CARE HOMES FOR OLDER PEOPLE
The Oaks Hartrigg Oaks Haxby Road New Earswick, York YO32 4DS Lead Inspector
Wendy Dixon Unannounced 27 June 2005 10:30 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 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. The Oaks J53 J04 S27974 The Oaks V235820 280605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service The Oaks Address Hartrigg Oaks, Haxby Road, New Earswick, York, North Yorkshire, YO32 4DS Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01904 750700 01904 752225 Joseph Rowntree Housing Trust Mrs Susan Jacqueline Davies Care Home with Nursing 42 Category(ies) of Dementia - over 65 years of age (11), Old age, registration, with number not falling within any other category (42) of places The Oaks J53 J04 S27974 The Oaks V235820 280605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Care home with Nursing Date of last inspection 4th January 2005 Brief Description of the Service: The Oaks forms part of the facilities in the Hartrigg Oaks retirement village in the village of New Earswick on the outskirts of York.The Oaks is a purpose built home able to care for up to 42 older people, which may receive a nursing service. The home is also registered to care for up to 11 service users with dementia care needs . Attached to the complex are a number of facilities including a gym, restaurant, coffee shop, library, shop and hydro therapy pool which can be used by service users from the home and the retirement village. The Oaks J53 J04 S27974 The Oaks V235820 280605 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This report relates to an unannounced inspection that took place on Monday 27th June 2005.The inspection lasted 4.0 hours (10.30am to 2.30pm). There were 41 service users resident in the home, 22 requiring nursing care and 19 receiving personal care, 11 of these service users were suffering from dementia. The inspection focused on a number of key standards and on the areas of concern identified at the last inspection. An inspection of the premises took place, including a number of bedrooms, the homes dining room and lounges. The care records of five service users were examined in detail and where possible these service users were spoken with about the care they receive. There were also discussions with members of staff on duty at the time of inspection. What the service does well:
The Oaks provides a very good standard of care. The home had a lovely calm relaxed atmosphere and the building makes access easy throughout so service users can use the lounges, gardens and restaurant facilities with as little staff support as possible. Detailed plans of care are in place and this helps ensure that all the service users health and social care needs are identified and met. Service users were able to spend the morning as they wished and the home had a relaxed friendly atmosphere. Service users were in their rooms watching TV or reading, some were in one of the homes lounges several were sat outside enjoying the good weather. Staff were well informed about service users health and personal care needs and were observed talking and assisting service users in a kind friendly and professional manner. The Oaks J53 J04 S27974 The Oaks V235820 280605 Stage 4.doc Version 1.40 Page 6 Service users were enjoying the food provided and there was a range of meals available and service users could choose to eat in the homes dining room, the main coffee shop or restaurant. 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. The Oaks J53 J04 S27974 The Oaks V235820 280605 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Oaks J53 J04 S27974 The Oaks V235820 280605 Stage 4.doc Version 1.40 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 standard(s) 3 Service users needs are properly identified and assessed prior to admission EVIDENCE: The preadmission records of 2 service users were inspected. A member of the qualified nursing staff had assessed both service users prior to admission. The service users had visited the home and been able to meet with staff and seen their prospective room before making a decision to come into the home. Information about service users health and personal care needs had been documented and information gathered from relatives and other health professionals giving a good picture of the care that needed to be provided. The Oaks J53 J04 S27974 The Oaks V235820 280605 Stage 4.doc Version 1.40 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 standard(s) 7,8 ,9 And 10The health needs of service users are well met, but some improvement in the monitoring of medication is needed EVIDENCE: The care plans of five service users were inspected and found to be of good quality. These contained detailed information about how service users needed to be cared for and showed any health problems were quickly and appropriately dealt with, consulting with other professionals where necessary. These were up dated on a regular basis. Where these service users were spoken to they confirmed that the information recorded was correct and up to date. Care plans were signed by the service users or where more appropriate their relatives showing they were aware of the contents. Staff were observed speaking to service users in a kind and respectful manner all service users doors are lockable as are bathrooms and toilets.
The Oaks J53 J04 S27974 The Oaks V235820 280605 Stage 4.doc Version 1.40 Page 10 Five service users medication was inspected. Two of these contained errors in the recording of medication. In one case signatures or codes were not present so it was not possible to judge if the medication had been given (the medication was a pain relieving gel). The other was that a service user had been prescribed a course of antibiotics and 20 tablets had been supplied but on counting signatures it appeared 22 had been given. It was not possible to get an accurate picture in these cases if medication had been administered as prescribed by the doctor. The Oaks J53 J04 S27974 The Oaks V235820 280605 Stage 4.doc Version 1.40 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 standard(s) 12 and 15 Service users can choose to spend their days as they wish, and there is a range of activities service users can participate in if they wish. EVIDENCE: The home had a relaxed atmosphere. Service users were at different points in their morning routine, some outside enjoying the gardens or watching the comings and goings at the home. Others still in the process of getting up, washed and dressed, showing that support for service users is individual to them and not based on fixed routines. One service user stated she felt unwell that day so was spending it in her room. There was no issue about the service user having her meal there staff were happy to take it. There are a wide range of activities, flower arranging, trips out, cooking to name a few, service daily records stated how much these things were enjoyed and and appreciated by service users. The meal served during the inspection was lunch, This was nicely presented and enjoyed by the service users who commented on how good the food was at the home. A choice is available at every mealtime and service users can either eat in their rooms though the majority prefer to eat in one of the homes dining rooms as meals are very much a social occasion.
The Oaks J53 J04 S27974 The Oaks V235820 280605 Stage 4.doc Version 1.40 Page 12 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 standard(s) 16 Service users and their families are aware of how to make a complaint. EVIDENCE: Service users are given a copy of the homes complaints procedure when they are admitted to the home and a copy is displayed on the homes notice board. There have been no complaints about the home since the last inspection. The Oaks J53 J04 S27974 The Oaks V235820 280605 Stage 4.doc Version 1.40 Page 13 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 standard(s) 19 and 26 The home offers very high quality accommodation to all its service users and is a clean comfortable and safe place for service users to live. EVIDENCE: The home is purpose built with good access into and throughout the building. Decoration and maintenance is to a very high standard. The home has secure well-maintained gardens for service users to enjoy. Service users are also able to access a library, gym and shop, which are just outside the care centre but in the same building. The home was clean and fresh smelling throughout and gloves and aprons were in good supply to help prevent the spread of infection. The Oaks J53 J04 S27974 The Oaks V235820 280605 Stage 4.doc Version 1.40 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 The home provides enough suitably qualified and trained staff to meet service users needs. EVIDENCE: There were 41 service users in the home on the day of inspection. 22 requiring nursing care and 11 because of their dementia The minimum number of qualified nurse hours needed to care for these service users is 212hours per week the home provided 220 week commencing 27/06/05 and the minimum number of care assistant hours needed is 611 the home provided 622 week commencing 27/06/05. The registered provider employs 1 nurse with specialist qualifications to care for service users with mental health problems and dementia who live in the home. The Oaks J53 J04 S27974 The Oaks V235820 280605 Stage 4.doc Version 1.40 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 and 32 The home is well managed and provides a safe place for service users to live and staff to work. EVIDENCE: The registered manager and the deputy manager have recently obtained the NVQ4 in care management in addition to their first level nurse qualification, these qualifications help ensure the home is well managed and service users, relatives and staffs problems/concerns are properly dealt with. The home had a calm relaxed and friendly atmosphere. The registered manager and or her deputy are available in the home on a daily basis to deal with issues as they arise. Regular meetings are held with service users and to enable everybody who lives and works in the home to have a say as to how it is run
The Oaks J53 J04 S27974 The Oaks V235820 280605 Stage 4.doc Version 1.40 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 x 15 4
COMPLAINTS AND PROTECTION 4 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 x x x x x x The Oaks J53 J04 S27974 The Oaks V235820 280605 Stage 4.doc Version 1.40 Page 17 No Are there any outstanding requirements from the last inspection? 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 OP9 Regulation 13 2 Requirement The registered manager must ensure medication is safely administered and accurately recorded Timescale for action On Receipt of this report and maintained thereafter 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. Refer to Standard Good Practice Recommendations The Oaks J53 J04 S27974 The Oaks V235820 280605 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection York Area Office Unit 4, Triune Court Monks Cross York, YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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