Inspection on 05/02/08 for Oaks Court

This inspection was carried out on 5th February 2008.

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

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

Oaks Court 15/06/10

Oaks Court 03/03/10

Oaks Court 24/11/09

Oaks Court 24/04/06

Oaks Court 26/07/05

Oaks Court 25/04/05

Oaks Court 29/04/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Oaks Court Oaks Crescent Wolverhampton West Midlands WV3 9SA Lead Inspector Martin George Unannounced Inspection 5th February 2008 09:20 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 Oaks Court DS0000058725.V356420.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. Oaks Court DS0000058725.V356420.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oaks Court Address Oaks Crescent Wolverhampton West Midlands WV3 9SA 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) 01902 715266 Quality Homes (Midlands) Limited Margaret Mary Sims Care Home 41 Category(ies) of Dementia - over 65 years of age (34), Old age, registration, with number not falling within any other category (41) of places Oaks Court DS0000058725.V356420.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide personal care to service users of both sexes whose primary care needs on admission to the home are within the following categories: Older People (OP) 41 Dementia over 55 years of age (DE)(E) 34 The maximum number of service users accommodated is 41 2. Date of last inspection Brief Description of the Service: Oaks Court is a purpose built residential home for 41 older people that was originally intended, and run for a short time, as a nursing home. It is situated in a quiet residential cul-de-sac close to Wolverhampton city centre. The building is on three floors, which are serviced by a couple of lifts. All the bedrooms have en-suite facilities. The home has an enclosed garden at the side of the building and a large car parking area at the front. The fees are in accordance with local authority rates. Oaks Court DS0000058725.V356420.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This unannounced key inspection was carried out by a single inspector between 09:20 and 15:00. As part of the inspection all National Minimum Standards defined by the Commission for Social Care Inspection (CSCI) as ‘key’ were inspected. Information about the performance of the home was sought and collated in a number of ways. Prior to inspection we were provided with written information and data about the home through their annual quality assurance assessment (AQAA). Information, including the last key and three subsequent random inspection reports, were analysed prior to inspection and helped to formulate a plan for the visit and helped in determining a judgement about the quality of care the home provides. On the day of the inspection we spoke to the deputy manager, registered manager, staff and service users, undertook a tour of the premises and observed practice and this provided evidence in support of the records that were also checked on the day. What the service does well: What has improved since the last inspection? What they could do better: Oaks Court DS0000058725.V356420.R01.S.doc Version 5.2 Page 6 To ensure service user clothes do not get mixed up the home should consider options for creating more space in the laundry. Risk assessments should be developed for those service users for whom it is assessed inappropriate to have their own room key. The home should purchase or get access to sit on scales for those service users who are unable to weight bear to ensure regular weight checks are carried out. 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. Oaks Court DS0000058725.V356420.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 Oaks Court DS0000058725.V356420.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): 1, 2, 3 and 5 Quality in this outcome area is excellent. Pre-placement assessments provide information necessary to provide service users with safe care, sensitive to their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The AQAA states that all admissions are initially on a 28 day trial basis to ensure the home is the right place in the longer term and a copy of the service user guide is given to them upon arrival. During our visit a person arrived at the home unannounced and asked if it would be possible to look around as he was looking for somewhere suitable to place a close relative of his. The manager quickly made the visitor feel welcome and immediately made arrangements to show him around. Oaks Court DS0000058725.V356420.R01.S.doc Version 5.2 Page 9 The service user records we looked at were well ordered and this made it easy for staff to find specific information relating to the needs of the service user. Pre-placement assessments contained useful information, consistent with National Minimum Standard (NMS) 3.3, to help carers meet the immediate and longer term needs of service users and this information was used to develop the service user plans. Terms and conditions are provided for all service users, all of whom are currently local authority funded. The home does not provide intermediate care. Oaks Court DS0000058725.V356420.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. Service user plans are well structured to assist staff in readily identifying needs. Medication practice is efficient and sensitive to service user needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service user plans are well structured and regularly reviewed. The plans contain information about the incidence and treatment of pressure sores and information relating to nutritional screening, but there are some service users who cannot weight bear and are subsequently not being weighed, as the home does not have access to sit on scales. To ensure nutritional screening is effective for these service users the home should address this issue without undue delay. Oaks Court DS0000058725.V356420.R01.S.doc Version 5.2 Page 11 We noted that service user records contain a “preference for final resting place” sheet, but none of the records checked had these completed. If completed they would help to show how the home maintains dignity for those approaching their final days. From discussion with the manager we are satisfied that although these records were not fully completed the home is committed to ensuring it has the necessary knowledge regarding this sensitive issue. The sheets used to record health professional visits are very useful and are kept up to date. As there is a separate sheet for each health professional it would be beneficial to have their name in the relevant column, rather than their profession, which is already stated in the heading. This would prove useful in situations when a service user’s regular doctor, chiropodist etc is not the person who they see. All staff who administer medication have completed an accredited handling of medication course. We observed the lunchtime medication run and found the practice to be very efficient and sensitive and respectful of service user preferences and their right to refuse. There are currently no service users who self medicate but the home has a policy to support it if required. We were talked through and shown the process of ordering, storage, administration, recording and disposal of medication and are satisfied it protects service users from risks associated with poor medication practice. We found this to be the case with controlled drug practice and storage also. The medication fridge and temperature measuring meets requirements. Several service users expressed the view that staff are very good and respectful of their needs and preferences. Oaks Court DS0000058725.V356420.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 excellent. The home makes significant efforts to provide service users with a stimulating and interesting daily programme. Choice is integral to how the home operates. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home offers a wide range of interesting physical and non-physical activity options. The home provides opportunities for service users to engage in activities in the wider community too. Information about activities is on open view in the main corridor. Another good source of information is the monthly newsletter being produced, which gives very easy to read and useful information about a number of topics relevant to all those working and living at the home. The manager informed us that a member of staff takes a lead on this. Several service users were very complimentary about the way the home listens to them. Oaks Court DS0000058725.V356420.R01.S.doc Version 5.2 Page 13 There are pleasant lounge areas on the first and second floors that are less frequently used than the one on the ground floor. They provide space, other than a service users own bedroom, for them to meet with visitors privately should they so wish. Our observation of interaction between staff and service users provided evidence that staff try to offer as much choice as possible in a range of situations. The recently built conservatory has enhanced the dining area by offering additional space. In warm weather the two external doors can be opened to give service users the option of an outdoor feel to their mealtime. We saw menus that had a very good variety of food choices and the meals provided at lunch were nicely presented and well received by service users. Staff were very attentive to service user needs during lunch, helping with feeding when required, but without being unnecessarily intrusive. Food preferences are determined by a combination of views gathered at service user meetings and through knowledge of what gets eaten, especially for those service users who find it difficult to express an opinion in any other way. Kitchen staff gave the impression of being proud of their work area and showed a genuine interest in making sure the nutritional needs and preferences of service users were met. Discussion with the deputy and one of the seniors evidenced a thorough knowledge of specific needs and preferences with regard to nutritional issues. Oaks Court DS0000058725.V356420.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. The home has a good complaints procedure, readily available to service users, their relatives and staff. Safeguarding is given high priority in terms of training and service users feel well cared for. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure is openly displayed in the entrance lobby of the home. The manager stated there had been no complaints in the last year. Service users who were willing and able to express a view stated they had no reason to complain but would know how to should the need arise and would have no worries about doing so. One service user who appeared unhappy on the day of our visit stated that no-one listened to her, even though we had observed staff trying to engage with her for several minutes beforehand. Our observation of practice evidenced that staff are skilled in performing their duties, with the safeguarding of service users as a primary consideration. Training in this area appears to have been effective and of benefit to service users, who are cared for by staff well equipped to meet their needs. Oaks Court DS0000058725.V356420.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, 21, 23, 24, 25 and 26 Quality in this outcome area is good. Service users benefit from a very spacious and well maintained living environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Upon arrival at the home we did note a faint odour but we are also aware that the home works very hard to address this issue and there is evidence that they have responded positively to previous occasions when this issue has been raised. The manager and deputy stated that the most recent Environmental Health Officer (EHO) visit was in mid 2007. The visit was very brief, apparently no longer than 10 minutes, and there were no requirements but the EHO provided Oaks Court DS0000058725.V356420.R01.S.doc Version 5.2 Page 16 no written report as confirmation of the visit. A report of the most recent Fire Officer visit was seen. No requirements were made following the visit. Records we checked evidenced that fire equipment checks and fire drills are carried out regularly. All bedrooms at Oaks Court are en-suite and are of a good size. One service user had requested to bring his own double bed and the size of his room accommodated this easily with room to spare. Rooms are pleasantly decorated and personalised to service user preference. Service users can have a key to their own room but for many it is assessed as inappropriate. The home needs to develop risk assessments explaining why a service user cannot have a key to their room. There are plenty of toilets and bathrooms throughout the home and equipment to assist in bathing is suitable for the needs of the service user group. Although there is a sink in the laundry which is used for hand washing of clothes there is no separate basin for staff to wash their hands and the home may wish to consider installing one to eliminate any potential risk of cross contamination. Washing and drying machines are of good quality, meet disinfection standards and are well suited to the number and needs of service users. One problem the manager identified related to the current layout of the laundry, which she believes creates some problems with regard to service user clothes sometimes getting mixed up with those of other service users. There may well be merit in the home exploring the possibility of following through on the manager’s suggestion of removing the wall in the laundry that restricts space and putting shelves up all along the back wall, hopefully eliminating the problem of service user clothes getting mixed up. The home has dedicated sluicing facilities in a separate room next to the laundry. The conservatory area just off the dining area has two wide openings leading onto the garden and during warmer weather this will provide service users with a very pleasant area to mingle or just relax. Oaks Court DS0000058725.V356420.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 excellent. Training, support, direction and guidance for staff creates a team well equipped to meet the complex needs of service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staffing levels and the mix of knowledge, experience and ethnicity provide service users with a degree of diversity that compliments their care needs. The cover throughout the 24 hour period is sufficient to meet their complex and demanding needs. Staff records we looked at provided evidence of effective recruitment practices, with all necessary checks completed. We looked at training records and are satisfied that the range of training covers all necessary health and safety and safeguarding areas of practice. The home also provides training for staff on topics such as dementia care and the Mental Capacity Act, both of which are particularly pertinent to the service user group being cared for. The induction programme is consistent with the Skills for Care common induction standards. Once completed they are signed off by the manager as Oaks Court DS0000058725.V356420.R01.S.doc Version 5.2 Page 18 confirmation that competence has been evidenced and then returned to Beckminster House for certification. Our observation of staff throughout the day evidenced a consistently respectful and sensitive approach in all interactions with service users. Speaking with some of the service users reinforced our observations, with very positive comments offered about how well staff treated them. We spoke to two of the seniors who are relatively young and were impressed with the appropriate level of authority they had over their older and longer serving colleagues. This is a very good example of lines of accountability being clearly understood and adhered to, with the subsequent benefits to service users. Oaks Court DS0000058725.V356420.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, 36 and 38 Quality in this outcome area is good. The manager oversees a competent and confident staff team who provide service users with sensitive and respectful care. Health and safety issues are given the necessary priority. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager is a very experienced practitioner and manager and has completed the required qualifications for the post she holds. The manager and deputy manager both have a good knowledge of service user needs and our observations suggest that their knowledge inspires confidence in the staff team. The lines of accountability were also clearly defined and adhered to. Oaks Court DS0000058725.V356420.R01.S.doc Version 5.2 Page 20 The manager has recently started a file that contains written comments from a range of professionals, which would be a useful resource to make available to prospective residents and their families, as long as prior permission was gained to do so. The home has a culture of professional development, evidenced by how it responds to requirements and recommendations from regulatory bodies and the views of anyone who has reason to come into contact with the home. We were informed by the manager that there is only one of the current service users who wishes to, and is capable of, dealing with their own finances. We saw evidence that the home manages money and valuables of service users in a way that protects their interests. The required health and safety related training and safeguarding and protection training has been completed. The manager informed us that the 50 of staff who have completed the safe food handling training were those who had direct contact with the kitchen but we feel the home should consider putting all staff through this training to take account of unexpected occasions when any member of staff may have reason to handle food. This would further safeguard service users from potential harm. Although we noted upon arrival at the home that two certificates on the wall in main reception area are out of date (basic food hygiene and appointed person’s first aid both expired May 2007) it was later evidenced that these have been updated. Care of substances hazardous to health (COSHH) records and practice safeguard those working and living at the home. Fridge and freezer temperatures are checked and recorded regularly. Water temperature checks are carried out regularly and the home has evidence of how it arranges for checks against Legionella. Accident records are recorded and kept consistent with requirements. Supervision frequency meets the National Minimum Standard (NMS) and the records we saw provided evidence of how supervision is focussed on staff professional development. Oaks Court DS0000058725.V356420.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 3 3 4 x 4 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 4 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 4 4 x 4 x 4 3 4 3 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 4 x 3 4 x 3 Oaks Court DS0000058725.V356420.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. 1 2 Refer to Standard OP8 OP24 Good Practice Recommendations The home should purchase or acquire access to sit on weighing scales to ensure service users who cannot weight bear can still be weighed regularly The manager should ensure that where it is assessed that the capability of a service user makes it too risky for them to have a key to their own room that a risk assessment is completed confirming this The home should explore whether removal of the central wall in the laundry is possible and if so consider putting shelving along the back wall, providing more space and hopefully reducing occasions when service user clothing gets mixed up 3 OP26 Oaks Court DS0000058725.V356420.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Oaks Court DS0000058725.V356420.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!