Inspection on 10/10/06 for Oakville Park Nursing & Residential Home

This inspection was carried out on 10th October 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

Oakville Park Nursing &... 03/02/06

Oakville Park Nursing &... 11/10/05

Oakville Park Nursing &... 08/12/04

Oakville Park Nursing &... 23/06/04

Oakville Park Nursing &... 24/02/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

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 Oakville Park Nursing & Residential Home 76-80 Duchy Road Harrogate North Yorkshire HG1 2HA Lead Inspector Anne-Marie Foster Key Unannounced Inspection 10th October 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 Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.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. Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakville Park Nursing & Residential Home Address 76-80 Duchy Road Harrogate North Yorkshire HG1 2HA 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) 01423 523939 01423 500083 www.oakvillepark.co.uk Mrs Christine Mitchell Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33), Terminally ill (33) of places Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service Users to include up to 33 (OP) and up to 4 (TI) up to a maximum of 33 Service Users. (OP) - 50 years plus (TI) - 40 years plus Date of last inspection 3rd February 2006 Brief Description of the Service: Oakville Park is made up of three large Victorian terraced buildings. There are well kept gardens and a large parking area to the rear. The home does not have a vertical passenger lift and access to the different floors in the home is by use of the stairs or stair lift. There are single rooms and shared rooms, most with en suite facilities, and rooms are decorated in a classic but homely fashion. The home is registered to take 33 residents and provides nursing and residential care. It is situated close to all the local amenities and shops in Harrogate. Weekly fees range from £442 to £650 as at September 2006. Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit took place over six hours on 10th October 2006. All of the key standards were inspected. Information for the inspection was gathered in a variety of ways. This included a pre inspection questionnaire, talking with six service users and five staff plus comments received by two relatives. Observations were made over the day on how the staff interacted with the service users. Notifications sent to the Commission for Social Care Inspection from the home were also used as part of the information gathering aspect of the inspection. The deputy manager was available to assist, and feedback was given at the end of inspection. What the service does well: What has improved since the last inspection? The small food service lift is now being used to transport food to the dining room, rather than it being taken outside of the building, and so reducing the risks of contamination by exposure. Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.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. Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.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 Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.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. Quality in this outcome area is good. Prospective service users are not admitted without a detailed assessment being carried out first, so that the home can be sure that they can meet the health, personal and social care needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care files of five service users were examined, and the pre admission assessments were looked at. Assessments are carried out by the registered manager and include any information available from health and social care services, if involved. These were detailed and thorough and provided staff at the home with information that would help them to develop a plan of care. Service users confirmed that they had been assessed in their own homes prior to being accepted for admission and that they were reassured that their needs could be met. The home does not provide intermediate care. Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.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. Service users live in a home where their care needs are met and where they are supported by a sound medication system. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service users plans of care were available for inspection. These are currently under review and the inspector looked at a sample of old and new care plans. The care needs of the service user are well set out and describe the actions to be taken to meet those needs. The four care plans examined had not had a monthly review; the deputy explained that this was because there had been no changes. It is, however good practice to review the plans at least monthly and if there are no changes to record this fact so that staff can be certain they are not missing any changing health and personal care needs. Service users said to the inspector that their needs were being met. One service users said “we wouldn’t expect anything less”. Service users looked well cared for. Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.S.doc Version 5.2 Page 10 The staff are enthusiastic about the care that they give and in particular are comfortable with referring to other health professionals when necessary for example the specialist nurse or G.P. The home ensures that service users are able to access health care services when needed. The medication system was examined. The home uses the Monitored Dosage System of cassettes for the administration of medicine, which staff say works well. The medicine administration records were inspected and no omissions were found. The controlled drugs were checked and found to be in order, however the room where these are stored is very small with no work surfaces which makes counting these drugs out awkward. Staff were observed during the course of the day and were seen to work in a quiet, respectful way. Service users are addressed in the way that they prefer, and staff knock before entering peoples rooms. Induction of staff includes training on how to treat service users with respect at all times. Those service users that share a room have adequate screening facilities to ensure that privacy is maintained. Service users were keen to tell the inspector that “staff treat me with respect” and “staff are kind and respect my privacy”. Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.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. Service users live in a home where they can enjoy a variety of activities and where they are helped to make choices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides a good quality range of activities for the service users. On the day of the inspection a qualified occupational therapist was organising a current affairs session, which was enjoyed. This was followed by a game of bingo. Twice a week an exercise session takes place; a qualified trainer runs this and enables the service users to participate by tailoring the session to suit their capabilities. The home has its own minibus, and recent outings included a trip to Studley Royal and a canal boat cruise. The home held a summer barbeque in the garden to which service users and their relatives or friends as well as the staff and their families were invited. Service users are able to attend church services or receive communion if they wish in the home. Service users spoken with said that “there are enough activities” and “we enjoy a variety of activities”. Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.S.doc Version 5.2 Page 12 Visitors are able to come and go as the service user wishes, and the home maintains the contact of the community. Choices are available, and the service users can choose how they wish to spend their day as the routine at the home is flexible. The lunchtime meal was observed in each of the two dining rooms. The downstairs dining room is smartly laid out and staff were available to assist as necessary. The meal looked wholesome and well balanced. The small upstairs dining room is not as well laid out and is next to a small open kitchen where the washing up is done. The setting here is not as congenial as the downstairs room. Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.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. Service users know how to make a complaint and are confident that any complaints they have will be listened to and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Five service users and three staff were spoken with and each agreed that they knew how to make a complaint, and were confident that they would be taken seriously. One service user said that there was an open system of management at the home and that the manager was very approachable, and so it would be easy to pass any comments on. The inspector examined the complaints policy, this was straightforward and informative, although some information in the entrance hall about the Commission for Social Care Inspection needed to be updated. The home has not had any complaints from service users or relatives since the last inspection. One anonymous complaint received by The Commission for Social Care Inspection, which related to an allegation of poor lifting practices, was thoroughly investigated by the provider and the complaint was not upheld. The home has robust policies that relate to the protection of service users, and these reflect the guidelines published by the Local Authority. They are kept under review and are included in the staff induction and foundation training so that staff are made aware of the procedures to follow if they suspect any abuse. Staff spoken with were aware of the procedures to follow should they Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.S.doc Version 5.2 Page 14 suspect any problems, and this will help to reduce any risks of harm to the service user. Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is adequate. Service users live in a clean home that is well maintained, however there are areas that need to be reviewed in order to maintain peoples safety and comfort. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is not purpose built and its layout is complex, but was found to be clean, warm and service users rooms were comfortable. A redecoration and improvement programme for service users rooms is in place at the moment to the top floor. One service user was keen to point out that the workmen were not being intrusive and that she was not being inconvenienced. The upstairs dining area is not as pleasantly laid out as the downstairs one and service users sit by the small open kitchen where, at times all of the used plates are returned and stacked up ready for washing. This kitchen has very little work surface. During the lunch time, used plates were seen to be stacked Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.S.doc Version 5.2 Page 16 up high, alongside plates with fresh sandwiches. This is unsightly for those service users that eat near the kitchen and a hazard for those working there. There is a small laundry area downstairs. This laundry however does not have enough room to accommodate an ironing board, so ironing needs to be done in a small area behind the door to the Community Care office. Whilst this is not a problem for the laundry person, it is a hazard for those coming through the door from the office and poses a threat to staff health and safety. The medication room is very small and the inspector and one nurse could barely fit into it. There is no room or work surface for the drugs register when completing the medication audit. The staff office where care plans are stored and written is just large enough to fit two people in, however there is no window or natural light, which makes the room claustrophobic. As the home is made up of three terraced houses joined in the middle there is no shaft lift available, this means that service users can only go up and downstairs by foot or by stair lift. All of the service users spoken with agreed that this was not a problem and that they knew about the situation prior to moving in to the home. The medication trolley cannot be wheeled around the home because of the lack of lift, and a tray has to be carried around in order to dispense medications to service users. It was noted by the inspector that medication pots had service users names on them however the deputy manager, assured the inspector that secondary dispensing does not take place. Three water temperatures were found to be too hot, which poses a risk of scalding to the service users. This was rectified immediately, and temperatures were tested again and found to be satisfactory. The sluice door has no lock. The hot water temperature in this room was 55 degrees and action was taken immediately to rectify the situation, in order to protect service users from risk of scalding. Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.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. A good compliment and skill mix of staff meets the service users needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users say that there are enough staff available. Five service users spoken with said that staff are “kind and work hard”, and that they “had enough time to do their jobs”. There were 8 staff on duty on the day of the inspection to care for up to 33 service users. Three staff members were qualified nurses and the remaining 5 staff were experienced carers. There was a good compliment and skill mix of staff available to meet people’s needs. Over half of the care staff have their National Vocational Qualification (NVQ2) certificate in care (excluding the qualified nursing staff) and there are plans to enrol more staff on to the course in the future. Service users’ needs are met by well-qualified staff. The recruitment system was examined. The inspector looked at 4 staff files and found the documentation required by regulation to be satisfactory. Service users are supported by the robust recruitment practice, policies and procedures. There is a staff-training programme in place, and staff were able to tell the inspector that they felt they had “enough training opportunities”. All the staff Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.S.doc Version 5.2 Page 18 spoken with were clear about their role in the event of an allegation of abuse and could demonstrate that they were knowledgeable about the home’s policy relating to the protection of vulnerable adults. In house and external training events are provided and staff are trained and competent to do their jobs. Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.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. Service users live in a home that is well run by an experienced caring manager. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An experienced manager runs the home with the assistance of a knowledgeable, enthusiastic deputy manager. Service users were complimentary about the style of management at the home and said that the manager was “approachable”. The home has a quality assurance system and annually seeks the views of service users and others about the quality of the service they receive. The results are collated, and the inspector was able to see that the responses were very positive, and that the home is run in the best interests of the service users. Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.S.doc Version 5.2 Page 20 The home holds some personal allowance monies on behalf of the residents, and records and receipts of transactions are kept. Residents do have a safe in their bedrooms with a key so they are able to keep their own monies if they wish to do so. The registered manager ensures that the health and safety of service users and staff is promoted, however the areas that have already been mentioned in the environment section of this report need addressing. The staff manual and induction training looks at issues relating to moving and handling, health and safety, first aid, fire safety, food hygiene and infection control. All staff receive this mandatory training at the start of their employment plus refresher training periodically. A random selection of safety reports and certificates were examined and found to be up to date. Accidents are clearly recorded within daily records and the home’s accident book. The polices and procedures relating to safety were available and these are reviewed regularly to ensure that the home is up to date with the best practice. Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.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 4 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 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 3 X 3 X 3 X X 2 Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.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 OP26 Regulation 23 (2) (f) Requirement The registered provider must ensure that a lock is fitted to the sluice door. The registered provider must ensure that hot water temperatures are maintained within the expected parameters (43 centigrade) and action must be taken when the temperatures exceed normal. (Immediate action was taken on the day to rectify this). Timescale for action 31/10/06 2 OP38 23 (2) 10/10/06 Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.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 Refer to Standard OP19 OP15 Good Practice Recommendations It is recommended that the upstairs dining room experience be reviewed in order to provide these service users an enjoyable, peaceful, pleasant setting in line with the standard available in the downstairs dining room. It is recommended that the laundry system be reviewed with particular attention to finding a safer place to do the ironing use. 2 OP26 Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.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: 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 Oakville Park Nursing & Residential Home DS0000027943.V311898.R02.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!