Inspection on 18/07/06 for Oaktrees Care Home

This inspection was carried out on 18th July 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

Oaktrees Care Home 19/04/07

Oaktrees Care Home 02/03/06

Oaktrees Care Home 26/04/05

Oaktrees Care Home 15/12/04

Oaktrees Care Home 24/06/04

Oaktrees Care Home 11/03/04

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Oaktrees Care Home Main Street Alne York North Yorkshire YO61 1TB Lead Inspector John McGarva Key Unannounced Inspection 18th July 2006 10:00 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 Oaktrees Care Home DS0000027975.V304747.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. Oaktrees Care Home DS0000027975.V304747.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oaktrees Care Home Address Main Street Alne York North Yorkshire YO61 1TB 01347 838262 01347 838986 admin@oaktreeshome.freeserve.co.uk 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) The Fisher Partnership Mrs Jaques-Morgan Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (45) of places Oaktrees Care Home DS0000027975.V304747.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd March 2006 Brief Description of the Service: Oaktrees is a care home, which can care for up to 45 residents who require personal or nursing care. It is owned by the Fisher Partnership and is one of four homes in the group. It is situated in the centre of the North Yorkshire village of Alne, near York. It is an older property, in red brick and was previously a domestic dwelling and converted and extended for to its present purpose. It has two floors including ground and a vertical lift provides level access to the first floor. Parking is provided to the front west facing aspect and there is an enclosed garden area to the rear the site. There are 31 single rooms, two of which have en-suite toilet facilities and seven double rooms. The fees charged at 10/05/06 are £300 - £700 per week. Oaktrees Care Home DS0000027975.V304747.R01.S.doc Version 5.2 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 Tuesday 18 July 2006. The inspection lasted 5. Hrs (10am to 3pm). There were 37 residents in the home, 21 of whom were in receipt of nursing care. The inspection focused a number of key standards and some areas of concern identified at the last inspection. An inspection of the premises took place, including a number of bedrooms, bathrooms, and lounge and conservatory areas. Discussions took place with Wendy Atkinson the nurse in charge, nurses, carers, and several residents. The residents appeared content and several made favourable comments about the care they receive from all the staff. What the service does well: The home continues to provide a good quality of care from kindly and wellmotivated staff. There are good systems of documentation in relation to care planning and policies and procedures. The number of care staff with NVQ Level qualifications exceeds the minimum standards required and further training of other staff will increase this further. All residents spoken to indicated their contentment at the quality of the care provided by the nurses and care staff and also commented favourably on the quality of the food provided. Oaktrees Care Home DS0000027975.V304747.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. Oaktrees Care Home DS0000027975.V304747.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 Oaktrees Care Home DS0000027975.V304747.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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are assessed and given sufficient information so that they able to make an informed choice about moving into the home. EVIDENCE: Evidence from the case tracked residents records confirmed that pre-admission assessment sheets are completed prior to admission. The manager or a deputy usually undertakes these either in hospital or the resident’s place of residence prior to admission. The written admission documentation was good and included all the information to ensure the care staff were enabled to meet the social, emotional and care needs of the new residents. Intermediate Care (Standard 6) is not provided in this home. Oaktrees Care Home DS0000027975.V304747.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, and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A good standard of care is being provided by staff who are well-motivated in what they do. EVIDENCE: Individual plastic covered folders are available for each of the home’s residents into which all information relating to their care plan and needs are kept. The plans inspected were of a good and well designed quality with all relevant information pertinent to each individual recorded. Daily statements are made and the timings of these records are recorded utilising the 24 hr clock. There is a place for the resident or relative to sign to evidence that they have seen and been consulted about the care plan. Oaktrees Care Home DS0000027975.V304747.R01.S.doc Version 5.2 Page 10 In conversation it was clear that the residents particular needs and wishes were respected in regard to when and how aspects of care took place. The residents looked well cared for with clean and well-pressed clothes and those spoken to were very happy with the care they were receiving. One lady said that although she no particular named nurse or carer allocated to her the home was small enough for her to know all the staff who were universally kind and caring. She could understand all the staff although some were from foreign parts and she could get all she wanted in reasonable time frames from requesting. The residents confirmed that they could have a bath when they wished and this seemed to be about once per week for most. The storage and administration of medications is managed in accordance with good practice. The ‘Manrex’ 28-day monitored dose system is in use and is well established and managed. Conversations with residents confirmed that their privacy and dignity is respected and the care staff were observed to knock on the residents room doors before entering after the invitation to do so. Oaktrees Care Home DS0000027975.V304747.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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is meeting the resident’s social and dietary needs in a sensitive and caring manner. The quality of the meals provided is good and commented on favourably by staff and residents alike. EVIDENCE: The resident’s routines of daily living are tailored to their needs and choice and there is an activities organiser for 15 hrs per week to assist with in social activities. They felt that there were enough activities; although several mentioned that they weren’t interested in group events. There was a trip organised for next week to Helmsley gardens for which the volunteer bus has been arranged and several of the residents mentioned this excursion to the inspector. Oaktrees Care Home DS0000027975.V304747.R01.S.doc Version 5.2 Page 12 Two residents routinely go to the local church on Sunday’s. Visitors can attend the home at any time they choose, day or night with drinks provided for them routinely and also meals when required. The residents were very complimentary about the quality of the food provided, and the staff spoken to confirmed that the quality of the meals was consistently of good quality. Although there is no proclaimed choice for the main meal of the day, alternatives are readily available when requested and there is a choice of meal at teatime. Many of the residents are rather frail and require assistance with their meals including liquidised meals and this is provided and delivered in a professional and dignified way. Oaktrees Care Home DS0000027975.V304747.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a relevant complaints procedure and the EVIDENCE: The complaints procedure of the home meets the required standard. The care staff confirmed that they had received mandatory training including on adult abuse issues and they knew how to respond to any complaints made by either the residents or their representatives. There have been no complaints made about the service either to the home or the CSCI in recent times. There is a training officer for the organisation who coordinates the statutory training for the four homes in this group. Oaktrees Care Home DS0000027975.V304747.R01.S.doc Version 5.2 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): 19,20, 21, 22, 23,24 25 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment is clean and comfortable with the exeption of the conservatories which are not suitable for old people to be sitting in during hot weather. Further investment in the bathrooms is required so that all the facilities in the home are usable. Oaktrees Care Home DS0000027975.V304747.R01.S.doc Version 5.2 Page 15 EVIDENCE: The premises meet the standards for homes registered before 2002. There are thirty-one single rooms, only two of which have benefit of on-suite toilet facilities. There are seven shared rooms, although in practice, only more than one person occupies two of the double rooms. The home is in consequence full when forty are in residence. There are six bathrooms, three of which have ceiling mounted hoisting tracks and two hoisting cassettes to facilitate transfer into the bath. The other bathrooms are not suitable to bathe those who require assistance. One bathroom has been furnished with a new bath, toilet and sink but is not suitable for the deployment of a hoist. At the last inspection it was mentioned that two bathrooms were to be refurbished with the possibility that one will become an assisted shower and the other provided with a bath in the centre of the room, (Island bath). This has not so far materialised. The temperature of the hot water outlet in the ground floor bathroom was 46 degrees centigrade which is three degrees more that that which is recommended. The lighting in this bathroom is from a small 20-Watt strip light, which seems barely adequate. There is a shower, but it not fit for purpose as there is a step into a rather small cubicle and therefore not accessible to the majority of the residents. There are two conservatories, one small one large but both are too hot for comfort in the summer. On the day of inspection it was very hot and the staff had put old curtains on the roof to minimize the heat in the smaller of the conservatories but to little effect. The larger conservatory was not in use due this problem. Oaktrees Care Home DS0000027975.V304747.R01.S.doc Version 5.2 Page 16 The general décor was satisfactory and there are grab rails provided in the corridors and communal areas to help the residents be independent when moving about. From discussion with the staff it emerged that an additional ‘stand aid’ would help them in assisting the residents to transfer from armchairs to other surfaces. Oaktrees Care Home DS0000027975.V304747.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Satisfactory recruitment practices are followed. There is sufficient staff to provide personal and nursing care. EVIDENCE: The staff spoken to felt that they were able to provide a good level of personal care and that the residents would confirm this when asked. The numbers of care staff with NVQ qualifications is 62 , thereby exceeding the 50 minimum standard and six have trained to NVQ Level 3 standard. There is a key worker and named nurse system on place whereby there is identified care staff are allocated to particular residents and this helps ensure the continuity of care. There is a dedicated activities person provided for 15 hrs per week. Oaktrees Care Home DS0000027975.V304747.R01.S.doc Version 5.2 Page 18 The care staffs are impressed by the support from the provider in regard to mandatory training episodes in Health & Safety, Fire Safety, First aid, Basic food hygeine,Moving & Handling and Abuse awareness. This small group of four homes have a training officer who and arranges all training. A physiotherapist employed by the home undertakes the moving and handling training of the care staff. Oaktrees Care Home DS0000027975.V304747.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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home is focused on benefits to the residents and there is a caring ethos in the home. The future permanent management arrangements need to be clarified and shared with the staff. Oaktrees Care Home DS0000027975.V304747.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager has been in post for several years and she enjoys the respect and support of the staff. Regular meetings are held with the staff to help keep them informed about the running of the home. Recently however, there has been a development in that the manager is taking more a strategic role in the four home organisation and the staff are uncertain what this means in terms of the future development of Oaktrees. Two senior members of the nursing staff have been identified to share the management responsibilities on a trial period of six months. After this time the management arrangemenents are unclear and the nurses spoken to do not know what the provider’s plans are. So far, the CSCI have not been formally informed of this and therefore the necessary screening procedures have not been activated. Staff morale appears good at the present time, save for some uncertainty about the future relating to the above. A newly trained nurse has recently been appointed and she was most impressed with the professional way that the care is planned and delivered to the residents. Questionnaires are routinely distributed to elicit the views of the residents and relatives about the running of the home. A review of the annual development plan, which was intended to be shared with all the staff, was underway at the last inspection. Interestingly, the care staff spoken to were unaware of any development plan for the home. The resident’s relatives in the main deal with their finances save for one person for whom the home is the appointee. Regular formal individual supervision is in place for the care staff. There are records to show that regular servicing takes place for the hoists, gas appliances, lifts etc. Oaktrees Care Home DS0000027975.V304747.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 2 1 2 3 3 1 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 3 X 3 X X 3 Oaktrees Care Home DS0000027975.V304747.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. 1 Standard OP25 Regulation 13 (4)(c) Requirement The water temperature in the bathrooms must not exceed 43 degrees centigrade. Timescale for action 01/09/06 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 OP20 OP21 Good Practice Recommendations Plans should be made to address the excessive temperatures in the conservatories. Plans should be made to bring the two bathrooms not presently functional into use. The lighting in the ground floor bathrooms should be improved. 3 4 OP22 OP32 An additional ‘Stand aid’ should be provided. The provider should discuss with the staff the future management arrangements of the home. Oaktrees Care Home DS0000027975.V304747.R01.S.doc Version 5.2 Page 23 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 © 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 Oaktrees Care Home DS0000027975.V304747.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. 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