is one trained nurse plus one care assistant. Both residents and staff spoken with felt the staffing levels were sufficient. Staff said they had the time to give the residents the attention and care they needed without rushing them. Domestic and kitchen staff are employed in sufficient numbers to ensure standards relating to food and cleanliness of the home are met at all times. On the day of the inspection the home had its full compliment of staff. The recruitment procedures for the home were checked and three staff files were seen. All files contained the relevant information including two written Oaklodge Nursing Home DS0000024188.V309346.R01.S.doc Version 5.2 Page 18 references and applications for Criminal Records Bureau checks (CRB). Some Criminal Records Bureau checks were taking several weeks to complete and under these circumstances staff were employed to work in the home under constant supervision while completing their induction training. All staff had a satisfactory Protection of Vulnerable Adults check (POVA) before commencing work in the home. Staff spoken with confirmed that they had completed all the mandatory training plus any specialist training required. A training programme planned for October and November was seen. The manager had compiled a chart for staff training that identified the dates that staff attended particular training courses, and also monitored when staff were due an update. Three members of the care staff had obtained the National Vocational Qualifications in Care and more staff were in the process of completing the course. Oaklodge Nursing Home DS0000024188.V309346.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome is good. This judgement has been made using available evidence including a site visit to this service. The home is run well by an experienced and competent manager. The health and safety and welfare of the residents is protected as far as practicable. EVIDENCE: Dr Dalmond the registered manager/proprietor has had approximately 15 years experience working in and running nursing and residential homes for the elderly. Staff and residents spoken with said that he was very approachable and available to speak with on any matters. Oaklodge Nursing Home DS0000024188.V309346.R01.S.doc Version 5.2 Page 20 Dr Dalmond does not have the Registered Managers Award (RMA) but plans to complete it in the near future. However there was evidence that he undertakes periodic training to update his skills and knowledge. A comprehensive quality assurance survey had been completed in June 2006 and this is completed annually. Seventeen surveys were distributed and twelve were completed and returned. An audit of the feedback contained in the surveys was completed and showed that all were completely satisfied with the services provided apart from one negative comment made about the food. The manager/proprietor said he regularly monitors services provided in the home and any negative comments are acted upon where appropriate. As previously stated the home has a policy not to handle the money and finances of residents but would support residents to handle and deal with their own money where capable. The policies and procedures file was examined and the process for updating and reviewing policies and procedures is on going. The file is available for staff for reference at all times. Equipment and systems in the home are under maintenance and servicing contracts with external companies that carry out the work at the appropriate intervals. The home calls upon a handyman to visit the home when needed to carry out any necessary maintenance work. Routine maintenance such as water temperatures, wheelchair checks, fire safety checks are carried out routinely by the handyman. The trained nurses are responsible for the weekly fire alarm testing and this was seen recorded in the fire safety log. An on-going maintenance programme is in place for replacing furnishings and decoration. Accidents, injuries and incidents are recorded and reported to the appropriate authorities. Risk assessments were in place for the environment and equipment used in the home and updated as required. Oaklodge Nursing Home DS0000024188.V309346.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 Oaklodge Nursing Home DS0000024188.V309346.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 Stan dard Good Practice Recommendations Oaklodge Nursing Home DS0000024188.V309346.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Southampton LO 4th Floor, Overline House Blechynden Terrace Southampton Hampshire SO15 1GW 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. 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