Inspection on 14/11/05 for Oakwood House

This inspection was carried out on 14th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Oakwood House 16/09/08

Oakwood House 20/09/07

Oakwood House 05/09/06

Oakwood House 01/03/06

Oakwood House 07/03/05

Oakwood House 19/10/04

Oakwood House 17/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

SignHealth

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

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

CARE HOMES FOR OLDER PEOPLE Oakwood House 400a Huddersfield Road Stalybridge Tameside SK15 3ET Lead Inspector Steve Chick Unannounced Inspection 11:30 14th November & 16 November 2005 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 Oakwood House DS0000005575.V265551.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. Oakwood House DS0000005575.V265551.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Oakwood House Address 400a Huddersfield Road Stalybridge Tameside SK15 3ET 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) 0161 303 2540 0161 303 2540 Mr Stephen Mycroft Ms Sheila Mannion Ms Sheila Mannion Care Home 18 Category(ies) of Dementia - over 65 years of age (14), Old age, registration, with number not falling within any other category (18), of places Physical disability over 65 years of age (14), Sensory Impairment over 65 years of age (1) Oakwood House DS0000005575.V265551.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users to include up to 18 (OP); up to 14 (DE) (E); up to 14 (PD) (E) and up to 1 (SI) (E) 7th March 2005 Date of last inspection Brief Description of the Service: Oakwood House is an appropriately converted, large detached building, set back from a fairly busy main road. There are public transport links to the centre of Stalybridge. Oakwood House is owned by two people, one of whom is also the registered manager. It offers accommodation to up to 18 older people, on two floors, mainly in single bedrooms. There is one lounge and a large dining room. Oakwood House DS0000005575.V265551.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During the inspection three service users were interviewed, as was one relative of a service user and two staff members. Additionally discussions took place with the manager and the other registered person. The inspector also undertook a tour of the building and scrutinised a selection of service user and staff records as well as other documentation, including staff rotas, medication records and the complaints log. What the service does well: What has improved since the last inspection? The vetting of new staff is undertaken with more rigour. The home has maintained its good standard of care. Oakwood House DS0000005575.V265551.R01.S.doc Version 5.0 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. Oakwood House DS0000005575.V265551.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 Oakwood House DS0000005575.V265551.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): 2, 3, 4 and 5. Service users are not routinely given the home’s terms and conditions containing all the required information. Service users have their needs assessed before moving to the home and can visit to assess the facilities. EVIDENCE: A selection of service users’ files relating to people who had moved to the home since the previous inspection was scrutinised. Only one had a copy of the homes’ terms and conditions. This copy was neither signed nor dated, nor did it have the name of the service user or the room to be occupied. The manager reported that service users were given the written terms and conditions, but did not always sign and return them. All files seen had a copy of an assessment undertaken by an appropriate professional based either in the community or hospital. Oakwood House DS0000005575.V265551.R01.S.doc Version 5.0 Page 9 Discussion with service users, staff and the manger and observation, indicated that Oakwood House was meeting the needs of service users living there. There was no evidence that confirmation of the home’s ability to meet the needs of prospective service users was routinely confirmed in writing. As with the terms and conditions, written confirmation would help ensure clarity and accountability. It is the policy of the home that people can visit before making a decision to move in. Similarly it is routine practice to hold a review a few weeks after moving into ensure the home is an appropriate place. Oakwood House does not offer intermediate care. Oakwood House DS0000005575.V265551.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, 8, 9 and 10 The written care planning process is inadequately implemented. The policies and procedures for the administration of medication were not rigorously followed. Service users health care needs were appropriately met, and they were treated with respect and dignity. EVIDENCE: In the selection of files seen, not all had written plans of care produced by Oakwood House. In one example seen, potentially useful guidance from a CPN (Community Psychiatric Nurse) had not been transferred to the care plan. One care plan seen was not dated, nor signed, nor was there documentary evidence that the service user had been involved or that the plan had been reviewed. Although all files seen related to people who had come to Oakwood House relatively recently, the written care planning was below the required standard. Oakwood House DS0000005575.V265551.R01.S.doc Version 5.0 Page 11 One example was seen where the daily records contained contradictory information in connection with food intake, which would serve to discredit other information in those records. Discussion with staff indicated that they did consult the written records, but relied more on their personal knowledge of the service users and the twice daily verbal handovers. Oakwood house benefits from a relatively small number of service users and a stable workforce which would assist the verbal process’s effectiveness. However, the absence of effectively documented information indicated a flawed system which could be detrimental to service users having their needs met. However, it was also evident through discussion with service users and a visiting relative, that a high level of satisfaction with the care offered at Oakwood House was experienced. The visitor described “ … good care … very well looked after … I’m entirely satisfied. I don’t think she [the service user] could be better looked after.” There was documentary evidence that service users had access to the full range of medical and para medical services available in the community. This was confirmed by service users spoken to. Similarly staff who were spoken to were confident that appropriate medical support was sought for the service users. The home has appropriate medication policies and procedures. Medication storage and records presented as being predominantly well maintained. However, inspection of the medication indicated that appropriate safeguards in connection with controlled drugs was not being followed. As with many other findings at this inspection this was an administrative issue and did not have an immediately detrimental impact on any service user. Service users who were spoken to, reported positively on the way in which they were treated at Oakwood House. All confirmed that they were treated well by staff and that their privacy and dignity was respected. One service user said about the home, “its all very nice, nothing to grumble about.” and another reported that the home was “very comfortable and caring.” A third service user said “it is very good, I can’t fault it. .. I couldn’t have had better treatment [anywhere]” Oakwood House DS0000005575.V265551.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 14 and 15. Service users are free to maintain links with family and friends. Service users are able to exercise control and choice over their lives within the context of communal living. The Home provides good food. EVIDENCE: The Home has a policy that visitors can visit at any reasonable time. Service users spoken to confirmed that there were no unreasonable restrictions on visiting and that service users can receive visitors in their own room. Similarly the visitor spoken to reported that there were no restrictions on visiting and that she was always made to feel welcome at Oakwood House. Discussion with staff and service users indicated that service users were able to exercise choice and control over their lives within the context of communal living and their individual capacity. Service users confirmed that they were able to get up and go to bed when they wished. They could freely access the communal areas or their own rooms and can have their meals in their room if they wish. One service user, when asked what the best thing was about the Home, replied, “I can please myself.” Oakwood House DS0000005575.V265551.R01.S.doc Version 5.0 Page 13 One meal was sampled during the inspection. It was tasty and pleasantly presented. All service users spoken to during the inspection spoke positively about the provision of food. The dining areas were pleasantly decorated and furnished. Oakwood House DS0000005575.V265551.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Service users were confident that any complaints would be responded to appropriately. Service users are protected from abuse or exploitation. EVIDENCE: Oakwood House has an appropriate complaints procedure. The complaints log presented as being appropriately maintained. All service users and staff who were spoken to during the inspection were confident that any complaint would be listened to and, if possible, resolved. One service user said “you can talk to the staff and they will sort it out.” The visitor spoken to also expressed the view that any complaint made would be taken seriously. The Home has an appropriate procedure for the protection of vulnerable adults. Staff who were interviewed demonstrated an understanding of their responsibility to protect service users from abuse or exploitation. This included an understanding of the procedure to be followed if they became aware of any inappropriate practices, including their responsibility to ‘whistle blow’. All service users spoken to expressed the view that they were safe at Oakwood House. Oakwood House DS0000005575.V265551.R01.S.doc Version 5.0 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, 20, 21, 23, 24, 25 and 26. Oakwood house offers appropriately maintained and decorated accommodation which is clean tidy and odour free. Service users bedrooms are appropriately personalised. Appropriate toilet and bathing facilities are provided. EVIDENCE: A tour of the building, including a random selection of bedrooms, identified no issues requiring remedial action. The home presented as being well maintained and decorated throughout. The décor and furnishings create a homely atmosphere. Service users’ bedrooms demonstrated an appropriate range of personalisation and were kept clean and tidy. The home was clean and tidy throughout, with no unpleasant odours. This was confirmed as the usual state of the home by service users spoken to. Oakwood House DS0000005575.V265551.R01.S.doc Version 5.0 Page 16 Appropriate toilet and bathing facilities were provided. Service users confirmed they were able to access either of the two main communal areas, or their own rooms whenever they wished. Oakwood House DS0000005575.V265551.R01.S.doc Version 5.0 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 and 29. Appropriate numbers of experienced staff are maintained at Oakwood House. The home follows appropriate procedures to recruit and vet new staff. EVIDENCE: The staff rota for the week ending 13th November 2005 was examined. This demonstrated that each day is split into three shifts with three staff on duty during the day, [08:00 – 15:00; 15:00 – 22:00] and two at night, [22:00 – 08:00]. It was reported that 16 service users were resident during this period. These staff levels include the manager on one of the day shifts Monday to Friday. Discussion with the manager indicated that a significant proportion of her time was taken doing care tasks. While this enables an appropriate level of care to be offered on a day to day basis, it may be a contributory factor in the poor administration identified elsewhere in this report. It was reported by the manager that only one carer had been recruited since the previous inspection. Scrutiny of their employment file provided documentary evidence of appropriate vetting procedures having been undertaken before that person started work at the home. Discussion with service users and the visitor indicated a high level of satisfaction with the staff. The “consistent staff team” and their commitment to their work was identified as a positive aspect of the home by the visitor. One Oakwood House DS0000005575.V265551.R01.S.doc Version 5.0 Page 18 service user said “all the girls are very nice” and another said ”all the girls are very good”. Oakwood House DS0000005575.V265551.R01.S.doc Version 5.0 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, 32, 35 and 36. The manger is appropriately skilled and experienced, but does not always effectively manage her time to undertake all managerial tasks with adequate rigour. The home has an ethos of openness and is service user centred. Service users’ financial interests are safeguarded. Staff are supervised appropriately. EVIDENCE: The registered manager has several years experience in a management role. The manager reported that she has completed the Registered Manager’s Award, but due to circumstances beyond her control, this has not yet been confirmed by the college supervising the award. Oakwood House DS0000005575.V265551.R01.S.doc Version 5.0 Page 20 All people who were asked, reported favourably on the manager’s open, approachable and supportive style. However, it was apparent that some aspects of her role were not being undertaken as assiduously as is necessary. These related to administrative issues which, while not being immediately detrimental to service users, undermined the transparency and accountability of the of the service. As mentioned elsewhere in this report, it was apparent that this was not a reflection of the manager’s ability to effectively undertake the tasks, but of the way in which her time was allocated to the different aspects of her role. There was evidence that formal, structured consultation with the service user group was infrequent, with the last recorded service user meeting being held over a year ago. However, there was evidence of continuing informal consultation leading to service users feeling that they were able to express their wishes which were taken account of in the running of the home. Staff meetings were held more regularly (the last two being in May and September 2005). Staff who were interviewed expressed the view that they were consulted and were able to make suggestions as to how the home should be run. Similarly staff were positive about their colleagues, describing a positive team approach to the work. One staff member identified the best thing about the home as being “getting on well with residents and staff”, and another cited the “nice atmosphere” in the home as one of the best things. A selection of records relating to money held by the Home on behalf of service users was scrutinised. They demonstrated that service users interests were protected by appropriate receipts being obtained for expenditure made on behalf of service users and appropriate signatures being obtained when returning cash. There was documentary evidence that staff received periodic formal one to one supervision. This was confirmed by staff spoken to and the manager. Whilst this was not always a very regular process, it was reported by the manager that opportunities were taken for group discussions when relevant issues arose in connection with individual service users. Oakwood House DS0000005575.V265551.R01.S.doc Version 5.0 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 2 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 X X 3 3 X X Oakwood House DS0000005575.V265551.R01.S.doc Version 5.0 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 OP2 Regulation 5 Requirement The registered person must ensure that each service user is given an appropriate, signed and dated copy of the home’s terms and conditions. The registered person must ensure that each service user is given written confirmation of the home’s ability to meet their assessed needs, before the service user moves to the home. The registered person must ensure that each service user has a detailed, written plan of care based on assessment of their needs. The registered person must ensure that controlled drugs are appropriately stored and their administration is appropriately recorded. The registered person must ensure that the manager apportions sufficient time to maintaining the required documentation for the effective and accountable running of the home. Timescale for action 01/01/06 2 OP4 14 (1)(d) 01/01/06 3 OP7 15 14/11/05 4 OP9 13 (2) 14/11/05 5 OP31 10 01/01/06 Oakwood House DS0000005575.V265551.R01.S.doc Version 5.0 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP31 OP32 OP36 Good Practice Recommendations The registered person should ensure that regular audits of administration systems are undertaken. The registered person should ensure that consideration is given to more frequent structured service users’ meetings are held. The registered person should ensure that consideration is given to more frequent staff supervision being undertaken on a one to one basis. Oakwood House DS0000005575.V265551.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Oakwood House DS0000005575.V265551.R01.S.doc Version 5.0 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. 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