Inspection on 02/10/06 for Oakwood House Residential And Nursing Home

This inspection was carried out on 2nd October 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 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 Residential And... 31/10/07

Oakwood House Residential And... 08/02/06

Oakwood House Residential And... 06/10/05

Oakwood House Residential And... 22/02/05

Oakwood House Residential And... 15/06/04

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

CARE HOMES FOR OLDER PEOPLE Oakwood House Residential And Nursing Home Stollery Close, Off Ropes Drive Grange Farm, Kesgrave Ipswich Suffolk IP5 7PQ Lead Inspector Cecilia McKillop Key Unannounced Inspection 2nd October 2006 12:30 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 DS0000024464.V314433.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. DS0000024464.V314433.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakwood House Residential And Nursing Home Address Stollery Close, Off Ropes Drive Grange Farm, Kesgrave Ipswich Suffolk IP5 7PQ 01473 612300 01473 623933 helen.rollin@anchor.org.uk sharon.blackwell@anchor.org Anchor Trust 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) Ms Helen C Rollin Care Home 24 Category(ies) of Dementia (24), Mental disorder, excluding registration, with number learning disability or dementia (12), Mental of places Disorder, excluding learning disability or dementia - over 65 years of age (12) DS0000024464.V314433.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th February 2006 Brief Description of the Service: Oakwood House is a care home, owned by Anchor Trust, which provides accommodation and nursing care for twenty-four older people with dementia and or mental health needs. The house was purpose built in 1993 and is arranged in three units for eight residents each. The home is located on the outskirts of Ipswich in a newly developed area of the village of Kesgrave. It is within easy reach of local shops, churches and the GP surgery. The accommodation is over two floors, which are connected by a passenger lift, with two units on the ground floor and one on the first floor. All twenty-four bedrooms, referred to as flats, have ensuite toilet and shower facilities. Each unit has a lounge/dining area with a kitchenette for making hot drinks and snacks. There is a large communal lounge on the ground floor and some smaller quiet seating areas. There is access to an attractive secure garden with seating. The weekly fees are £775 DS0000024464.V314433.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on a weekday between 12.30 and 17.30. The registered manager was on annual leave so the deputy manager and the administrator helped with the inspection process. A follow up visit was undertaken within 3 days on the 5th of October to deliver questionnaires and follow up progress on an issue, which had been identified. Questionnaires were sent to residents, and staff to complete. A total of seven residents questionnaires and 5 staff questionnaires were returned completed and the comments made have been incorporated into the report. One staff file and four residents care plans were seen. The complaints log, the staff rotas and health and safety auditing records were all inspected. A tour of the home was undertaken and all areas were visited including the laundry, the kitchen and each unit. A number of residents and staff were spoken with and the system for managing residents’ personal finances was explained by the administrator. Some medication administration records (MAR sheets) were checked. What the service does well: What has improved since the last inspection? The food being stored in the kitchen was appropriately covered and labelled. DS0000024464.V314433.R01.S.doc Version 5.2 Page 6 There are auditing arrangements in place with regard to the administration of medication and there were no gaps noted on the sample of medication sheets, which were examined as part of the 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. DS0000024464.V314433.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 DS0000024464.V314433.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): 1,2,3,4 The quality for this outcome area is good. People who use this service can expect to be provided with information about the home and to have their needs assessed before moving in. EVIDENCE: The inspector was provided with a copy of the information given to all new residents on admission. This contains a folder from Anchor entitled The Statement of Purpose with supplementary information relating to Oakwood House. The information provided complied with the standards and regulations however there was no evidence that residents are provided with a copy of the last inspection report, although it was on display in the entrance to the home. The inspector was shown a copy of the terms and conditions and the contract, which outlined the room to be occupied, and the fee. The majority of individuals who completed the questionnaires indicated that they had received a contract but a small number were not clear or could not remember. All those who replied said however that they had received enough information about the home before they moved in. DS0000024464.V314433.R01.S.doc Version 5.2 Page 9 The residents’ files seen had documented evidence of an assessment by health colleagues and a pre-admission assessment undertaken by the manager. The File of a newly admitted resident was examined as part of the inspection but the care plan or Individual Lifestyle Agreement had not yet been drawn up. This was drawn to the Deputy Managers attention and had been addressed by the time of the follow up visit three days later. The inspector was informed that the newly admitted resident had visited the home prior to their admission. DS0000024464.V314433.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): 7,8,9,10 The quality for this outcome area is adequate. Service users can expect to be treated with respect and have their needs identified but cannot be assured that staff will respond to their needs in a consistent way. The medication systems are safe and offer protection. EVIDENCE: Four care plans, called Individual Lifestyle Agreements (ILA), were seen and they all covered a number of areas of care. Residents are encouraged to sign the agreement where possible. There were interventions for personal hygiene, management of continence, nutrition, mental health needs, night needs and social needs. Individual needs and requests were incorporated into the care plans such as requests for a daily shower or the bathroom light being left on at night. There were also nutrition assessments, regular weight checks recorded and assessments of mobility. None of the residents had pressure sores at the time of the inspection. One of the agreements examined had been written some years previously and while reviewed regularly did not fully reflect the service users needs. It was agreed that the plan would be updated and the inspector noted at the follow up visit that efforts had been made to address the issues. However further clarity DS0000024464.V314433.R01.S.doc Version 5.2 Page 11 was needed within the plan to ensure that staff were picking up on issues, investigating them and responding to the service user in a consistent way. The responses from the questionnaires completed by residents or their relatives were that resident’s were “always” or “usually” receiving the care and support needed. Each file had a record of any professionals involved with the resident such as psychiatrist, psychologist, social worker and GP. There was evidence from discussion with staff and from records that staff monitor service users psychological health and refer to other professionals as appropriate. A chiropodist visits the home regularly and optician was due to visit. The Medication Administration Record (MAR) sheets from one unit were examined and there were no gaps in evidence. The deputy manager informed the inspector that newly appointed staff are provided with training and weekly audits are undertaken of Mars sheet. DS0000024464.V314433.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): 12,13,14,15 The quality for this outcome area is good. People who use this service can expect to be encouraged to maintain contact with their family and receive a well balanced diet. Activities are on offer but not all service users are aware of them. EVIDENCE: Residents’ rooms had been personalised and residents were observed being offered choices during the inspection. Individual records reflected resident’s views with regard to their care and preferences. Responses from the questionnaires indicate that staff listen and act on what residents say. Personal files contained contact details for resident’s family and visitors were observed coming and going throughout the day. One relative was observed assisting a resident with eating and the inspector was informed that on occasion another family visits the home eats with the resident. There was evidence in the files of a variety of activities that had taken place over a period of time, such as trips to the local shops. An activity organiser provides activities on two afternoons each week and residents interviewed said that they enjoyed the craft and cookery sessions. On the display board in the entrance there were posters giving details of a prospective visit by some local DS0000024464.V314433.R01.S.doc Version 5.2 Page 13 children and a shoe shop. The questionnaire responses to the area of activities was conflicting and ranged between a response indicating that there were always activities arranged to there was never activities arranged. There was a section on personal files of service users for the recording of activities but in one of the files examined it had not been completed for some time. One resident who was interviewed said that they would like to see more activities on offer. The Deputy manager said that the home were trying to involve care staff more in the provision of activities on a daily basis. The meal served on the day of the inspection consisted of cottage pie and the meals looked appetising and were nicely presented. Residents who were in receipt of a pureed diet had each item pureed separately. The cook was observed preparing the evening meal from a list of options chosen by the residents. The kitchen was clean and food was being stored appropriately in the fridge. DS0000024464.V314433.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): 16,18 The quality outcome for this area is adequate. People who use this service can expect that any concern raised will be taken seriously but not always formalised and documented. EVIDENCE: The complaints log was seen and there were no complaints recorded since May 2005. CSCI has not received any complaints about the service since the last inspection. Residents spoken with on the day of the inspection were clear about the process for raising concerns. Responses to the questionnaire supported this with the respondents confirming that they were aware of who to speak to if they were not happy and how to make a complaint. One resident indicated during the inspection that they had raised some concerns about their care in the past but were not sure that they had been taken seriously. There was no evidence in the records to indicate that the matters had been investigated, although the Deputy Manager was able to outline steps that the manager had taken. Staff informed the inspector that matters raised by the resident were dealt with by staff on a daily basis and sometimes were part of the resident’s illness. The care plan for the service user had been amended to reflect this, by the time of the follow up visit but further clarification was needed. The homes management have responded promptly to concerns regarding staff practices in the past. Staff interviewed said that they had undertaken POVA DS0000024464.V314433.R01.S.doc Version 5.2 Page 15 training although one out of the seven staff who responded to the questionnaire said that they had not had this training. DS0000024464.V314433.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): 19,23,25,26 The quality for this outcome area is good. People who use this service can expect to live in a pleasant environment with rooms that are personalised and specialised equipment available to help maintain their independence. EVIDENCE: Oakwood House is a purpose built home. There are three units within the home each caring for eight residents. All the residents’ rooms are single occupancy and have ensuite toilet and shower facilities. Each unit has an assisted communal bathroom. The units have a lounge and dining area and a small kitchenette to make hot drinks and snacks without going to the main kitchen. There is a large communal lounge off the main entrance to the home that was being used for training on the day of inspection. There are small seating areas throughout the home. The gardens are accessible from several doors and are secure. The décor was fresh and the rooms were personalised with individuals’ possessions and photographs. The lighting was domestic and the temperature in the home on the day of the inspection was comfortable. The radiators are DS0000024464.V314433.R01.S.doc Version 5.2 Page 17 low surface temperatures. Some rooms had specialised pressure relieving mattresses and crash mats in use. Tracks had been fitted on the ceiling in each of the resident’s bedrooms and ensuites to assist with moving and handling. The home was trialling the use of a new bed, which lowered to the floor and was being used with a service user who had been identified as at a high risk of falling out of bed. The laundry was visited and was clean and tidy. DS0000024464.V314433.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): 27,28,29,30 The quality for this outcome area is good. People who use this service can expect to be cared for by adequate numbers of trained and correctly recruited staff. EVIDENCE: The duty rotas were seen and showed that there were generally two trained nurses on an early and a late shift with six carers. On the afternoon of the inspection there were 5 care staff and 3 trained nurses. In addition a student was working as an additional member of staff. Staffing levels appeared satisfactory A number of new staff had recently been appointed and were undergoing their induction on the day of the inspection. One newly appointed member of care staff was also working on a super numerary basis and observed shadowing experienced staff. The inspector was shown a copy of a new staff induction workbook, which newly appointed staff had to complete in conjunction with their manager. Staff who completed this were awarded with a B Tech qualification. The deputy manager said that staff are supported to obtain National Vocational Qualifications and there are currently 8 staff who have achieved NVQ11 and 1 member of staff with NVQ3. Four staff are currently working towards NVQ2. The personal file of a newly appointed member of staff was seen as part of the inspection. There was evidence on file that a POVA first check had been DS0000024464.V314433.R01.S.doc Version 5.2 Page 19 undertaken prior to starting work and a CRB had been applied for. References had been obtained including one from the last employer. Nursing staff Personal Identification Number (PIN) was checked and there was evidence that checks of ID were undertaken. Records are maintained of interviews. DS0000024464.V314433.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): 31,33,35,38 The quality for this outcome area is good. People who use this service can expect to live in a well managed home where their health and safety will be taken seriously EVIDENCE: The registered manager has a registered mental nurse (RMN) qualification and has managed this service for a number of years. Although they were not present at this inspection previous discussion with them demonstrated that they have a wide experience in the field of mental health and dementia care. Staff spoken with expressed confidence in the management of the home and said they felt able to approach the manager with any concerns. The home conducted a service users survey in May 2006 and the results were outlined to service users and their relatives in the Newsletter, which was produced that month. The finding of the survey was positive and the manager DS0000024464.V314433.R01.S.doc Version 5.2 Page 21 outlined the actions she intended to take to address two of the themes identified. In addition Anchor asked an independent company to conduct research on its behalf and the summary of the results have been provided to the home. The administrator explained the system in use for managing residents’ personal money and provided the inspector with written information about the scheme, which has been provided to residents. Residents are encouraged to retain full control of their financial affairs and to deposit their money with a bank or building society. However the home does have a facility to hold small amounts of resident’s money in an account on which statements can be produced. Residents are made aware that this account does not pay interest. Risk assessments were in place in resident’s files The inspector was informed that a new Health and safety manual had been introduced with clear auditing arrangements and named staff now had responsibility for monitoring different aspects, such as first aid. The fire records were examined and the inspector noted that there was evidence in place of regular testing and drills. The Fire officer had undertaken an inspection of the home the month before the inspection and found that the fire prevention system in place was satisfactory. There was evidence on resident’s files of action being taken in response to falls including liaising with the GP and the provision of specialist equipment. A number of residents were using hip protectors. Bath temperatures are monitored and recorded by staff each time a resident receives a bath. The temperatures recorded were within the recommended levels. Staff confirmed that they had received sufficient training to undertake their role and that the home has sufficient mobility aids to support resident’s needs. DS0000024464.V314433.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 3 3 3 3 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 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X 3 X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 DS0000024464.V314433.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 15 Requirement The homes manager must ensure that all individual lifestyle agreements are up to date and that these outline how the resident’s health and welfare will be met. The homes manager must maintain a record of concerns/complaints made by service users and details of the action taken. Timescale for action 01/11/06 2 OP16 17 01/11/06 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 Refer to Standard OP12 Good Practice Recommendations It is recommended that the programme of activities for service users is further developed and more information is provided to service users about what is on offer. DS0000024464.V314433.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 DS0000024464.V314433.R01.S.doc Version 5.2 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. 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