Inspection on 19/04/07 for Oaktrees Care Home

This inspection was carried out on 19th April 2007.

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 18/07/06

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 19th April 2007 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.V335389.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.V335389.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 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) John.fisher@fisherpartnership.com The Fisher Partnership vacant post Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (45) of places Oaktrees Care Home DS0000027975.V335389.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th July 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 of the site. There are 31 single rooms, only two of which have en-suite toilet facilities. There are seven double rooms. The fees charged at 26/03/07 are £350 - £750 per week. Oaktrees Care Home DS0000027975.V335389.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, which took place on Thursday 19th April 2007. Mrs Kate Simpson, the senior nurse, was on duty and was available to assist with the process. The manager Mrs Jaques Morgan left the home on 28th February 2007 and two of the senior nurses have been proposed as joint managers. The inspection took from 10:00hrs till 13:00hrs, 3 hrs in total. There were 35 residents in total, with 22 of these receiving nursing care and 13 receiving social care only. The inspection focused on all the key standards and issues, which were raised at the previous inspection. An inspection of some of the residents’ rooms, lounges and bathrooms took place. Discussions took place with the person in charge, care staff residents and relatives. What the service does well: What has improved since the last inspection? The water temperature in the ground floor bathroom no longer exceeds 43 degrees centigrade. Regular meetings with the staff have been arranged and one was held last week. This provides the opportunity for the staff to be informed about the running of the home. A new activities organiser has been employed for 16 hrs per week. Oaktrees Care Home DS0000027975.V335389.R01.S.doc Version 5.2 Page 6 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 summary of this inspection report can be made available in other formats on request. Oaktrees Care Home DS0000027975.V335389.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.V335389.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): 3 and 6 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are records to evidence that the residents’ needs are sufficiently assessed so that their care plans can be developed. EVIDENCE: Evidence from the case tracked residents’ records confirmed that preadmission assessment sheets are completed prior to admission. These are undertaken either in hospital or the resident’s place of residence prior to admission. The written admission documentation is good and includes all the information to ensure the care staff are enabled to meet the social, emotional and care needs of the new residents. Oaktrees Care Home DS0000027975.V335389.R01.S.doc Version 5.2 Page 9 Intermediate Care (Standard 6) is not provided in this home. Oaktrees Care Home DS0000027975.V335389.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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The residents’ needs are assessed and met in a professionally planned and programmed manner. The care staff should be recording the care they provide for all residents. EVIDENCE: Individual 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 are 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. Oaktrees Care Home DS0000027975.V335389.R01.S.doc Version 5.2 Page 11 Currently the care staff only record their interventions in the notes of the residential but not in respect of the nursing cases. Ideally, the care staff making the care interventions should be recording them for all residents and this was discussed with the nurse in charge. There is a place for the resident or relative to sign to evidence that they have seen and been consulted about the care plan. There were thirty-five residents in the home, with one in hospital. Twenty-two were in receipt of nursing care with thirteen requiring social care only. Many require significant assistance with the activities of daily living such as feeding, washing & dressing and assistance with toileting. The relatives of a resident recently transferred from another home expressed satisfaction with the care provided, contrasting it favourably with their relatives previous placement. They said that the nurses were more forthcoming in the information they shared with them and that the general care provided was better. They said the food was good but that the helpings were less than at the previous home. Oaktrees Care Home DS0000027975.V335389.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 & 15 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is meeting the residents’ 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 residents’ routines of daily living are tailored to their needs and choice and there is a new activities organiser for 16 hrs per week to assist with in social activities. The volunteer bus is sometimes arranged for trips out when weather permits. Visitors can attend at any time they choose, day or night with drinks provided for them routinely and also meals when required. Oaktrees Care Home DS0000027975.V335389.R01.S.doc Version 5.2 Page 13 Staff spoken to said there was list of choices for the residents to choose from and alternatives are readily available when requested. Many of the residents are rather frail and require assistance with their meals including liquidised meals. Oaktrees Care Home DS0000027975.V335389.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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a relevant complaints procedure and the staff has received abuse awareness training. EVIDENCE: The complaints procedure of the home meets the required standard and care staff spoken said that they know 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. Staff also confirmed that they continue to receive mandatory training on adult abuse issues. There is a training officer for the organisation who coordinates the statutory training for the four homes in this group. Oaktrees Care Home DS0000027975.V335389.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, 20,21,22, & 25. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The environment is clean and comfortable with the exception of the conservatories which are not suitable for old people to be sitting in. Further investment in the bathrooms is required so that all the facilities in the home are usable. 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 Oaktrees Care Home DS0000027975.V335389.R01.S.doc Version 5.2 Page 16 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. Before the last inspection one bathroom had been refurbished with a new bath, toilet and sink but deployment of a hoist for the bath is not possible and in consequence it cannot be used. There is a shower, but it cannot be used as there is a step into a rather small cubicle and therefore not accessible to the majority of the residents. At the last inspection a resident mentioned the lack of showering facilities to the inspector. At the last inspection the inspector was informed that two bathrooms were to be refurbished, one becoming an assisted shower and the other providing a bath in the centre of the room, (island bath). These plans have not has not so far materialised. The lighting in the ground floor bathroom is from a small 15-inch strip light, which provides insufficient light for the staff to make observations about the quality of the residents skin when darkness falls. There are two conservatories, one small one larger, but both get too hot in summer and are inadequately heated for winter use. In consequence the communal areas appear rather cramped. The décor is generally satisfactory and there are some grab rails provided in the corridors and communal areas to help the residents be independent when moving about. Additional garb rails are required to facilitate the residents’ self-locomotion around the ground floor corridors. From discussion with the staff at the last inspection it emerged that an additional ‘stand aid’ would help them in assisting the residents to transfer from armchairs to other surfaces. This was recommended in the report but so far no extra provision has been made. Oaktrees Care Home DS0000027975.V335389.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 & 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Satisfactory recruitment practices are followed and there are sufficient staff to provide personal and nursing care. EVIDENCE: The staff spoken to feel that they are able to provide a good level of personal care with the numbers of staff provided. Since the last inspection in July 2006 twenty-two members of staff have left, eleven of which were care or nursing staff. This has helped reduce the total numbers of care staff who have NVQ Level 2 from 62 to 33 . There is a key worker and named nurse system in place with identified staff allocated to particular residents, helping ensure the continuity of care. There is a new activities person provided for 16 hrs per week. Oaktrees Care Home DS0000027975.V335389.R01.S.doc Version 5.2 Page 18 The provider provides good support in regard to mandatory training in Health & Safety, Fire Safety, First aid, Basic food hygeine,Moving & Handling and Abuse awareness. There is a designated person who is responsible for ensuring that statutory and other training takes place. A physiotherapist who works 14 hrs per week undertakes the moving and handling training of the care staff. Oaktrees Care Home DS0000027975.V335389.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 & 38 People who use the service experience good quality outcomes in this area. 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. EVIDENCE: At the last inspection there was uncertainty amongst the staff about the future management of the home when the manager who had been with the home for a number of years left in February 2007. The provider’s plans for the home have now been clarified however and Mrs Sue Tunstall and Mrs Wendy Atkinson, senior nurses, who have been sharing the management responsibilities on a trial period of six months, have been proposed as joint Oaktrees Care Home DS0000027975.V335389.R01.S.doc Version 5.2 Page 20 managers. Formal procedures for registration of these managers with the CSCI have not yet been completed. Regular meetings are held with the staff to help keep them informed about the running of the home and one was held last week. Regular formal individual supervision is in place for the care staff. Quality assurance questionnaires are routinely distributed to elicit the views of the residents and relatives about the running of the home. The resident’s relatives in the main deal with their finances save for one person for whom the home is the appointee. There are records to show that regular servicing takes place for the hoists, gas appliances, lifts etc. Oaktrees Care Home DS0000027975.V335389.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 X X 3 X STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Oaktrees Care Home DS0000027975.V335389.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 OP31 Regulation 9. (1) (2) Requirement The provider must submit an application / applications to the CSCI for the manager/managers of the home. Timescale for action 01/06/07 Oaktrees Care Home DS0000027975.V335389.R01.S.doc Version 5.2 Page 23 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 3 Refer to Standard OP8 OP20 OP21 Good Practice Recommendations All the care staff should make a record of their interventions and observations, not just the nurses. 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 bathroom should be improved. 4 5 OP21 OP22 The provider should consider providing the residents with assisted shower facilities. An additional ‘Stand aid’ should be provided. Additional grab rails should be provided in the ground floor corridors to help the resident’s access throughout the home. 6 OP28 The provider should endeavour to have at least 50 of care staff trained to NVQ Level 2 standard. Oaktrees Care Home DS0000027975.V335389.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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. 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