Inspection on 05/09/06 for Oakwood House

This inspection was carried out on 5th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 House 16/09/08

Oakwood House 20/09/07

Oakwood House 01/03/06

Oakwood House 14/11/05

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 5th September 2006 11:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Oakwood House DS0000005575.V310955.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 House DS0000005575.V310955.R01.S.doc Version 5.2 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.V310955.R01.S.doc Version 5.2 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) 1st March 2006 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 for up to 18 older people, on two floors, mainly in single bedrooms. There is one lounge and a large dining room. Oakwood House charges £323.66 for all service users, as at the date of this visit. Oakwood House DS0000005575.V310955.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. For the purpose of this inspection four service users were interviewed in private, as was one visiting professional and two members of staff. Additionally discussions took place with the manager. The inspector also undertook a tour of the building and looked at a selection of service user and staff records as well as other documentation, including staff rotas, medication records and the complaints log. This key inspection included an unannounced site visit to the home. All key standards were assessed. What the service does well: What has improved since the last inspection? Procedures relating to the administration of medication had improved to maximise the safety of service users. More staff either had, or were working towards, an appropriate NVQ which will improve their knowledge. Oakwood House DS0000005575.V310955.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Oakwood House DS0000005575.V310955.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 House DS0000005575.V310955.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is adequate. Service users’ needs are not always assessed before moving to the home to ensure that their needs can be appropriately met. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: A random selection of service users files was looked at. Not all had a written copy of an assessment undertaken by an appropriate professional, or an assessment undertaken by the home. No file seen had a copy of any written confirmation from the home stating they could meet the assessed needs of the service user. Oakwood House DS0000005575.V310955.R01.S.doc Version 5.2 Page 9 Observation and discussion with service users and staff indicated that, in practice, service users’ needs were being appropriately met. The absence of effective records in connection with assessment made it difficult for the home to demonstrate that they only accepted service users’ whose needs they were confident they could met. Oakwood House does not offer intermediate care. Oakwood House DS0000005575.V310955.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is adequate. Written care planning is inadequate to demonstrate the care needs of service users are identified and met. Service users have access to appropriate community based medial services to ensure their health needs are met. The home’s procedures in connection with administration of medication are implemented to the benefit of the service users. Practices in the home promote the dignity of service users. This judgement has been made using available evidence, including a visit to the service. Oakwood House DS0000005575.V310955.R01.S.doc Version 5.2 Page 11 EVIDENCE: No written care plan could be located for three of the four files seen. The one written plan seen was undated, did not include the name of the service user to whom it related and was not signed. There was no record of the service users’ needs or plans being reviewed on a regular basis. Similarly there was no record to indicate the extent to which service users had been involved in the care planning process. Service users who were asked, could not recall being involved in any structured discussion about their care needs. Weighed against this poor recording and administration were the reported experiences of the service users and staff, and the observations of a visiting professional. Service users spoken to were happy with their care and the manner in which it was delivered. One service user said they were confident they could talk to staff about their care “if necessary”. Another service user was clear that staff “do things the way I want them to”. The visiting professional described the care they had observed to be “of a high standard”. Staff who were interviewed identified the verbal handover at each shift change, the communication book, and their personal knowledge of the needs of the service users as being the main processes by which they kept up to date with service users’ changing needs. Service users spoken to were confident that appropriate medical support was accessed when necessary. There was documentary evidence that service users had appropriate access to the full range of medical and para medical services available in the community. The manager reported that at the time of this visit no service user had any pressure sores. The home uses a pre dispensed monitored dosage system to administer service users’ medication. Medication was seen to be appropriately and securely stored. Medication administration records presented as being appropriately maintained. It was reported by the manager that, at the time of this visit, no service user was administering their own medication. Observation and discussion with service users visitors and staff indicated that service users were treated with respect, and that their dignity was maintained. One service user, when asked if staff treated them with respect and dignity, appeared surprised by the question and replied “of course!” Oakwood House DS0000005575.V310955.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. An appropriate range of activities was available for service users to participate in if they wished, which enhanced their fulfilment and social stimulation. Visitors are welcome in the home to maintain community and family links for the benefit of service users. Service users are able to maximise their autonomy within the context of community living. Dietary needs of service users are appropriately catered for with a balanced and varied selection of food that meets service users’ tastes and choices. This judgement has been made using available evidence, including a visit to the service. Oakwood House DS0000005575.V310955.R01.S.doc Version 5.2 Page 13 EVIDENCE: It was reported that service users expressed little interest in organised social activities. This was confirmed in discussion with service users. The manager reported that activities which were regularly organised included visits from local churches, occasional entertainers and the celebration of service users’ birthdays. The range of activities had been identified as an area which the home could address in the internal Quality Audit report of July 2005. The manager reported that not all strategies identified in that report had been implemented. The last ‘service users’ meeting’ (held in March 2006) addressed the activities in the home. The record indicated that there were no requests for additional social activities. The home has written policies to enable visiting at any reasonable time. This was confirmed as the actual practice by the manager, service users and the visitor. The visitor spoken to described the staff as making them feel welcomed into the home. Observation and discussion with service users and staff indicated that service users were able to exercise personal choice and autonomy within the context of communal living. Service users confirmed they could get up and go to bed when they chose. Similarly they were able to use the privacy of their rooms, or either of the two lounges, whenever they chose. One meal was sampled during the site visit. This was tasty and pleasantly presented. All service users spoken to were positive about the provision of food at Oakwood House. Discussion with the cook and observation confirmed that there were ample food stocks. The daily record for each service user included a record of what they had eaten at each meal. There was a record of the last ‘service users’ meeting’, at which the home’s menus were discussed. Oakwood House DS0000005575.V310955.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. Service users are confident that any complaint they may have would be dealt with appropriately. Service users are protected from abuse or exploitation by the home’s policies and practices. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: Oakwood House has an appropriate complaints procedure which was not looked at this inspection. All service users and visitors who were asked, were confident that any complaint would be responded to appropriately by staff and management in the home. Similarly staff spoken to expressed confidence that the management structure within the home would respond appropriately to any complaint. The record of complaints presented as being appropriately maintained. All service users and visitors spoken to during the visit were confident that service users were protected from abuse or exploitation. Staff who were interviewed demonstrated an understanding of the need to be vigilant about the possibility of abuse, and of appropriate action to take. This included the ‘whistle blowing’ procedure. Oakwood House DS0000005575.V310955.R01.S.doc Version 5.2 Page 15 The manager reported that no specific training had been provided for staff in connection with the identification of abuse or exploitation of older people, although the issue was addressed in the home’s induction program for new staff. Oakwood House DS0000005575.V310955.R01.S.doc Version 5.2 Page 16 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, 21, 23, 24, 25 and 26. Quality in this outcome area is good. The home is appropriately maintained, decorated and cleaned to enable service users to live in a pleasant, safe and hygienic environment. Suitable toilet and bathing facilities are available to enable service users to maintain their personal hygiene in a dignified manner. This judgement has been made using available evidence, including a visit to the service. 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. Oakwood House DS0000005575.V310955.R01.S.doc Version 5.2 Page 17 One area of the downstairs corridor was in need of redecoration. There was documentary evidence of the home already having obtained a quote for this work top be undertaken. 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 and the visitor spoken to. The cleanliness was cited by one service user as one of the things she liked most at the home. Appropriate toilet and bathing facilities were provided. Oakwood House DS0000005575.V310955.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. Minimum staffing levels are maintained to ensure the health and safety of service users. The numbers and skill mix and number of staff on duty promotes the independence and well being of service users. Recruitment procedures were predominantly applied to minimise the risk to service users of inappropriate staff being employed. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: The staff rota for the week beginning 4th September 2006 was examined. This demonstrated that staffing levels were maintained at a minimum of 2 carers and a senior between 08:00 –22:00 and two carers at night from 22:00 – 08:00. Twelve service users were resident at the time of this visit. Additionally the home employs a cook and a domestic. A significant proportion of the staff team have worked at the home for several years. This would be a positive contribution to the continuity of care experienced by service users. Oakwood House DS0000005575.V310955.R01.S.doc Version 5.2 Page 19 There was documentary evidence that five carers held NVQ II and one NVQ III. There was also evidence that four staff were undertaking NVQ II and that two were undertaking NVQ III. This was a notable improvement from the situation at the previous visit. The manager and staff who were spoken to confirmed that staff did have regular, one to one, supervision sessions. There was also a documentary record of these sessions. Staff did not receive an annual appraisal nor were there staff training or development plans. Service users and the visitor spoken to were positive about the approach and competence of the staff team. One service user said all the staff were nice and helpful, always coming when you need them. This included night staff, who were reported by service users as being equally responsive. One service user was able to cite examples where the night staff had made her cups of tea if she could not sleep. Another service user said that the night staff reminded her that she should always ring the bell if she wanted anything. A selection of files relating to the recruitment of ‘new’ staff was looked at. The vetting process presented as being predominantly appropriately applied. However in none of the examples seen was a full employment history recorded. In one example only one reference had been received, before the staff member was employed. The manager reported that two references had been sought, but the second had not responded despite reminders. Oakwood House DS0000005575.V310955.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is adequate. The manger is appropriately skilled and experienced, but does not always effectively manage her time to undertake all managerial tasks with adequate rigour to protect the overall interests of the service users. Service users’ views are taken into account and influence the running of the home. Service users’ financial interests are protected by the home’s practices. Risk assessment practices do not assist in maximising the health and safety of service users. This judgement has been made using available evidence, including a visit to the service. Oakwood House DS0000005575.V310955.R01.S.doc Version 5.2 Page 21 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, the award has not yet been received. The registered manager is also one of the two owners of the business. An overall assessment of many areas of administration and documentation indicated a managerial failure to effectively prioritise this aspect of running a safe and accountable home. Oakwood House has a structured Quality Audit system involving anonymous questionnaires. Additionally the small size of the home, occasional service user meetings and service users’ confidence that they can raise issues at any time, all indicate that service users’ views are taken into account in the running of the home. A number of survey forms were seen in the home’s office, ready for distribution. A copy of the previous Quality Audit report, from a survey in July 2005 was seen. This presented as being appropriately undertaken, although actions identified had not all been followed through, which weakened the effectiveness of the process. A selection of records relating to money held by the Home on behalf of service users was looked at. These presented as being predominantly appropriately maintained. One example was seen where the hairdresser had, accidentally, been paid twice for the same service. The manager undertook to rectify this oversight. As at the previous inspection, general risk assessments could not be located at this visit. One example was seen where a service user was using ‘bed rails’ but there was no record of a risk assessment having been undertaken. A selection of records relating to the appropriate maintenance of equipment in the home were seen. Records of the home’s testing of the fire detection and alarm system presented as being appropriately maintained. The manager reported that all staff receive training and regular refresher courses in the correct methods of moving and handling. This was confirmed by staff who were spoken to. Staff confirmed the availability, and use, of disposable gloves and aprons to minimise the risks of cross infection. This equipment was also seen in appropriate places around the building. Oakwood House DS0000005575.V310955.R01.S.doc Version 5.2 Page 22 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Oakwood House DS0000005575.V310955.R01.S.doc Version 5.2 Page 23 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 OP3 Regulation 14 Requirement The registered person must ensure that all service users are appropriate assessed before being admitted to the home other than in an emergency. The registered person must ensure that individual care plans are written and are regularly reviewed. The registered person must ensure that a full employment history and two satisfactory written references are obtained in connection with any applicant before they are employed. The registered person must ensure that all necessary risk assessments are written and regularly reviewed. (Timescale of 01/05/06 not met) Timescale for action 16/09/06 2. OP7 15 16/09/06 3. OP29 18 16/09/06 4. OP38 13 01/10/06 Oakwood House DS0000005575.V310955.R01.S.doc Version 5.2 Page 24 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. Refer to Standard OP38 OP30 Good Practice Recommendations The registered person should ensure that regular audits of administrative systems are undertaken. The registered person must ensure that individual staff members have a structured training program, which reflects their assessed developmental needs. Oakwood House DS0000005575.V310955.R01.S.doc Version 5.2 Page 25 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.V310955.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!