Inspection on 14/05/08 for Oakwood Care

This inspection was carried out on 14th May 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Oakwood Care 06/05/09

Oakwood Care 15/05/07

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Oakwood Care 192 West End Road Bitterne Southampton Hampshire SO18 6PN Lead Inspector Mark Sims Unannounced Inspection 14th May 2008 13:30 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 Oakwood Care DS0000069021.V363144.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. Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakwood Care Address 192 West End Road Bitterne Southampton Hampshire SO18 6PN 02380 466143 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) G & A Investments Projects Ltd Mrs Karen Lynn Perrin Care Home 28 Category(ies) of Dementia (0), Mental disorder, excluding registration, with number learning disability or dementia (0), Old age, not of places falling within any other category (0) Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following catergory/ies of service only: Care home - to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Dementia (DE) 2. Mental Disorder, excluding learning disability or dementia (MD) The maximum number of service users to be accommodated is 28. Date of last inspection 11th October 2007 Brief Description of the Service: The service is situated in a quiet area off a main road. It has parking at the front and to the rear. The accommodation is on both the ground floor and first floor, which is accessed by stairs of a chair lift. The home has pretty gardens and seating outside as well as a lounge and dinning area. There are two double rooms that are separated by a curtain both rooms have two sinks. The other rooms are all single with ensuite facilities. The fees for the home are £480 per week. Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection was, a ‘Key Inspection’, which is part of the regulatory programme that measures services against core National Minimum Standards. The fieldwork visit to the site of the agency was conducted over six hours, where in addition to any paperwork that required reviewing we (the Commission for Social Care Inspection) met service users, staff and management. The inspection process involved pre fieldwork activity, gathering information from a variety of sources, surveys, the Commission’s database and the Annual Quality Assurance Assessment information provided by the service provider/manager. The response to the Commissions surveys was reasonable, with seven service user surveys returned prior to the report being written. What the service does well: The environment is being upgraded and/or updated with the entire ground floor having been freshened up and largely refurbished. Investment is also being committed to improving the first floor environment, one bedroom visited during the fieldwork visit having been updated and refurnished. The standard of the new décor and furniture is good and the home has a pleasant ambiance. Meals are home cooked, including the cakes that are supplied for afternoon tea, and fresh fruit was noticed to be available to residents during the visit. The service is good at meeting people’s requests for support in accessing external entertainments or community based services, with people discussing visiting the local church and one persons’ records indicating how they are being supported to attending the local ‘British Legion’. The company’s complaints process is prominently displayed within the main corridor of the home and also within the ‘service user guide’ and ‘statement of Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 6 purpose documents, which are accessible to people within the main corridor of home. 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. The summary of this inspection report can be made available in other formats on request. Oakwood Care DS0000069021.V363144.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 Oakwood Care DS0000069021.V363144.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): Standards 3 & 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who may use the service and their representatives have the information needed to choose a home that will meet their needs. EVIDENCE: We (the commission) received seven service user comment cards, all of which were ticked ‘yes’ in response to the questions: ‘did you receive enough information about this home before you moved in so you could decide if it was the right place for you’ and ‘have you received a contract’. During the visit we spoke with two people who had recently moved into the home, one person accompanied by a relative who was helping them settle into their new accommodation. Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 9 The first person stated that their family had found the home via the Internet and had arranged for them to move into the home from abroad, the manager confirming during a conversation that the company has a website, which provides people with details of its services. The person, for obvious reasons could not visit the home prior to being admitted, however, they were clear that the home was meeting their needs. The second person spoken to and their family discussed having attended a recent open day at the home and how they had been shown around and visited the room their relative was to move into. The relative stated that they had been impressed by the way the home managed the admission process and were pleased by the efforts of the staff and the manager to prepare their next-of-kin’s room in preparation for their arrival, putting up extra shelving, etc for them. During the review of the home’s documentation we saw several completed in house pre-admission assessments and professional assessments provided by the placing authority care managers. In addition to this documentation the manager has also introduced an enquiries form, which staff completed when people visit the home or when they call about possible placements/vacancies. This form is used to gather basic information about the prospective resident and to facilitate a return call by the manager, who can explore the possible admission further and arrange for assessments to be undertaken. During the visit the manager produced a draft copy of the home’s new ‘service users guide’ / brochure documentation, which is being revised and updated. The manager also produced a diary entry, as evidence of a forthcoming meeting with the publishers, which she stated was to finalise the details of the new document. Standard 6 was not reviewed and/or considered, as the home does not provide an intermediate care service. Oakwood Care DS0000069021.V363144.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): Standards 7, 8, 9 and 10: Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive may be based on their individual needs, however this is poorly demonstrated via the home’s care planning process. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Four ‘service user plans’ were reviewed during the fieldwork visit. The records maintained by the home were found to be confusing and complicated, with the manager stating that she is presently in the process of updating and revamping the system. What was found during the visit was that presently the staff are being asked to work with three separate files, each of which contains information about the residents care that often crosses between each file, leading to the person reviewing the care failing to maintain the records accurately. Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 11 An example of this being the risk assessments documents, which are split between the file, leading to situations whereby some aspects of the service users behaviours are not being properly identified and managed. A potential conflict between two residents, which might recently have result in one person pushing the other over, documented within the running records but not entered onto the risk assessment documentation. Another, example, was the failure to consider how the home would manage a clients diabetes if the persons’ blood sugars became too low, although despite identifying the potential risks associated with a high blood sugar and having obtained information on the likely causes and ill-effects of hyperglycaemia (high blood sugars). Whilst it should be acknowledged that these issues might have arisen even if the care planning system were simplified, it is more likely that an audit, by the manager, etc, would have picked up on the shortfalls and lead to the issues being appropriately planned and managed. The view of the residents, as expressed via the commissions’ surveys, is that generally people are receiving the care and support they require. People spoken with during the visit also provided evidence and/or testimony to the support provided by the staff, one person discussing how they have been supported in attending church, which is of importance to them from both a religious and social prospective. The residents’ surveys also indicate that people feel they are being appropriately supported when accessing health care services, all seven people ticking ‘always’ in response to the question: ‘ do you receive the medical support you need’. The ‘service user plans’, referred to above, do contain documented evidence of people’s involvement with health and social care professionals, these records including the running records and correspondence between health care providers and the resident. An example of the records maintained, include an account of the recent incident between two residents’, as mentioned above, which resulted in the staff contacting NHS direct and arrangements for one of the people involved to be taken to ‘Accident and Emergency’ (A&E) for treatment. The records show the person was accompanied throughout this visit and that details of the action taken by the hospital staff in assessing and treating the injuries sustained during the fall, fully documented. Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 12 Other records, i.e. the admission information sheet, etc, contain details of the primary care professionals the people are involved with, General Practitioners and Care Manager’s, etc. Other records indicate that arrangements are in place for people to receive visits from chiropodists and opticians, two people noted to have recent sight evaluation records on their files. The care staff were also noticed to have access to a range of moving and handling equipment, including free moving hoists, static bath hoists and wheelchairs. Other equipment provided by the service to promote and ease the delivery of care included a medications cabinet, which enabled the staff to safely transport people’s medicines around the home during medication administration, although as the home does not have a lift this could not be taken further than the bottom of the stairs. The storage of the service users medication was reviewed during the fieldwork visit and found to be safe and secure, whilst the records appertaining to the handling and administration of the residents’ medicines accurately completed. A review of the medication procedure used by the service was undertaken during the visit and was found to be acceptable, however, guidance has been produced by the ‘Royal Pharmaceutical Society’ on the safe management of medicines in social care settings, it is advised that a copy of this document be obtained, as a supplement to the services own policy and procedure. During the visit it was established that no residents’ were taking controlled medications and so the storage facility for these medicines was not examined. Stock medications are held within a separate medication storage facility, which is located away from any area of the home routinely accessed by the residents. Medication stocks are kept to a minimum and records indicate that the home’s medication fridge is checked on a daily basis to ensure it operates within safe and acceptable parameters. Staff observed administering medicines did so safely and appropriately, taking the medication to the service user, administering the medicine and then returning to sign the medication record. During the tour of the premise creams belonging to residents were found in communal facilities and not either secured in the residents’ bedroom or returned to the appropriate storage area. This was discussed with the manager, who accepts that this should not have Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 13 happened and pointed out that it was isolated occurrences, with only two creams noted during the tour. During the fieldwork visit the staff were noticed knocking on people’s bedroom door (if closed) and on the office, toilet and bathroom doors before entering. The residents preferred term of address was document on their ‘service user plan’ and the interaction between the staff and the residents and the staff and the visitors noted to be appropriate and respectful. The environment is designed to provide a degree of privacy for the residents’ with communal facilities fitted with appropriate locks, which can be operated by people with both physical and cognitive impairments. Bedrooms are either single occupancy or shared, with the shared rooms fitted with screening to provide privacy during the delivery of personal care. Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 14 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): Standards 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. People who use services are able to make choices about their life style, and supported to develop their life skills. Social, educational, cultural and recreational activities could be improved to better meet individual’s expectations. EVIDENCE: The service tell us via their AQAA, that: ‘Our activities have improved and I have opened a sensory room for all our residents to have group discussions and one-to-one or religious observances, ‘Father Ray’ visits the home on a regular basis’. During the fieldwork visit ‘Father Ray’ visited the home and spoke to us about his time with the residents and how he seldom undertakes a religious service, with people preferring to visit the church, therefore his visits are often social and involve talking to people about a variety of topics. Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 15 He also discussed the care provided at the home and described the care staff as lovely and how he felt they provided a good service to the people residing at the home. As mentioned earlier people spoken with during the visit discussed the activities they are involved with outside of the home, which included visits to a local church, visits to the Royal British Legion and pub outings. People also discussed the recent open day, which was described as fun by residents and informative and enjoyable by relatives. The new sensory room was visited during the fieldwork visit. This room, which is located just off the main lounge provides the residents’ with a quiet area, which can be accessed when the person requires peace and solitude or as a facility that will promote sensory stimulation aimed at relaxing the individual. The area also houses many of the home’s games and puzzles, etc and staff were observed preparing for a bingo session during the tour of the premise. The communal facilities of the home consist of one large lounge, the dining room and the sensory or quiet room. The main lounge, whilst one large room, is sectioned off into three areas, each area allowing for a different activity, etc to take place within it, including a quiet area, a games and social activities area and a television area, which during the visit was being used to screen Mary Poppins. The ‘service user plans’ are used to document the activities people are involved in both on a day-to-day basis, as in the case of the bingo sessions, hairdressing visits, etc and as part of their on-going care needs, as in the case of the church and Royal British Legion visits. The response to the residents surveys indicate that generally people feel sufficient activities are provided at the home, with four people ticking ‘always’, one ‘usually’ and two ‘never’ in reply to the question: ‘are there activities arranged by the home that you can take part in’. The home’s visiting arrangements are detailed within the ‘service user guide’ and ‘statement of purpose’ documentation, which the manager states she provides to all prospective residents’ or their representatives, copies of these documents were available within the home’s reception hall. During our visit a number of visitors were observed arriving at the home and being welcomed by the staff prior to meeting up with their next-of-kin. In conversation with a relative it was established that a member of their family will be visitng everyday to support their next-of-kin and that so far they have found the home and the staff to be very friendly and welcoming. Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 16 The above relative being the people who confirmed they had visited the service during its recent open day. A signing in book is located within the main hallway, which provides a good indication of the number and variety of people visiting the home, which included both professional and social visitors. The manager comments via the AQAA, that: ‘some residents would want to participate in activities, etc, whilst others would wish to be left alone with some level of indpendence and privacy. All residents are within the home are left to exercise choice and control re their lives’. As mentioned previously the care planning records and the assessment documents identify people’s needs and wishes in respect of their social activities, an example being the person who requested that they be supported in accessing the local ‘Royal British Legion’ and whose care plan and running record document that this has been achieved. The tour of the premise established that people have been encouraged to personalise their rooms and the efforts are made by the staff and/ot manager to support residents in this process. The family of a recently admitted resident discussing how the staff had arranged for shelving to be put up in their next-of-kin’s room, prior to their arrival so they could display some personal items. Other people’s rooms, visited during the fieldwork visit, also showed signs of having been personalised by the occupant, with pictures, ornaments and furniture used to create familiar and individual environment. Information, taken from the residents’ surveys, indicate that people generally feel they receive both the ‘care and support they require’ and that the staff are available to help them when required, listen to their requests and respond appropriately’. The residents’ surveys also indicate that the meals provided at the home are popular with five people ticking ‘always’, one ‘usually and one ‘sometimes’, in response to the question: ‘do you like the meals at the home’. One person also added: ‘we have a female chef who works Monday to Friday but at the weekends the carers cook the meals, which aren’t so good. The chef’s meals are excellent’. During the fieldwork visit the catering arrangements for the weekends were discussed with the manager, who confirmed that there is no weekend cook and that members of the care team are rostered to cook and that they are Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 17 employed in addition to the care staff. The manager producing copies of the forthcoming duty rosters, which evidenced that in addition to the three care staff on duty a fourth person was allocated to the kitchen. The tour of the premise enable us to visit the kitchen, dining room and food storage facilities, where time was taken to speak to the cook. She confirmed that she had completed food hygiene training courses and had experience as a catering manager. She also discussed the menus and showed us the records she maintain in respect of the food served and the equipment check undertaken. The food storage facilities were appropriate and provided sufficient dry, cold and frozen food stores and there was a range of catering and/food items available. Observations made during tea, established that mealtimes are social occasions and that sufficient staff are around to support the service users eat their meals. The dining room is spacious and comfortable and provides adequate seating for all of the people accommodated at the home, although people can choose to dine in their rooms, should they wish. The manager during the tour of the premise discussed the home’s arrangements for breakfast, which is a self service arrangement, although staff are in the dining room to assist people, with breakfast cereals laid out on a bench along with fruit juices, milk, sugar, etc. Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 18 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): Standards 16 & 18: Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns, and have access to a robust, effective complaints procedure, and are protected from abuse, and have their rights protected. EVIDENCE: The service tells us, via their AQAA that: ‘I have issued a complaints book, which is situated in the hallway near to the signing in book. I have placed, on display where complaints can be forwarded onto if they need to inform a higher authority. Residents’ have a complaints form but all complaints are recorded on a questionnaire form and then recorded into the quality assurance file’. The dataset, which forms part of the AQAA documentation, establishes the existence of the home’s complaints and concerns procedure and that this was last reviewed in the June of 2007. The dataset also contains information about the home’s complaints activity over the last twelve months: No of complaints: 2. Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 19 No of complaints upheld 0. Percentage of complaints responded to within 28 days: 100 . No of complaints pending an outcome: 0. The evidence indicates that people’s complaints are being appropriately handled, with written responses, where appropriate, being dispatched by the manager, a complaints logging system, as mentioned above, is used to document all activities associated with complaints. Details of the home’s complaints process are on display within the home and are made clear to people via the ‘service users guide’ and ‘statement of purpose’, which are also accessible around the home. The indication, from the survey respondent is that people are generally aware of the home’s complaints process and when people have raised concerns these have been appropriately handled. The dataset indicates that policies on the protection of residents’ are in place, ‘Safeguarding adults and the prevention of abuse’ and ‘Disclosure of abuse and bad practice’, both policies updated in the March of 2008. The dataset also establishes that over the last twelve months no safeguarding referrals have been made to the Local Authority, a statement that is not support by our (the Commission) database, which established that one alert had been brought to the Commission’s and Local Authorities attention during this period, an alleged mishandling of a resident, which caused bruising and prompted the manager to alert the above agencies. This incident has now been investigated and satisfactorily resolved. The service tells us, via the AQAA that their aim is to: ‘also keep up with protection of vulnerable adults (POVA) / abuse training’. However, the during the visit the manager discussed the loss of the company’s training manager, a role that has yet to be refilled, which has lead to a stagnation in the delivery and/or planning of training. On reviewing the training matrix, it was apparent that none of the care staff had recently completed ‘safeguarding training’. The manager acknowledging that this was a priority and that a full review of all staff training and development needs would be undertaken. In conversation with staff it was apparent that they appreciated their role in ensuring people are protected from abuse and/or harm, although during discussions with two senior staff the need to ensure issues, like the incident identified earlier within the report, involving the two residents whom appear to Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 20 clash, are promptly brought to the authorities attention and that risk assessments are completed. The staff are aware of the company’s policies and procedures on complaints and protection and identified that files are available in the managers’ office. Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 21 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): Standards 19 & 26: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: A tour was made of the premise in the company of two senior carers. The building was generally in a good state of repair, with the ground floor bedrooms and communal areas all having been recently redecorated and furnished to a good standard. During the tour of the premise a vacant residents’ bedroom, on the first floor, was visited, this was in the midst of being redecorated, which the senior carers informed us was standard practice when a room was vacated, however, the Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 22 plan is to redecorate the entire first floor to the same standard as the ground floor. Several residents’ were visited in their bedrooms during the fieldwork visit, each room found to provide living space that meet the needs of the occupant, some rooms provide en-suite facilities, all rooms had been personalised by the occupant. The service indicates, via the AQAA that three maintenance personnel are employed at the home and that they are responsible for the upkeep of both the internal and external areas of the home. The AQAA also indicates that faults are reported via a maintenance log, a statement support by the findings of the fieldwork visit, when the maintenance logging system was checked. The system currently requiring the care staff to entered into the maintenance log and faults or defects noted during their shift, which the maintenance personnel then address and sign off as completed. The home employs two domestic staff who are responsible for the day-to-day cleaning of the home. During the tour of the premise the home was noticed to be clean and tidy throughout, a view shared by the residents’ with all seven respondents ticking ‘always’ in response to the question: ‘is the home fresh and clean’. The dataset tells us that staff receive access to training on the management and control of infections and that policies and procedures are available, these were last reviewed and/or updated in the March of 2008. Communal toilets and bathrooms were noted to contain liquid soaps; paper towels and bins for the disposal of waste and chemicals were generally stored in accordance with the ‘Control Of Substances Hazardous to Health’ (COSHH) regulations, although two items governed by these regulations were located in areas that could be accessed by residents, however, the manager promptly arranged for these to be removed and secured appropriately. Data sheets, guiding the staff on the use, storage and management of the chemicals used in the home, in emergency situations, were available and a designated, lockable cupboard is available to store all COSHH materials. The laundry is located within the main building and the staff are responsible for laundering residents clothing and returning this to the client room. Clothes are labelled to reduce the possibility of lose or the item being returned to the wrong person, however, the manager acknowledged that from time-to-time errors do occur. Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 23 Whilst the laundry is small it does appear functional and contains both a large industrial washer and dryer. Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 24 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): Standards 27, 28, 29 and 30: Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and provided in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. EVIDENCE: The service tells us via the AQAA that: ‘a rota system is in place for both day and night staff. The rota is flexible and changes based on the needs of the service users, which determine the numbers of staff on duty. We have two wakeful night staff, who carryout hourly checks, which are documented and all night staff are over the age of 21 years old. All new staff complete and induction and are enrolled either on a National Vocational Qualification (NVQ) level 2 or 3’. Copies of the home’s duty roster were seen during the fieldwork visit and seemed to indicate that sufficient care staff were on duty to meet the needs of the residents’. The indication from the residents’ surveys is that people generally feel the staff are available when required and that they provide the care and support they need. Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 25 Observations made during the fieldwork visit indicate that sufficient staff are on duty to support the residents’, with staff noted preparing to play bingo with the residents, as well as being available to assist them with their evening meals. Staff training opportunities have been effected by the loss of the company’s training manager, as mentioned earlier in the report. The manager during a conversation stated that she and the manager’s of Oakwood’s sister home’s have been meeting in order to produce a training plan, however, this is not yet available. Within the manager’s office and displayed on a staff notice board were details of a forthcoming training session on the management and prevention of fires. The manager was also able to produce a training matrix that documents the courses attended by the staff over the preceding twelve months, including dementia awareness, moving and handling and health and safety, although not all of the staff had attended these training events. The manager, also produced a copy of an ‘ASET’ (a training company) file on dementia awareness that she and five senior care staff are to complete, the manager also produced a dairy entry, as evidence of a forthcoming meeting with the ‘ASET’ training provider, which she stated was to finalise the details of the course. The service tells us, via the AQAA that: ‘all staff have or are undertaking National Vocational Qualifications (NVQ) 2 or above training or equivalent’. Information taken from the dataset and confirmed with the manager indicates that currently the home employs nineteen care staff. Fourteen of the nineteen care staff have completed or are completing a National Vocational Qualification (NVQ) at level 2 or above and this provides the home with a ratio of 73 of its care staff possessing an NVQ at level 2 or above. Information contained within the dataset establishes that a recruitment and selection strategy/procedure exists to support the manager when employing new staff. It also indicates that all of the people who worked in the home over the last twelve months have undergone satisfactory pre-employment checks. However, when reviewing the files of four staff newly recruited to the home, the above statement was found to be misleading, as one person had been employed but no references had been taken up, the manager saying that this was due to the fact that the person had come straight from college and had Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 26 not worked. Whilst a second person had commenced employment before her Criminal Records Bureau (CRB) or Protection of Vulnerable Adults (POVA) checks had been received. The remaining two files indicated that the person(s) had been subject of an appropriate recruitment and selection process, their files containing Criminal Records Bureau checks, Protection Of Vulnerable Adults checks and two references. The files of all four people contained completed application forms, health declarations, photographs of the employee, interview summaries, personal information and information used to support the CRB application process. Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 27 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): Standards 31, 33, 35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. EVIDENCE: The manager states, via the AQAA that ‘I have been in care for twenty years. I have completed National Vocational Qualifications at levels 2, 3 and 4 and the Registered Managers Award (RMA). During the fieldwork visit the manager arranged for her two deputies to attend the home and participate in the inspection process, as she stated that she Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 28 delegates responsibilities to her deputies for some aspects of the service, such as the medication administration system. The duty rosters indicate that when the manager is not on duty that one of her deputies is on duty and that on call duties and weekend cover is shared between senior staff. The evidence produced in support of this report, indicates that generally the manager is running the home well, although issues such as the failure to ensure a robust recruitment and selection process is being applied and the mistakes made in assessing and identifying the risks to service users are fundamental areas, which the manager will need to work on. Information taken from the residents’ surveys suggest that the manager is felt to be approachable and a person who addresses issues appropriately, with three of the seven people mentioning the manager directly when asked ‘do you know who to speak to if you are not happy’. The relative’s spoken with during the visit also praised the management of the home and the efforts made by the management and staff to assist in the settling of their next-of-kin into the home. The manager states via the AQAA that ‘I have a good quality assurance programme which enables me to monitor the running of the home and ensure all records are maintained’. A quick review of the manager’s quality assurance file, indicated that records of residents and staff meetings are maintained, that complaints and maintenance records audited and questionnaires and surveys available. The care plans seen during the fieldwork visit, whilst confusing, where being regularly reviewed and future review dates scheduled and each month the key worker produce a synopsis of the residents’ monthly activities. The dataset makes a clear statement that about the home’s policies and procedures being regularly updated and reviewed, with all policies reviewed in the March of 2008. The homes’ management and storage of residents’ monies was considered safe and appropriate, with people’s monies held individually and separate accounts or books maintained of the amounts stored. The books or accounts are regularly audited by the management who sign too confirm completion of the audits, all transactions were double signed and have an accompanying receipt. Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 29 The management had only the recently undertaken and audit of all accounts and each one balanced according to their statements, at the time of the visit four records were dip-sampled and all balanced. The service tells us, via the AQAA and dataset information that health and safety policies and procedures are made available to the staff and that domestic appliances and personal equipment is regularly maintained and serviced. Health and safety training is being made available to staff, with the training matrix and plan providing evidence of the courses attended and those to be attended by staff, including: health and safety, moving and handling and fire safety is planned for later this month. The tour of the premise identified no immediate health and safety issues, and the environmental risk assessments do consider both potential areas of harm and how these can be managed, as highlighted by the service’s decision to improve the ramped access at the front of the home. Generally the service users and their relatives are satisfied with the service being provided at the home and raised no concerns in relation to either Health or Safety issues. Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 30 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 2 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 2 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 31 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation Requirement Timescale for action 29/06/08 Regulation The manager must ensure that 13 risk assessments are carried out for all residents’ where the potential for harm or injury exists. Regulation All checks must be carried out 19 when recruiting staff to ensure that people who use the service are protected. 2. OP29 29/06/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. Extracts may not be used or reproduced without the express permission of CSCI Oakwood Care DS0000069021.V363144.R01.S.doc Version 5.2 Page 33 - 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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