CARE HOMES FOR OLDER PEOPLE
Oakwell Oakwell Lyddicleave Bickington Barnstaple Devon EX31 2JZ Lead Inspector
Adele Adams Unannounced Inspection 11:00 30 January 2006
th 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 Oakwell DS0000039186.V252675.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. Oakwell DS0000039186.V252675.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Oakwell Address Oakwell Lyddicleave Bickington Barnstaple Devon EX31 2JZ 01271 327252 01271 329332 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) Devon County Council Joan Kay Addison Care Home 20 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (10) of places Oakwell DS0000039186.V252675.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The home may admit up to 10 service users on the intermediate care unit over the age of 50 years The maximum number of placements including that of the service users under 65, will remain at 20, of whom 10 may be in the intermediate care unit 6th July 2005 Date of last inspection Brief Description of the Service: Oakwell is situated in the quiet village of Bickington on the outskirts of Barnstaple and was originally constructed in 1974 as a home for older people, it is owned by the Local Authority. In 1994, there was a total refurbishment of the premises; it reopened as the North Devon Community Care Support Centre. The centre houses a residential unit providing accommodation and personal care for up to 20 older people with physical and/or mental health needs; of this 20 up to 10 clients aged fifty years and over may be admitted for short term intermediate care. A respite service is also provided. The centre also houses a home care service and a day centre. Oakwell is spacious, bedrooms are airy and all have full ensuite facilities. Clients are encouraged to bring in personal items to individualise rooms. Clients have lounges and dining rooms they use. There are grounds outside the home and clients do access these. Food is prepared on site and is enjoyed by clients. The decoration is tasteful and the communal areas and atmosphere is homely. Oakwell DS0000039186.V252675.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The Commission for Social Care Inspection has introduced “Key Standards “ to be inspected over each inspection year. Therefore, unless it is felt necessary by the inspector, some standards will not be inspected. To obtain a full picture of the home it is recommended that previous reports also be taken into consideration. This inspection was unannounced and began at 10:50 a.m. and ended at 14:50. The manager and staff were welcoming, and contributed to the inspection. The internal structural work that was previously in progress has been completed. There were 15 clients in residence in the home during the inspection. The inspector toured parts of the home, read client records, staff records, talked with clients and spoke wit and observed staff in order to gather information necessary for this inspection. What the service does well:
This inspection found that the clients at Oakwell are cared for in a pleasant, caring environment, the atmosphere at the home is relaxed and professional. Clients in the Intermediate Care Unit, benefit from having a dedicated team of care staff. These clients also receive support and direction of therapists, nurses and a doctor on a regular basis, this helps to make sure that there is continuity in approach to health and social care and gives clients confidence in the service. The Intermediate Care Service supports clients to be in a position to be able return to living in their own homes. Clients on the two other ‘units’ at Oakwell also benefit from receiving care from dedicated care staff; this helps to ensure continuity and gives clients confidence in the care they receive and the staff that care for them. Oakwell has a respite facility; this provides a really important service for carers in particular. The service enables carers to benefit from a break from their caring role, knowing that their family member will be well cared for in a safe and caring environment. Oakwell DS0000039186.V252675.R01.S.doc Version 5.0 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. Oakwell DS0000039186.V252675.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 Oakwell DS0000039186.V252675.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): 6 There is a dedicated service provided at Oakwell for Intermediate Care and staff are experienced and good at encouraging client independence. EVIDENCE: Oakwell has it’s own dedicated Intermediate Care Unit and team, which can accommodate up to 10 clients. During this inspection, the inspector visited the unit, met and spoke with four of the clients, spoke with staff and read client care records. The care records clearly show the expectations of the clients and it is possible to track progress when reading the records. Clients feel well cared for and that they are benefiting from the care they receive at Oakwell, 3 clients described to the inspector that they are at Oakwell to get them able enough to return to their own homes – something they said is really important to them. Staff are positive about the value of the work they do and what they help clients to achieve during their stay at Oakwell.
Oakwell DS0000039186.V252675.R01.S.doc Version 5.0 Page 9 Oakwell DS0000039186.V252675.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 Each client has an individual plan of care, which identifies health, and social care needs, however the information provided is not always individualised and the monthly review of the care plans needs to take place. EVIDENCE: The inspector read the care records of 4 clients, spoke with clients and spoke with the manager and assistant manager. The client care records do not reflect the level of care that is received by clients, for example one ‘front sheet’ only contained the clients name, another did not provide enough detail about how an element of care needs to be carried out in respect of an individual client. The records of clients receiving Intermediate Care clearly show what the aims of are – this is not the case for all clients. The care plans read generally identified care needs, for example: soft diet but did not provide more information in relation to what additional support the client needs when eating. Oakwell DS0000039186.V252675.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): 12 and 15 Routines within the home are suited to clients’ needs. Clients at Oakwell receive a nutritious well balanced diet. EVIDENCE: Clients told the inspector that they enjoy the food at Oakwell. ‘The food is lovely’ two clients told the inspector. The inspector saw that the menu is displayed on notice boards in the home, the menu runs on a four weekly basis. A copy of the menu commencing on 30/01/06 was provided for the inspector. Each floor of the home has a kitchenette where drinks and snacks can be prepared, the inspector saw these. The inspector read client care records; these gave details of special dietary requirements. The inspector was told that a light supper has been introduced in the evening at approximately 20:00 hrs. The inspector did not have lunch on this occasion. The inspector was shown books about the local area which have been brought for the home, these will be used in a variety of ways – to stimulate conversation and discussion, as a reminiscence tool and as part of a ‘quiz’ –
Oakwell DS0000039186.V252675.R01.S.doc Version 5.0 Page 12 one of the books asks questions about the area. The inspector was advised that clients at the home also enjoy music. The inspector spoke with a member of staff, saw the books that have been purchased, spoke with the manager about activities for clients, read care records and spoke with clients, two of whom say their days at Oakwell are ‘full’. Oakwell DS0000039186.V252675.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): These standards were looked at the previous inspection EVIDENCE: Oakwell DS0000039186.V252675.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): These standards were looked at during the previous inspection EVIDENCE: Oakwell DS0000039186.V252675.R01.S.doc Version 5.0 Page 15 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): 28 and 29 Clients at Oakwell are well cared for by appropriately skilled staff. Staff personnel files could not be accessed. EVIDENCE: The inspector read staff training records and the staff-training plan, which demonstrated all staff undergo essential training such as manual handling and fire training. The inspector saw records that show which staff have completed NVQ course and there are only 3 staff that do not have an NVQ Level 2 in Care. The inspector saw NVQ certificates for some staff who have undertaken this type of course. Conversations throughout the inspection with the manager and various members of staff confirmed that staff have access NVQ training and are at different stages with this. Staff records were not accessible as they continue to be held centrally at a separate Devon County Council establishment. This will be looked at again at the home’s next inspection. Oakwell DS0000039186.V252675.R01.S.doc Version 5.0 Page 16 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 and 38 The experienced manager runs the home effectively putting the needs of clients first. The recording of some health and safety checks needs to be improved. EVIDENCE: The inspector spoke to staff and clients who have confidence in the way that the home is run. Staff advised the inspector that the manager is approachable, supportive and accessible. The inspector observed staff, clients and the manager in conversation together and this confirmed what the inspector had been advised about the manager. The manager has the required Registered Managers Award and much experience of both management and hands on care in the care sector. Devon County Council undertake it’s own yearly quality audit of the home and the home’s own ‘in – house’ quality tool was read by the inspector – these
Oakwell DS0000039186.V252675.R01.S.doc Version 5.0 Page 17 focus on the experience of clients receiving respite care, and Intermediate Care, these are being developed to seek the views of visitors to the home such as, visiting healthcare professionals. Standard 38 was not inspected in full on this occasion as it was met at the last inspection, however it is referred to on this occasion in relation to Standard 15 – the inspector found gaps in the recording of fridge and freezer temperatures. This was drawn to the attention of the manager. Oakwell DS0000039186.V252675.R01.S.doc Version 5.0 Page 18 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 X X X 4 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 3 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 2 Oakwell DS0000039186.V252675.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 OP7 OP29 OP38 Good Practice Recommendations The client plan is reviewed by staff in the home at least once a month and updated to reflect changing needs. Staff record should be accessible. Fridge and freezer temperatures should be recorded every day. Oakwell DS0000039186.V252675.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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