CARE HOMES FOR OLDER PEOPLE
Oakside Main Street Northiam Rye East Sussex TN31 6BN Lead Inspector
Caroline Johnson Unannounced Inspection 12th October 2005 10.40 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 Oakside DS0000021395.V255332.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Oakside DS0000021395.V255332.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Oakside Address Main Street Northiam Rye East Sussex TN31 6BN 01797 252165 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) Peasmarsh Place (Country Care) Limited Mrs Barbara Anne Clark Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Oakside DS0000021395.V255332.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. The service users accommodated will be aged sixty five years (65) or over on admission. That the registration category is old age, not falling into any other category (OP) That the home may continue to accommodate one (1) named existing service user who has a dementia type illness. The maximum number of service users to be accommodated must not exceed seventeen (17). 14th March 2005 Date of last inspection Brief Description of the Service: Oakside is a building of wooden construction situated in the village of Northiam overlooking the village green. Village shops and local amenities are a short distance from the home. Main bus routes run close by. Accommodation for service users is provided on three floors. The upper floors can be accessed via stair lifts. The home is registered to accommodate seventeen older people. Oakside DS0000021395.V255332.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the first in the year running from April 1 2005 to March 31 2006. The inspection lasted from 10.40pm until 16.45pm. The registered manager facilitated the inspection. During the inspection there was an opportunity to meet with approximately nine residents. One member of staff was interviewed and another member of staff assisted with aspects of the inspection. A number of records were examined and plans for the care to be provided for two residents were seen. There was an opportunity to meet with the relatives of one resident who were visiting at the time of inspection. A full tour of the building was not undertaken. However, a number of the bedrooms and the communal areas were seen. What the service does well: What has improved since the last inspection?
Work was underway to replace windows and repaint the external building. Works completed since the last inspection include; - the fitting of a new hoist/shower, the carpeting and repainting of two bedrooms, new toilets in two rooms, new door frames fitted, a new boiler fitted, a new tumble drier installed, a new dining room table, a new TV and video unit in the lounge and new chairs for some of the bedrooms. There are plans to re-carpet the stairs and the office. A new wheelchair has also been ordered for one of the residents. Four staff have recently commenced training to study for their NVQ, two at level two and two at level three. Regular training opportunities have also been provided for staff on a variety of topics to enable them to meet the needs of residents. A detailed fire risk assessment has been carried out and as a result
Oakside DS0000021395.V255332.R01.S.doc Version 5.0 Page 6 of this new doorframes have been fitted on some of the doors and door guards have been fitted where it has been assessed as necessary. 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. Oakside DS0000021395.V255332.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Oakside DS0000021395.V255332.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4,5 The home is thorough in assessing the needs of prospective residents and if they are not sure that they can meet the needs highlighted, they will suggest a short stay until a more detailed assessment can be carried out. The manager needs to write to prospective residents to let them know how they propose to meet their needs. EVIDENCE: Pre-admission documentation was seen in respect of one resident who was due to be admitted to the home. The assessment was still in the early stages although the resident had visited the home and the manager had assessed that they would be able to meet their needs in the short-term. She also stated that a more detailed assessment would need to be made before being able to determine if they could meet the long-term needs of the individual. The home was still in discussion with the social worker concerned, to ascertain more detailed information regarding the resident’s needs. The home needs to ensure that in respect of all referrals to the home they should, following assessment, confirm in writing to the referrer the outcome of the assessment. The home does not cater for intermediate care.
Oakside DS0000021395.V255332.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The home is thorough in their care planning. Specialist advice and support is always obtained when needed and there are good links with the local nursing service. EVIDENCE: Care plans were seen in respect of two residents. Detailed information is recorded to ensure that each resident’s needs are met. A record is kept of the care provided to residents daily. The plans are reviewed on a monthly basis. There is a lockable facility in each of the bedrooms for the storage of medication. A central store is also located in the office. There are appropriate measures in place for the handling of medication and for the storage of the keys. All staff receive training on the medication in use in the home. There are procedures in place for arranging advice and support when required in relation to terminal care. The local district nurses provide this support during the day and the hospice provides this support out of hours. At the time of inspection four residents required assistance from two staff members for
Oakside DS0000021395.V255332.R01.S.doc Version 5.0 Page 10 some aspects of their personal care. The local district nurse provides regular advice and support to staff to meet the needs of residents. Oakside DS0000021395.V255332.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): There is a varied range of activities available. The home makes good use of local amenities and village life. The relationship between the home and relatives of the residents is very strong whether this is in person, by telephone and also by e-mail. EVIDENCE: Residents make good use of their local facilities. Those who choose to attend coffee mornings one run by the local church and one run by age concern. Some of the residents enjoy watching football matches in their village. Outings include shopping trips to Rye market or to Hastings. A keep fit session is held once a month. A music and movement group had been planned and the manager advised that if this were successful this would also become a monthly activity. There are good links with the local nursery and the children visit occasionally to spend time with the residents. At the time of inspection one of the staff team was planning an activity as part of her NVQ training. This activity involved arts and crafts and her chosen activity was to run a session involving the making of cards for special occasions. One of the residents has a dog. Staff assist in the care for the dog and in ensuring that she has regular walks.
Oakside DS0000021395.V255332.R01.S.doc Version 5.0 Page 12 There are good links between the home and the relatives of the residents. Where relatives live at a distance from the home there is communication via email in addition to the telephone. Visitors are welcome to the home at any reasonable time. Residents spoken with during the inspection all commented positively on the quality of the food served. Oakside DS0000021395.V255332.R01.S.doc Version 5.0 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The complaint procedure is detailed but needs to be amended slightly to reflect that the complainant may contact the Commission at any stage of the complaint process. EVIDENCE: There is a detailed complaint procedure in place. However, it is recommended that the procedure be amended to reflect that the complainant may contact the Commission at any stage of the complaint process. Oakside DS0000021395.V255332.R01.S.doc Version 5.0 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): A lot of work has been carried out within the past year in terms of maintenance and décor. The home is comfortable and homely in design. The lock on the lounge needs to be removed. EVIDENCE: At the time of inspection there was scaffolding around the front of the home. A surveyor had assessed the building and the outcome was that some of the wood was to be replaced, some windows were to be replaced and the building was to be repainted. Works completed since the last inspection include; - the fitting of a new hoist/shower, the carpeting and repainting of two bedrooms, new toilets in two rooms, new door frames fitted, a new boiler fitted, a new tumble drier installed, a new dining room table, a new TV and video unit in the lounge and new chairs for some of the bedrooms. There are plans to re-carpet the stairs and the office. A new wheelchair has also been ordered for one of the residents.
Oakside DS0000021395.V255332.R01.S.doc Version 5.0 Page 15 Not all areas of the home were seen during this inspection. There is a large lounge and a separate dining room. Residents who were present in the dining room stated that they enjoy the aquarium and there was a good debate about how many fish there were. There is a bolt lock on the door leading to the lounge. It was recommended that this be removed. All areas of the home seen were clean and there were no unpleasant odours. Oakside DS0000021395.V255332.R01.S.doc Version 5.0 Page 16 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Regular training is provided to staff to ensure that they can meet the needs of the residents accommodated. The home is on target to having 50 of the staff trained to NVQ level two or above. EVIDENCE: Two care staff already old NVQ level two. Another four staff have commenced training, two at level two and two at level three. The manager advised that another member of staff is also keen to commence training. The staff rota indicated that there were satisfactory staffing levels in the home. Recruitment records were seen for one recently recruited member of staff. The home had carried out all checks appropriately. Since the last inspection two staff members have completed their induction package. Training has also been provided on medication. Two staff members attended training on anxiety and depression. The staff team also received training on catheter care, advocacy, adult protection and prevention of abuse, infection control and moving and handling. Oakside DS0000021395.V255332.R01.S.doc Version 5.0 Page 17 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): The home is run well and residents receive a good quality of care. There are good measures in place to ensure the health and safety of the residents and staff. EVIDENCE: Staff spoken with during the inspection described the manager as `extremely supportive’ and that `she always goes the extra mile to make occasions special for the residents’. Staff meetings are held regularly to ensure that there is good communication between staff. Staff receive supervision on a fairly regular basis but this needs to be monitored more closely to ensure that everyone has six supervisions a year. A detailed fire risk assessment was carried out in April 2005. As a result of the assessment new doorframes were fitted to a number of rooms and door guards were fitted to seven doors. Record keeping held in relation to measures taken by the home in respect of fire safety was satisfactory. However it was
Oakside DS0000021395.V255332.R01.S.doc Version 5.0 Page 18 recommended that the home record the length of each fire drill and that they write a more detailed evaluation of the outcome of each drill. During the inspection the fire alarms sounded and all staff met at the meeting point within a couple of minutes. PAT (portable appliance testing) had been carried out in March 2005, testing for Legionella was carried out in July 2005 and the stair lifts were serviced on the day of inspection. There were a number of thank you cards from relatives each saying very complimentary things about the home and the care provided to their relatives. During the inspection there was an opportunity to speak with the relatives of one of the residents who was visiting the home. They too were very positive in their comments about the care their relative received. They also stated that they looked at approximately nine other homes before deciding that Oakside was the home for their mum. They stated that it was `way ahead of others’. The main reasons given for choosing Oakside were that it was homely, had a very good atmosphere, and it was a relatively small home. Oakside DS0000021395.V255332.R01.S.doc Version 5.0 Page 19 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 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X 2 3 3 X X 3 X X 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 X 3 3 3 3 2 X 2 Oakside DS0000021395.V255332.R01.S.doc Version 5.0 Page 20 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. 1 Standard OP4 Regulation 14(1)(d) Requirement Timescale for action 30/11/05 2 3 OP19 OP38 The manager must write to prospective residents to confirm that having regard to their assessment the home can or cannot meet their needs in respect of health and welfare. 13(4)(a)(c The bolt lock on the door leading ) into the lounge must be removed. 23(4)(e) Records held in relation to fire drills must show the length of each drill and each drill must be fully evaluated. 30/11/05 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 4 5 Refer to Standard OP16 OP36 Good Practice Recommendations The home’s complaint procedure should be amended to reflect that the complainant may contact the Commission at any stage of the complaint process. A central record should be kept to remind the management of when staff supervisions are due.
DS0000021395.V255332.R01.S.doc Version 5.0 Page 21 Oakside Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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