Inspection on 18/06/08 for Oakworth Manor

This inspection was carried out on 18th June 2008.

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

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

Oakworth Manor 19/06/07

Oakworth Manor 27/06/06

Oakworth Manor 15/12/05

Oakworth Manor 13/04/05

Oakworth Manor 06/10/04

Oakworth Manor 18/05/04

Similar services:

Abbey The

Snydale Care Home

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Oakworth Manor Oakworth Manor Colne Road Oakworth Keighley West Yorks BD22 7PB Lead Inspector Nadia Jejna Key Unannounced Inspection 18th June 2008 10:00 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 Oakworth Manor DS0000001166.V366827.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. Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakworth Manor Address Oakworth Manor Colne Road Oakworth Keighley West Yorks BD22 7PB 01535 643814 F/P 01535 643814 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) Mrs Christine Lynn Flood Manager post vacant Care Home 21 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (17), of places Physical disability over 65 years of age (3) Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th June 2007 Brief Description of the Service: Oakworth Manor is located in the middle of the village of Oakworth a bus ride away from the town of Keighley. It is a detached adapted property set in its own grounds in the centre of the village of Oakworth. It is conveniently placed for local shops and a bus route. There is adequate parking close to the building. There is level access available to the rear of the building and people can easily access two patio areas from the lounges. There are three separate communal rooms comprising of two lounges and a dining room. Bedrooms are located on the ground and first floor. Access to the first floor is by a stair lift. Accommodation is provided for up to twenty-one people over the age of 65. The weekly fees range from £308 to £415 weekly. Additional charges are made for chiropody and hairdressing. This information was provided before April 2008. Information about the services provided by the home is available in the Service User Guide. Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. One visit was made on 18 June 2008. The purpose of this visit was to make sure that the home was being managed for the benefit and well being of the people using the service. During the visit people living in the home, their visitors and staff were spoken to. Records were looked at such as staff files, complaints and accidents records. Before the visit was planned the provider was asked to complete an annual quality assurance assessment (AQAA) of the service. This asks them to look at what they do well, what was in place to prove this, what improvements had been made over the last twelve months and what was planned for the year ahead. Other information asked for included what policies and procedures are in place, when they were last reviewed and when maintenance and safety checks were carried out. The AQAA was not returned even though the deadline for its return was extended on two occasions. The provider must make sure that it is completed and returned. Questionnaires were sent to the home to be distributed to people living in the home, their relatives and healthcare professionals before the visit took place. At the time of the visit four people living in the home had returned surveys. The information from these was used to inform the visit and is referred to throughout the report. What the service does well: People and or their relatives can visit the home to look round and see if they think it will be suitable for them. One person said that the home ‘ticked all the boxes’ when they looked round and that was why they had chosen it. People told us they had received enough information about the services provided to be able to make an informed decision whether or not it would suit them. Care and support is provided to people in a home that is kept clean and tidy. The atmosphere in the home is warm, welcoming and friendly. Visitors can call at any time. They told us that they are welcomed and offered refreshments. Information from talking to people and returned surveys told us that: • The staff were very kind, caring and helpful. • Visitors/relatives were kept up to date with changes either when they visited or by telephone calls. Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 6 • • • • • • • They were happy with the meals and snacks provided and that if they wanted some ‘extra’ treats they would be provided. They were satisfied with how things were in the home and the care and support provided. Staff treated them with respect and knocked on doors before entering their rooms. They were happy with their rooms and could bring in their own possessions to personalise and make them more homely. They can choose when to get up, go to bed, where to spend their time either in one of the lounges or in their rooms - and where to eat their meals. People’s religious needs are met. Know who to talk to if they have any concerns. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Oakworth Manor DS0000001166.V366827.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 Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 5. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s needs are assessed before moving into the home. They are provided with enough information about the services and facilities provided to decide if it will be suitable for them. EVIDENCE: Information from surveys and talking to people told us that: * They had received enough information about the home and the services it provides so they could decide if it would be suitable for them. * People had come to look round the home, meet staff and other people who live there before deciding it would be suitable for them. One person told us that it ticked all the boxes and they liked it because it was smaller and more intimate. * Two had received a contract and two said they had not. Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 9 The acting manager told us that most people living in the home are partly funded by the local authority and that there are three way contracts in place between them, the local authority and the home. Some people are privately funded and she was not sure if contracts were in place and said she would check with the provider. The provider told us that contracts are issued by head office and they keep copies. Information about the newest person to come and live at the home was looked at. The acting manager completed a pre-admission assessment a week before the date of admission. The information on it was very brief, it did not say why they needed residential care or give an indication of how much they could do for themselves and how much help they would need from staff other than the comment needs help. It did say that social services were doing an assessment of needs but a copy of this was not seen. We saw another pre admission assessment in one of the care plans we looked at and again the information was brief and the only indication that the person needed residential care was an entry vulnerable - safety issues at home but there was nothing to say what they were. Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Most people had a care plan that told staff about their needs and abilities and how to meet them. But the information is not always detailed enough to make sure that people receive the individualised care they prefer. One person did not have a care plan at all which means there is a risk that some of their needs might not be identified. EVIDENCE: Somebody who moved in on the 4 June 2008 did not have a care plan at all when we visited on 17 June, even though a brief assessment of their needs was available in the pre admission assessment. The only records about their care were in the daily notes and the carer information sheets. This person was admitted with a possible pressure sore and staff had informed their doctor and asked the district nurses to come and assess their pressure area care needs. The lack of care plan means that staff do not have access to the detailed information abut the individual’s needs and what needs to be done to meet Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 11 them. We were told it had not been done because staff were busy with other issues and each day something had occurred that stopped it from being done. The acting manager told us that new care plans are going to be put in place for each person living in the home. They said that they would be person centred and individual to people’s needs. Some had been done but not all. It was intended that all care staff would be involved with writing them and keeping them up to date. We looked at two care plans. They showed us that: * It was not always clear when somebody had come to live at the home. We saw the date the pre-admission assessment had been completed but could not find the date they had been admitted. * There is a section about social, leisure and personal profile/information that is intended to be used to help with the care planning process. * Health care assessments looking at the risks of developing pressure sores, losing weight and falling are completed. However when a risk was identified the information from these was not carried through into a care plan telling staff what to do to reduce the risk. For example a nutritional assessment said the person was at risk of losing weight and that supplements should be used, the person did lose weight and they were referred to their GP, which is good practice; apart from what was in the assessment there was no other care plan or guidance about eating/drinking and maintaining weight. We were told that the information in the assessments is what is used as the care plan. * Somebody has been supplied with a height adjustable bed fitted with bedrails. There was no risk assessment or consent to use the bedrails from the person or their relatives in the care plan. * There was no evidence to show that the person or their relatives had been involved in the care planning process. Some of the visitors we talked to had not seen the care plans at all and others said they had seen them a long time ago. * The care plan for somebody with dementia did not tell us how it affected them or how staff could help them. We saw staff helping people to walk without using any moving and handling aids when it would have been far safer for all if they had. We were told that this would be reviewed and staff would be reminded about using appropriate moving and handling aids. We saw that staff interactions with people were warm, friendly and inclusive. Talking to people who live in the home and their visitors staff told us that: * They were satisfied with the care and support provided. * The staff were very kind, caring and helpful. * Visitors/relatives were kept up to date with changes either when they visited or by telephone calls. Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 12 It was clear from the information we saw, talking to staff and people that people have access to healthcare services such as their seeing their own GP, district nurses, opticians and chiropodists. We saw the morning medications being given to people. The person followed safe practice in that they checked the MAR before getting the tablets out, gave the tablets to the individual making sure they had been taken and then returning to sign the MAR. We looked at the MARs and saw that they had been used to record new stocks received into the home and to record medications given to people. The acting manager told us that named people deal with medications and they have all completed appropriate training and updates, the last one being in June 2008. She said she was looking for further relevant training courses. We asked if the medication policies and procedures had been revised in line with the latest guidance Safe handling of Medications in Social Care Settings from the Royal Pharmaceutical Society. She was not sure but would check with the provider. We were told that when the monthly repeat prescriptions are ordered the new ones are not seen in the home before they go to the pharmacy to be dispensed. They should be checked by somebody in the home before this happens to make sure they are going to receive what they have ordered and be able to deal with any problems before the new supplies arrive. We saw staff treat people with respect and as individuals. We saw staff knock on doors before entering people’s bedrooms. Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People maintain contact with family and friends and exercise choice and control over their daily routines. People enjoyed the food provided and mealtimes are a relaxed social occasion. EVIDENCE: The atmosphere in the home was warm, friendly and welcoming. Visitors were calling at different times and told us that they were always made welcome and offered drinks. The activity organiser is on maternity leave. We were told that all the staff are ‘mucking in’ to provide different activities that people can join in with. They said this usually happens in the afternoons and staff will use a variety of things available, for example music to sing along and dance to, dominoes and other games, some people enjoy getting a daily newspaper. The acting manager told us that they are looking at increasing the range of social and leisure activities offered to people. Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 14 The mobile library now visits the home and some people have joined it. Every two weeks the Roman Catholic priest visits to do a communion service. Once a month there is an interdenominational Christian service that all people are invited to join in with if they want to. The home does not have permanent cook and are in the process recruiting somebody to the post. In the meantime staff are doing additional shifts to cover the vacancy. People told us that they were happy with the meals and snacks provided and that if they wanted some ‘extra’ treats they would be provided. For example one person likes and gets a banana every day for breakfast and while we there somebody was given a bag of tangerines to keep in their room and to eat when they wanted to. They told us that they choose when to get up, go to bed and where to spend their time during the day, either in one of the lounges or their own room. Lunch was a relaxed and unhurried meal. Most people went to the dining room but others chose to stay in the lounge. The meal looked and smelled appetising and people said they enjoyed it. People who needed help to eat were given it in a discreet way. Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People know what to do if they want raise concerns about the services provided. There are systems in place to protect people from abuse. These will be improved when all staff have received appropriate training. EVIDENCE: The complaints procedure is displayed in the reception area. People told us that they knew who to speak to if they were not happy about something. One person said they were not aware of the complaints procedure but that they would find somebody to talk to if they needed to. There were no complaints detailed in the complaints record that the acting manager showed us. However we are aware of three complaints about staff issues that we referred to the provider to investigate. They had also been referred to the adult protection unit who asked the provider to investigate the concerns raised. The provider worked with the local authority and appropriate action was taken as a result of the findings. We talked to the provider about making sure that complaints records were kept up to date; if they were of a confidential nature the record could show a complaint has been received and where the records are being kept. Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 16 When relatives reported that items had gone missing from their relatives room the home contacted the police so that the incident could be dealt with properly. Copies of the local authority adult procedures were seen in the home. Staff told us that they would report actual or suspected abuse to the person in charge or to the provider. However not all staff have received training around abuse and adult protection yet. The acting manager should consider attending the two day course for social care managers provided by the local authority adult protection team. Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24 and 26. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a clean and tidy home that is safe and suitable to their needs. EVIDENCE: We looked around the home and visited some people’s bedrooms. It was clear that people bring in their own belongings to personalise their rooms and make them feel more homely. One person told us that their room was cold and we saw that there were a lot of electric radiators around the home, in the lounges and some bedrooms. The acting manager told us that the heating systems were working well but some people liked their rooms to be very warm. The heating system should be effective enough for additional heating sources not to be needed Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 18 The home was clean and tidy but some chairs in the communal areas did smell. The acting manager told us that staff are reminded often to use the washable chair protectors. We saw that staff had access to equipment that would help to reduce the risk of cross infection such as gloves, plastic aprons, liquid soap and disposable towels in communal bathrooms/WC’s and anti bacterial hand rub. Information from surveys told us that people in the communal lounges do not have call bells within reach. We saw that this was true. People were sat in the lounges and only one person had access to a call bell lead, other people would have to rely on staff being around as the call bell points were on the wall behind their chairs and not easy to reach. The acting manager was advised to review this situation. Information from surveys also told us that somebody’s bedroom is used as the hairdressing room. This practice should be stopped as is it is an invasion of the individual’s privacy. Minutes of a relatives meeting in January 2008 showed that this had been raised as a concern but no action was taken. The provider told us that they are looking at using one of the larger ground floor bathrooms as the hairdressing room in future. We were also told that sometimes a ground floor bedroom is used for GP visits rather than going to the person’s own room. The provider said that this would be reviewed so it does not happen in future. We saw that some repair works that need to be done and were told the provider was dealing with them. For example half of the floor covering in the staff toilet was missing, there were bare pipes and wiring on the ground floor. The provider told us the work had been done and that only the staff toilet still needed attention. The carpet in one person’s bedroom was ‘bubbled’ and presented a trip hazard. We were told this had happened because the carpet was frequently shampooed. The provider said that alternative floor coverings could be considered after carrying out risk assessments on which would be the best for the individual. We were told that the fire safety officer had visited 10 June 2008 and the provider was waiting for the report. The laundry and food stores are in the basement and there is no lift, staff carry items up and down the stairs. We asked if risk assessments were in place and none could be found. Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are enough staff on duty to meet people’s needs. The staff training programme needs to be reviewed to make sure that they have all received training that will help them to maintain the health, safety and well being of people living in the home and themselves. EVIDENCE: When we visited twenty-one people were living in the home. We were told that there would always be four staff on duty through the day and two at night, including a senior carer at all times. Staff are not taken away from their caring role because they are supported by ancillary staff seven days a week including domestic staff, laundry assistant and a cook. We looked at five staff files, one person had been employed from June 2007 and the others since April 2008. These included staff files where the provider had told us that an audit had identified that not all pre employment checks were in place. We saw that that they all contained: • Completed application forms and an interview record. But the forms ask for six years employment history rather than a full one. • Interview records are kept. We were told that these would be altered to include looking at the reasons for any gaps in employment. Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 20 • • • Two written references. For one person a reference had been supplied by the previous manager, which is not best practice. If it is a long time since the person was employed other sources of good character references should be looked for. Proof of identity. Satisfactory POVA first and enhanced CRB. The induction training has been an house package that is not to the Skills for Care common induction standards. The acting manager said that new packs to this standard are being introduced. Looking at the training records showed us that there are large shortfalls in the training given to staff. The five files we looked showed that: • Four had done the in house induction • Three had done moving and handling training. The training records seen were not up to date. There were no dates at all for training listed on one persons record, for two others the last entries were December 2005 and April 2006. Staff have not been given the training needed to maintain the health, safety and well being of people living in the home and of themselves. This was highlighted recently when somebody collapsed and was revived by the paramedics; the acting manager realised that senior care staff need to receive training around emergency first aid and basic life support. Because an AQAA was not provided we do not have an accurate number of how many staff have achieved an NVQ equivalent to level 2. Some staff told us that they were enrolled on this training and were enjoying it. Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The acting manager is well supported by the provider but does not yet have the experience or knowledge needed to manage the home. The supervision and support provided needs to continue to make sure that the home is run and managed in the best interests of the people who live there. The systems for looking after personal money held in safekeeping are not robust. There is a risk that peoples personal money will not be properly looked after. EVIDENCE: The registered manager left in April 2008 and since then a senior carer recruited in January 2008 has been ‘acting up’ as the manager while decisions Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 22 are made about who will manage the home. We were told the providers are very supportive and visit the home at least once a week, often twice, and they are in regular contact by phone. The manager of a nursing home owned by the providers is also giving support. We were told it has been a difficult time as a lot of staff left but new carers have been recruited and are settling into the home and getting to know people and the routines. The provider told us that they found that the record keeping systems in the home have not been as robust and as accurate as they should have been. They are auditing all records to identify what is missing and what needs to be done. We were told that copies of the monthly Regulation 26 visits were available on site when we visited, because the acting manager is new to the role she did not realise these were what we had asked to see. Copies have sent to us. We were told that a survey of people’s views of the home had not been done recently. One would be done in the near future. Because the AQAA was not returned to us we did not have a statement of whether or not the maintenance and safety checks of mechanical, electrical and gas installations/equipment are up to date. After the visit the provider sent it; it shows that the checks are up to date. The acting manager said that the home does not act as appointee or agent for anybody but they do look after small amounts of money for people. We asked to see the records kept. They showed us that: • A written record had been set up for one person but there was a discrepancy with the amount that should be have been available and what was actually there. • One person had an envelope with a sum of money in that did not match up with what was written on the envelope. • Another person had an empty envelope with a list of different sums of money on it. The systems for looking after people’s personal money are not robust and there are no clear records of what has been received, returned/spent and what should still be held by the home. In two cases there was a discrepancy between what should be available and what was actually available. The acting manager said she would investigate and find out if staff had used any money over the weekend without recording it. When feedback was given to the provider we were reassured that it would be investigated and appropopriate action taken. When we looked at the accident records we saw that when people fall or have accidents staff in the home are assessing them and making the decisions as to whether or not they should call for professional help. We asked if there was a policy in place for staff to follow in the event of accidents and one could not be found. We asked if staff had received first aid training to help them make Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 23 these decisions, we told not. We asked these questions because accident records showed us that one person had fallen three times in mid April and one occasion sustained grazes around their eye but the ambulance services were not called and they were not seen by a district nurse or the GP. Another accident report showed that the district nurse had been called in to see the individual but we had not been informed about it. The acting manager was not aware of this requirement and was told that guidance is available on our website. The accident records seen had not been audited and did not have any information added about the outcomes of the accident. Doing this would make sure that: • All accidents were followed up to make sure there were no lasting ill effects • Any additional support needed by the individual would be identified. • Any ‘trends’ could be identified and specialist advice asked for from appropriate healthcare professionals such as the falls prevention specialist. Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 24 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 3 2 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X 1 X X 2 Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 25 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 Care plans must be in place for each person living in the home. They must be more detailed and, where possible, be written with the involvement of the individual so that their personal preferences, abilities and wishes are recorded. This will make sure that staff have clear guidance about how to meet individual needs and deliver care in accordance with individual wishes. When somebody needs the use of bedrails to maintain safety detailed risk assessments and care plans must be put in place to show: * Why they are needed, * That the person and or their relatives have consented to their use, * How often they are to be checked and by who to make sure they are correctly fitted and in good working order, * Where these records will be kept. DS0000001166.V366827.R01.S.doc Timescale for action 30/08/08 2 OP8 13 30/07/08 Oakworth Manor Version 5.2 Page 26 3 OP30 18 The induction training programme for new employees must be revised in line with the Skills for care common induction standards. All staff must receive training that helps them to maintain the health, safety and well being of people living in the home and themselves and to meet people’s specialist care needs. 30/09/08 4 OP35 13(6) 16(2)(l) There must be safe and robust 30/07/08 systems in place if people ask for personal money to be held in safekeeping. Accurate records of monies received and returned must be kept. Guidance about what to do in the 30/08/08 event of accident or injury to people living in the home must be in place. After an accident people must be assessed by staff who have had the appropriate training to help them make decisions about what actions to follow. This will make sure that appropriate action is taken in the event of an accident or injury to somebody, that professional advice is sought as needed in a timely manner and people receive the correct treatment. In order to promote and protect 30/07/08 the health and safety of staff, risk assessments around carrying laundry, food stores and other items, up and down the basement steps must be put in place. We must be informed as soon as practicably possible of any accident or incidents that affect DS0000001166.V366827.R01.S.doc 5 OP38 13(4) 6 OP38 13 7 OP38 37 30/07/08 Oakworth Manor Version 5.2 Page 27 peoples safety and well being as detailed in guidance available about Regulation 37 notifications. 8 RQN 24 The AQAA must be completed and returned to CSCI. 30/07/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP3 Good Practice Recommendations The information about people’s needs in the pre admission assessment should be more detailed so that an informed decision can be made as to whether or not the facilities and services provided in the home will be suitable to meet them. The information gained from the healthcare assessments should be used to produce detailed care plans telling staff how to reduce the risks and when help from healthcare professionals should be asked for. The policies for dealing with medications should be revised using the Royal Pharmaceutical Society guidance issued in October 2007 Safe handling of medications in social care settings. Medication prescriptions should be seen in the home before they are sent to the pharmacy. This will make sure that all items requested have been supplied. This will make sure that medication prescribed for people is available to be administered to them as instructed by their doctors. 4 OP12 The scope of social and recreational activities offered to people should be increased and be based on their personal preferences and abilities. All staff should receive training around abuse and adult DS0000001166.V366827.R01.S.doc Version 5.2 Page 28 2 OP8 3 OP9 5 OP18 Oakworth Manor protection. This will make sure staff will know how to recognise abuse and know what to do if they see or suspect it. 6 7 OP28 OP33 At least 50 of care staff should be qualified to NVQ level 2 or above. There should be systems in place for getting the views of people who live in the home, their visitors and relatives as well as healthcare professionals/other stakeholders who visit the home. The outcomes of these surveys should be presented in a way that can be easily understood, showing what action will be taken in response to answers and comments made. There should be systems in place to follow up the outcomes of any accidents in the home. This will make sure they have been dealt with properly and help to identify trends where specialist help and advice might be needed to reduce the risk of further accidents. 8 OP38 Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Oakworth Manor DS0000001166.V366827.R01.S.doc Version 5.2 Page 30 - 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!