Inspection on 12/12/08 for Oasis House

This inspection was carried out on 12th December 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

Oasis House 12/01/08

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 19/06/2009.

CARE HOMES FOR OLDER PEOPLE Oasis House 20 Linden Road Bedford Bedfordshire MK40 2DA Lead Inspector Katrina Derbyshire Unannounced Inspection 12th December 2008 09:45 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 Oasis House DS0000070190.V374500.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. Oasis House DS0000070190.V374500.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oasis House Address 20 Linden Road Bedford Bedfordshire MK40 2DA 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) 01234 346269 01234 345355 GB Care Ltd Mrs Jacqueline Cousins Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (30) of places Oasis House DS0000070190.V374500.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Can include residents who have physical disabilities. Date of last inspection 12th January 2008 Brief Description of the Service: Oasis House is a large detached Victorian House that has been adapted to provide permanent and respite residential care for thirty people who are 65 years of age and may have dementia. New owners took over the running of the home in July 2007. The home is situated in a popular residential suburb of Bedford within walking distance of the towns amenities, which include rail and bus stations. The accommodation is provided on three floors and there is a shaft lift. There is a large lounge with views over the garden at the rear, and a smaller lounge is located to the front of the property. A variety of bedrooms for single and double occupancy are provided. Privacy screens are provided in the three shared rooms. Eleven bedrooms have en suite facilities. Toilet and bathing/showering facilities are located on each level of the home. There is a pleasant garden with patio furniture at the rear and side of the property. A few parking spaces are provided at the front of the house with metered parking on the road. The fees for this service are £425.86 per week. Fees do not include hair dressing, chiropody or toiletries. Further information about this home can be obtained by telephoning or visiting the home direct. Oasis House DS0000070190.V374500.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. This was an unannounced key inspection carried out on the 12th December 2008. The care of three people was looked at in detail and this is known as case tracking. Tracking people’s care is the methodology we use to assess whether people who use social care services are receiving good quality care that meets their individual needs. Through discussion, observation and reading records, we track the experiences of a sample of people who use a service. During the visit the communal areas of the home were seen alongside some of the individual rooms. Time was spent with many of the people who live at the home in one of the sitting areas. Observations of care practice and communication between the people living at the home and staff was also made at the inspection. We also visited the home in September 2008; this was following a request by the local authority when the passenger lift at the home had broken down. The focus of this inspection was to look at the key standards. What the service does well: The management are good at the way they deal with complaints. They look into the concerns that have been raised, find out what happened, and then try to change things so it won’t happen again, letting the person who made the complaint know what they have done. Records of all concerns that have been made are still kept at the home and these show that the home have always responded to everyone, this means residents know that they will be listened to by the home and their views will be acted upon. This included prompt feedback to Social services in Bedfordshire when the passenger lift at the home broke down. People living at the home and staff also think that the manager is ‘very organised’ and ‘supportive’. The manager makes sure that she knows about all the residents’ needs and works very hard to build a trusting relationship with Oasis House DS0000070190.V374500.R01.S.doc Version 5.2 Page 6 them. She also thinks it is important to learn new skills and develop her own knowledge to improve the standard of care for the residents and attends training courses on a regular basis so that she can try to improve on the standard of care at the home. We spoke with nine people on the day of inspection and this was their view of the manager. What has improved since the last inspection? What they could do better: The home still needs to improve or change in some areas, these include: The way some staff have been recruited needs to change. There is a special check by the Criminal Records Bureau that must be carried out each time a person is employed in a home, this had been done. However in addition a minimum of two references one from the most recent employer, must be secured before someone is allowed to work in the home in any capacity, this had not been carried out for some staff. We looked at 3 staff files, none of these had the correct references in place, and the staff had been recruited through an agency paid by the home. This increases the risk of someone being employed at the home, who may not be suitable to work there. It is acknowledged that other staff recruited not through this agency had all records required in place. The care records need to improve for some people living at the home. One person for example had seen their General Practitioner in November 2008 for ‘agitation and aggression’. However their daily progress notes had not mentioned this, the only entries prior to this visit were, ‘fine this morning or slept well’. It is very important that all records are accurate and reflect the person’s current well being so that any changes can be acted upon promptly and safely. When we visited the home we spent time in the main lounge with people who lived at the home. We observed on two occasions the use of an illegal lift. Two staff on two separate occasions assisted someone to move by lifting them under their arms, this is not safe for the person or the staff and can place them at risk of injury. Oasis House DS0000070190.V374500.R01.S.doc Version 5.2 Page 7 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. Oasis House DS0000070190.V374500.R01.S.doc Version 5.2 Page 8 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 Oasis House DS0000070190.V374500.R01.S.doc Version 5.2 Page 9 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, 4 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a clear effective guidance on the philosophy of care for those people with dementia at this home that helps them to receive the care and support that they require. EVIDENCE: The care files examined included pre-admission assessment. Assessments included information from visiting the person at the hospital, or wherever he or she was living prior to admission and information from any referring social worker or health professional. There were sections covering the social, psychological and physical needs of the person although not all areas had been completed for every person and there were sections that had been left blank. Oasis House DS0000070190.V374500.R01.S.doc Version 5.2 Page 10 Copies of the terms and conditions of residency were seen alongside contracts. These gave an outline of fees, responsibilities and notice periods. The statement of purpose was examined; a copy was on display at the time of this visit. The document provided information on the staffing, accommodation and services available at the home. Minor changes are needed to reflect recent changes, for example the document stated that the home was inspected twice each year, this is no longer the way the frequency of inspections are determined. It was observed that during the morning one person constantly called out to others in the sitting area in the home, reaching out to others and touching their personal items. Staff as they walked through this area asked the person to sit down and took the person by the arm gently and walked with them along the corridor. Other people at the home became agitated and several started to shout out, one person sitting by the door who started to bang the arm of their chair received attention from staff immediately in this period of observation. Intermediate care is not provided at the home. Oasis House DS0000070190.V374500.R01.S.doc Version 5.2 Page 11 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, 10 & 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Medication systems in this home are sufficient to ensure people receive their medication when they need it. EVIDENCE: Care plans and risk assessments were examined within the care records of the individuals living at the home. A plan was in place for each of the assessed needs of the residents. Appropriate risk assessments were also in place in relation to pressure area care, moving and handling, falls, nutrition and dependency. However the quality and accuracy of some entries within the care records was not sufficient. Daily notes on many occasions contained entries that said, fine, no change or slept well. This did not reflect the actually reality of the current Oasis House DS0000070190.V374500.R01.S.doc Version 5.2 Page 12 well being of the person, so in one instance when a Doctor had been called in for aggression, the daily notes were valueless. Sufficient equipment was present in the home to maintain pressure area care for the residents. Care records contained documentary evidence to support that access to external healthcare professionals, for example chiropody, dentist, General Practitioner and optician had occurred. Staff, through discussions, were clear on their responsibilities to ensure access to external healthcare professionals was maintained and residents confirmed that this took place. One resident said “They always call the Doctor if l need one”. Medication storage in the home was noted to be satisfactory as was the ordering of medicines. The recording of medication stocks and balances were sufficient so an audit of the medication systems was possible. The medication administration records were seen to contain the signature of staff and showed that medication had been given as prescribed. Oasis House DS0000070190.V374500.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 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The systems and support to residents in maintaining personal relationships is good, and enhances the resident’s standard of life. EVIDENCE: Activities are on offer in the home, all activities are shared with anyone who wishes to participate. People are encouraged to join in, but can choose whether or not to participate. Activities specifically designed to assist people with dementia are also available. People are able to bring personal possessions into the home and the evidence of this was seen in individual rooms. People confirmed that they are consulted and are given choices as to how they conduct their lives within the home; choices offered included meals, activities and relationships. Oasis House DS0000070190.V374500.R01.S.doc Version 5.2 Page 14 Nutritional risk assessments were seen within the care records. A choice of meals is available, a brief observation of the lunchtime meal showed it to be unrushed and enjoyed by the residents from their positive comments. The relatives of two residents were spoken to and both commented on how the staff in the home always made them feel welcome. They could see their relative in private and felt that the home were good at keeping them up-todate on any changes concerning their family member. Oasis House DS0000070190.V374500.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 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Concerns and complaints are acted upon so residents feel that they are listened to and that staff take their concerns seriously. EVIDENCE: The homes complaints procedure, as it did in January 2008, gave sufficient guidance to staff on the action that they should take on receiving a complaint. The procedure described the rights of residents and that all complaints must be responded to. Within the homes statement of purpose a summary of how to complain had been included for residents and their relatives. Records of complaints received were seen and showed the investigation undertaken by the home and the responses to the complainant. The homes policy for the protection of vulnerable adults was examined and again remained the same as when assessed in January 2008, the policy was comprehensive and included how any incident of abuse should be reported. Staff training records also showed that they had attended workshops on this area and they were able to describe the varying types of abuse, which included physical and financial. Oasis House DS0000070190.V374500.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Several areas in the home provided an environment suitable for people at the home however improvements are still needed in other areas to ensure all of the home is of a standard that provides a pleasant environment for people to live in. EVIDENCE: As previously assessed the parts of the home that were seen were clean and there were no unpleasant odours. Designated cleaning staff were busy with their duties which included carpet cleaning. Domestic staff were well motivated, trained, and had all the equipment and products they required. Oasis House DS0000070190.V374500.R01.S.doc Version 5.2 Page 17 There were personal items on display in the bedrooms seen, and people spoken with said that they were satisfied with their room. Shared bedrooms were seen and were equipped with privacy screening. Although the home had been re decorated in some areas and carpets had been replaced in others, there remained areas still in need of attention. One example was the carpet as you entered the home, this was frayed and stained. The home has a contract in place for pest control so that if there is any infestation professional help can quickly be secured. Oasis House DS0000070190.V374500.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The systems for reruiting and training staff is not sufficent for all employees to fully safeguard the people living at the home. EVIDENCE: A check of staff files was undertaken to look at recruitment practices, three staff files were selected for this purpose. It was noted that the files contained proof of identity and Criminal Records Bureau clearance. However verification of employment history had not been obtained through the correct uptake of references. None of these references had been sought as a direct result of this employment and were titled ‘to whom it may concern’. It is acknowledged that those staff employed direct by the home and not through an agency had all relevant paperwork in place. All staff receive induction and on-going training. Staff training that has taken place during the last 12 months include COSHH, Fire, First Aid, Health and Safety, Moving and handling. Staff confirmed that they were encouraged and supported to attend training as part of their development. Oasis House DS0000070190.V374500.R01.S.doc Version 5.2 Page 19 Residents spoken with said that they felt there were sufficient staff at the home to meet their needs. Staff spoken to also stated that they felt that they had sufficient time within their working day to care and support the residents, they reported that there were busy periods in the day but they felt that these were managed well. Observations were made of staff supporting and providing care to residents throughout the day. A good rapport existed between the staff and residents, staff took time to explain to each resident what was happening and they were given the opportunity to express their own wishes. Oasis House DS0000070190.V374500.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 & 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Monitoring systems in the home has not been sufficient in all areas to ensure residents are protected at all times and always receive the care that they require safely. EVIDENCE: Health and Safety information provided by the home showed contracts with approved contractors are in place for the maintenance and servicing of equipment. The most recent inspections undertaken by Environmental Health and the Fire Service showed the home had maintained standards in these Oasis House DS0000070190.V374500.R01.S.doc Version 5.2 Page 21 areas. However it was observed during the visit that two staff assisted a resident to move at 10:15 and then 10:30, this resident was not able to stand without assistance and the use of an underarm lift was used. This is unsafe for both the resident and staff. The Home Manager has many years experience, which is directly relevant to the role of manager in the home. Many of the staff spoken with stated that they felt the home to be “like one family” and felt that they had a good level of support and encouragement from the manager of the home. In addition several residents also commented on how the manger always took an interest in them personally and that they found her to be very approachable. However the concerns raised within the staffing section of the report needs to be addressed, as the recruitment of staff is a key safeguarding area. The home had undertaken a review in which they had sought views of on the standard of care at the home this was in July 2008. They developed an action plan relating to the views received and demonstrated how they have used the information to influence the running of the home for example the manager advised that there had been changes to the menu. Oasis House DS0000070190.V374500.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 2 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X X X X 2 Oasis House DS0000070190.V374500.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 Timescale for action 30/04/09 2 OP19 16 3 OP29 7, 9, 19 Schedule 2 4 OP38 12, 13 & 18 Care records must be accurate and sufficient enough to show clearly the changes in a persons well being. This is to ensure that and change or deterioration can be identified quickly and acted upon. Measures must be taken to 30/06/09 ensure all of the carpeting/flooring is sufficient in all areas to provide a pleasant environment for the people to live in. Two references and all other 30/04/09 matters listed in schedule 2, one reference from the most recent employer must be secured prior to commencement of employment of staff to verify their suitability to work with the people who use the service. This is to protect the people living at the home, from receiving care by someone who may not be suitable to work in a care home. The moving of all residents must 30/04/09 follow safe practice at all times to prevent injury to both residents and staff. DS0000070190.V374500.R01.S.doc Version 5.2 Oasis House Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP1 Good Practice Recommendations The statement of purpose must be kept up to date to ensure people living at the home have access to accurate information. Oasis House DS0000070190.V374500.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Oasis House DS0000070190.V374500.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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