Inspection on 19/02/09 for Oakwood House Nursing Home

This inspection was carried out on 19th February 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oakwood House Nursing Home 18/01/07

Oakwood House Nursing Home 01/12/05

Oakwood House Nursing Home 04/08/05

Oakwood House Nursing Home 06/01/05

Oakwood House Nursing Home 19/10/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Oakwood House Nursing Home Old Watton Road Colney Norwich Norfolk NR4 7TP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Marilyn Fellingham     Date: 1 9 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Oakwood House Nursing Home Old Watton Road Colney Norwich Norfolk NR4 7TP 01603250101 01603458097 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): BUPA Care Homes (BNH) Ltd Name of registered manager (if applicable) Mrs Amanda Marie Mallett Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: Persons accommodated or provided services with a physical disability may be aged 40 years and over Date of last inspection Brief description of the care home Oakwood is a fifty-bedded nursing home in Colney on the outskirts of Norwich. It is one of BUPAS homes. The building is of new design and is on two floors. It is set in pleasant grounds, with several very large oak trees being a notable feature. There is a car park at the front of the home. There is good wheel chair access to the home and to the garden. The internal environment, especially the residents rooms, are of a very high standard. The Home provides general nursing care for persons over forty, and also cares for persons over forty, who may have a physical disability. There is a large Care Homes for Older People Page 4 of 25 19 0 31 Over 65 0 31 0 care home 50 Brief description of the care home dining room that is furnished with separate tables, seating various numbers of Service Users; it is a most pleasant room that has been tastefully decorated and allows accommodation for wheelchair users. The home has recently undergone an extension and now provides accommodation for ten more service users. These new rooms have en suite facilities and patio doors leading to extensive landscape gardens. A new small conservatory has been added which leads off the dining room. The new extension also provides a new dining room, satellite kitchen, quiet room and a nurses station. Recently the home has been registered to enable it to use nineteen of its rooms on the first floor as a unit for persons with dementia. Fee levels range from £885 to £1020.00 per week. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection that took place over eight and a half hours. The key inspection for this service has been carried out using information from previous inspections, information from some residents, relatives and visitors to the home and people who work in the home. The main method of inspection used was case tracking. This involved selecting individual care plans and information available about people who live in the home and tracking their experience as a result of the support provided. Care Homes for Older People Page 6 of 25 Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents to the home are given sufficient information to make an informed decision about whether they want to live in the home. Residents who are admitted for intermediate care are helped to maximise their independence. Evidence: We looked at two records of assessment for two newly admitted residents, we noted that a full assessment of needs had been carried out for both these residents. The assessments were detailed and contained relevant information regarding the individuals needs. Once the assessment has been carried out the manager informed us that they decide if the prospective residents needs can be met and if they can, then a care plan is formulated from this assessment. We asked the manager if a letter of confirmation was sent to confirm that the needs can be met and she told us that they did not send one. Care Homes for Older People Page 10 of 25 Evidence: Each new resident is given a contract of terms and conditions and we saw examples of these. We spoke with the two residents whose records we had looked at and they told us that they had been given sufficient information to enable them to make a decision about moving into the home. One said I came and looked round the home to begin with. People are admitted to the home for intermediate care which allows them to be helped after hospital treatment to maximise there independence before moving home again. We spoke with one person who felt that she had, had good care and she told us that she was going home that day. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The practice regarding the planning and delivery of care means that the residents can be sure that their health and personal care needs will be met. Evidence: We spoke with seven residents living in the home and one relative, all the residents commented that they were well cared for. The relative we spoke with told us that their relative had been in the home for five weeks and that the care is second to none, the staff are kind and caring, they listen, they act upon things and they look after the family as well; they went on to say that the night clothes were changed frequently and that the staff were very attentive. One resident we spoke with said the staff are extremely kind, another resident we spoke with said that the staff were kind but went on to sayI dont like the way they undress me at night and pull all my clothes off at once. We spoke to the manager about this and she said that she would look into it and assured us that the practice would not continue. We looked at care plans for six residents, they were informative and indicated care that addressed the assessed needs of the residents. We noted lifestyle profiles in the Care Homes for Older People Page 12 of 25 Evidence: residents records and maps of life for those residents on the dementia unit. Each of the care plans we looked at had records for manual handling, risk assessments for skin integrity and assessment documentation for the residents nutritional status. We also noted that the residents were weighed on a monthly basis and more if there was concern about weight loss. The care plans for the residents on the dementia unit had good records for giving care in relation to their behaviour needs as well as their physical needs; however we noted one resident spent a long time in a Kirton chair and there was no care plan in relation to this use that suggested that this was depriving this resident of their liberty. Consideration needs to be given to the use of the Occupational Therapists who link in with the home to discuss use of this chair and arrange for them to do a seating assessment for this resident. All the care plans we looked at had evidence of review of care and had been updated when the needs had changed. We checked the medicine record charts for those residents care plans we were looking at; prior to the new manager being in post there had been a number of incidents with medication errors. More training has been given and the way medication was being managed has been reviewed and improved; we saw records for this. Two of the medicine charts had blanks which indicated that a record had not been made of either giving the medicine or that it had been refused. We also noted that those residents that had prn (as required) medicines did not have care plans to justify continued use. During our inspection process we did note however that medicines were being audited frequently and there was evidence of weekly audits for Temazepam. The home has policies for all procedures concerned with the administration and handling of medicines. Records are kept of all G.P. visits and other professional agencies. The staff we spoke with have an overall understanding of the care planning process, one carer told us that they used the care plans to give care and also recorded things they had done or observed in the daily notes. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A wide range of activities within the home means that the residents have many opportunities to participate in stimulating and motivating activities. Meals are managed very well. Evidence: We were able to discuss with a number of residents about the opportunities for activities within the home whilst having lunch with them. They told us that most days there was something going on. They said that they enjoyed the special days such as Valentines Day and the tables in the dining room had been decorated with hearts and that they had had heart shaped biscuits for tea. They also told us about how they celebrated the Chinese New Year and how the home caters for everyone. We were also able to observe lunch being served to the residents and some social interactions taking place and interaction between staff and the residents. The staff appeared to be familiar with the likes and dislikes of the residents as did the kitchen staff and the chef; we did note that everyone was given choices. The lunch time was unrushed and an enjoyable social occasion. The menus are well planned and geared around nutritious food for the elderly. The chef has been on a course to learn more about food and the elderly and we were told by him about a nite bite box of snacks for all Care Homes for Older People Page 14 of 25 Evidence: residents but particularly for those on the dementia unit to enable them to have light snacks when they wanted. On the day of our visit there were numerous activities taking place and a number of visitors coming and going. A local priest was taking a service and we noted that a number of the residents were participating; one resident was being taken out for a walk. We learnt from the manager of other activities that had taken place; these included a river trip, summer fair, picnic, physical exercises and entertainiment from an outside source once a month. We saw a new system for recording activities and the involvement of the residents. We noted that the manager was always available to speak with the visitors and answer any questions that they had. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents feel safe and listened to. The staff have been given the knowledge to recognise all aspects of abuse, this means that every effort is made to protect the residents. Evidence: A complaints procedure is in place and is made available to all the residents and other significant people. We spoke with seven residents who all told us they knew how to air their concerns and who to go to. One relative told usI have no concerns and I have found the staff do listen to us. A resident told us I do not have any concerns, another told us that they did not like the way they were undressed and when asked if they felt able to tell someone about this replied yes I know who to go to. We looked at records for complaints, most had been made during the period in which the home had a number of care taker managers. We noted that there had been no complaints since the new manager had been in post. The manager keeps a record of all concerns made however small and indicates how they are dealt with. The staff we spoke with were well aware of the procedure for making a complaint and they were also aware of issues relating to safeguarding adults and what their responsibility was in raising any concerns with the manager. We looked at staff training records that confirmed that the staff had received training in safeguarding adults. Care Homes for Older People Page 16 of 25 Care Homes for Older People Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents live in a safe and comfortable environment. Evidence: We looked around the home, both outside and inside and found it to be very clean and tidy; there were no noticeable offensive odours anywhere. The residents we spoke with told us that they felt that their rooms were always kept clean and that it was nice to talk to the domestic staff whilst they were cleaning their rooms and looked forward to this activity. There is an on going maintenance programme and the manager pointed out areas in the home that were next going to be refurbished. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are well supported by adequate numbers of skilled and knowledgeable staff. The residents are protected by the homes recruitment practices. Evidence: We examined the duty rosters, these were seen to reflect the needs of the residents both on the main unit and the dementia unit. The members of staff we spoke with felt that the ratio of staff was adequate to enable them to meet the assessed needs of the residents. We spoke with six members of staff who shared with us the training that they had received; this included fire training, manual handling, dementia care, Safe Guarding Adults, food hygiene and other training related to the specific needs of the residents they are looking after. The manager told us that the Occupational Therapists and Physiotherapists are involved with some of the training particularly in relation to moving and handling. We also saw induction records for new members of staff, one who we spoke with confirmed that she had been given a thorough induction when she started. When we looked at the training matrix this confirmed that the training included subjects related to the residents conditions and there were certificates in place for all training that had been undertaken. Further discussions with the staff confirmed that they were well supported and that the Care Homes for Older People Page 19 of 25 Evidence: new manager was keen to involve all staff in any study days that became available as part of regular on going training. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The improved management structure has ensured that the service is well run and in the best interests of the people who use the service. Evidence: Records are in place for formal supervision, we looked at these and those members of staff that we spoke with confirmed that these sessions take place and found them useful and informative. One staff member told us I find these sessions good and especially when we talk about my professional development and what courses I can do. We noticed on our visit that the communication system between staff and management was good, the manager told us that she often as well as having meetings for relatives and residents also has one to one sessions with them which have proved to be most beneficial. Overall the comments made to us suggested that the staff, residents and relatives were getting the support they needed from the management. We looked at health and safety related information these showed us that there are Care Homes for Older People Page 21 of 25 Evidence: servicing arrangements for all equipment these included all hoists and fire fighting equipment. Fire safety records are in place and we saw records for all fire training. The service does carry out a monitoring system of the quality of the service it offers and we saw records for this. We looked at the records that are made for handling the residents monies that are held by the service, these were good abd we saw receipts for purchases and also records of audits that are carried out. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The medication administration records must be accurate. This will ensure that the residents receive the correct medication at the correct time. 09/07/2009 2 9 13 People who use the service who have medicines prescribed on a p.r.n. (as required) basis must have care plans for this practice. This will justify and monitor the continued use of the medicine. 09/07/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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