Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 10/10/06 for Oldfield Residential Home

Also see our care home review for Oldfield Residential Home for more information

This inspection was carried out on 10th 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides a homely environment for the current residents. The staff have a very good understanding of the individual needs of the people living at the home. High levels of personal and physical care are provided to all people living at the home. The manager, deputy and staff are highly aware of equality and diversity and its implications even when few residents with recognised diversity issues are in receipt of the service. Visitors commented ` staff are always friendly and give good care to my relative`, relative is very well looked after, and I have no complaints`. Residents stated ` staff are very helpful`, ` I would not wish to live in any other care home`, ` the food is always good, and I like it`.

What has improved since the last inspection?

The manager explained of the further improvements to the environment with the replacement of some fittings and furniture.

What the care home could do better:

Assessments and specific care plans must be completed for identified care needs. For the safety of residents, staff and visitors doors must not be kept open with wooden wedges or pieces of furniture. All bedroom doors must be fitted with an appropriate locking facility to offer residents a true choice of whether to lock their door or not. The provision of a lockable storage space in each bedroom would be of benefit to some people living at the home.

CARE HOMES FOR OLDER PEOPLE Oldfield Residential Home Derrington Road Ditton Priors Bridgnorth Shropshire WV16 6SQ Lead Inspector Joy Hoelzel Key Unannounced Inspection 10th October 2006 11:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Oldfield Residential Home DS0000020717.V297453.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. Oldfield Residential Home DS0000020717.V297453.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oldfield Residential Home Address Derrington Road Ditton Priors Bridgnorth Shropshire WV16 6SQ 01746 712286 01746 712411 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) Mr Simon James Badland Selina Broome Care Home 35 Category(ies) of Dementia (14), Learning disability (1), Mental registration, with number disorder, excluding learning disability or of places dementia (9), Old age, not falling within any other category (10) Oldfield Residential Home DS0000020717.V297453.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th February 2006 Brief Description of the Service: Oldfield Residential Home is a care home for older people, registered to provide accommodation and personal care for up to 34 people. The Home is a purpose built single storey building, situated on the edge of the small Shropshire Village of Ditton Priors and offers both single and double bedroom accommodation. It has well-maintained grounds with shrubs, mature trees, flower borders, lawns and woodland walks. Weekly fees range from £303.00 - £ 400.00. Information of the home and the provision of the service are available in the statement of purpose and service user guide, both documents have recently been revised, (September 2006), and are readily available. Commission for Social Care Inspection Reports for this service are available from the provider or can be obtained from www.csci.org.uk Oldfield Residential Home DS0000020717.V297453.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection is the first of key inspections for 2006/07 and took place over five and a half hours on Tuesday 10th October 2006. It was conducted by one Commission for Social Care Inspection regulation inspector. Twenty four of the thirty eight National Minimum Standards for Older People were inspected. Thirty three people are currently living at the home; and throughout the time of the inspection were observed to be accessing all areas of the home. The registered manager and deputy manager were on the premises supported by six care staff with additional domestic and catering staff. Two case files were selected for case tracking, relevant documents were inspected, discussions were held with residents, visitors and members of staff. Observation was made of the various daily activities and a tour of the premises was conducted. Building work is in progress to expand the premises with an additional ten bedrooms, the anticipated completion date being December 2006. What the service does well: What has improved since the last inspection? The manager explained of the further improvements to the environment with the replacement of some fittings and furniture. Oldfield Residential Home DS0000020717.V297453.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Oldfield Residential Home DS0000020717.V297453.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 Oldfield Residential Home DS0000020717.V297453.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): OP 3,6 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have their care needs assessed before moving into the home. Relatives, and whenever possible the person requiring care, are provided with the opportunity to visit the home to assess its quality, facilities and ability to meet an individual’s needs prior to admission. EVIDENCE: The case file of the person most recently admitted to the home contained details of the care needs and was supported by information in a transfer form from a previous placement. A full assessment of care needs is carried out by a member of staff prior to offering a placement at the home and is based on the activities of daily living. Visitors confirmed that they visited the home prior to making the decision for the relative to move in and stated that he and additional family members made the decision as the person concerned was unable to make the choice due to cognitive difficulties. He stated that he was ‘extremely satisfied with the care offered …. well looked after, cared for and very comfortable’. Oldfield Residential Home DS0000020717.V297453.R01.S.doc Version 5.2 Page 9 The home does not offer an intermediate care service. Oldfield Residential Home DS0000020717.V297453.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): OP 7,8,9,10 Quality in this area is adequate. This judgement has been made using available evidence including a visit to this service. Each resident has a care plan. The plan in most cases includes the basic information necessary to plan the individuals care, some omissions of recording information has the potential for not fully meeting a persons needs. EVIDENCE: Two case files were selected for inspection, one being of the person most recently admitted to the home, the other had been at the home for a period of time. Each resident has a plan of care initially based on the pre admission assessments and formulated at the point of admission. The care plans are reviewed at least monthly. Where ever possible the resident and/or representative is involved in the process but it is acknowledged that at times some people do not wish or are unable to partake. The manager discussed the future plan of changing the recording assessment and system from a paper base form to a computer based programme. Oldfield Residential Home DS0000020717.V297453.R01.S.doc Version 5.2 Page 11 One plan identified a change in condition that required full care and interventions to be carried out by staff. This change had not been recorded in the care plan giving the full instructions for staff as to how the new identified care needs were to be carried out. For example this person was now bed bound and subsequently required extra pressure area care, the risk assessment had not been completed, turn charts, interventions for pressure area care or fluid intake and output balance had not been completed or recorded. However, staff were observed during the day to be regularly attending to this person and a visitor stated that they thought the care offered was ‘excellent and couldn’t be better’. The resident appeared to be comfortable and restful. The manager confirmed of frequent visits from the district nurse service. Other changes to be persons needs identified at the review stage had not been linked to a specific care plan. This was discussed with the manager and deputy at the time of the inspection. The home operates a twenty eight day medication administration regimen using a monitored dose system with the additional use of bottles and boxes. The lunchtime medication round was observed with staff offering the medication and assisting in an appropriate manner. The Medication Administration Record (MAR) charts were completed at the time of the administration. The manager confirmed that protocols for the use of ‘when required’ medications have not been produced, without this information staff may not be aware of the triggers for the administration of such medications. During the tour of the premises tubs of external creams and lotions were in use, the date of opening had not been placed on the container, it was not possible to establish whether the recommended shelf life had expired. The fridge for the cold storage of medication is kept locked; the temperature is taken daily and recorded. The care staff were observed to be assisting service users with personal care discreetly and in a manner which promotes service users’ dignity. Lots of chatter, conversations and interactions were observed between the service users, staff and visitors during the time of the inspection. All appeared to be very well at ease with each other. Oldfield Residential Home DS0000020717.V297453.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): OP 12,13,14,15 Quality in this area is excellent. This judgement has been made using available evidence including a visit to this service. The daily living and social activities arranged for residents takes into account the differing expectations, preferences, lifestyle and capacities of each individual. EVIDENCE: The manager stated that recruitment is ongoing for a full time activities coordinator with the opportunity for existing care staff to take on the role. During the inspection one member of staff approached the manager asking about the possibility of job sharing the position and the benefits of this. The manager responded in a positive way detailing the closing date for applications from other staff members ensuring equal opportunities for all. Meanwhile, in-house and community based activities continue to be arranged on a weekly and monthly basis. One resident commented that the musical evenings are very enjoyable, as they like to join in with the singing. During the morning of the inspection a harvest festival service was being enjoyed by a number of residents. Many people were at the home visiting friends and family, and stated that they are always offered a warm welcome when visiting. During the tour of the premises many of the bedrooms were individualised with personal belongings. Staff were observed to be offering choices to residents Oldfield Residential Home DS0000020717.V297453.R01.S.doc Version 5.2 Page 13 throughout the day, the choices and options very much dependent on the capacity of the individual. However the lack of locks and ‘vacant /engaged’ signs on communal toilets and bathroom areas mean at times peoples privacy may be challenged when they use these facilities. The inspector was invited to join residents with the midday meal; the dining room was well prepared in advance, with the meal being presented in a commendable manner. Staff were observed to be serving and assisting in a relaxed, unhurried and discreet manner. One resident stated that the ‘food is always good and there’s plenty of it’ and went on to describe the meals and content of the meals offered throughout the day. Oldfield Residential Home DS0000020717.V297453.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): OP 16,18 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. Concerns and complaints are dealt with promptly and professionally with robust procedures and practices in place to ensure that individuals are protected from abuse. EVIDENCE: The home has its own complaints/concerns procedures, a copy of which is displayed at the entrance of the home and is also included in the statement of purpose and service user guide. Visitors stated that if they had any concerns whatsoever they would not hesitate to see a member of staff and felt confident that their concern would be taken seriously. A complaint file records the last complaint received at the home in November 2004. No complaints have been made to the Commission for Social Care Inspection since the inspection in February 2006. The policies and procedures for adult protection are available for staff reference. The manager stated that all policies and procedures are currently being reviewed. External training in April 2006 has been accessed. The manager and deputy demonstrated a good knowledge of the actions they would take if an allegation or suspicion of abuse were made. Staff demonstrated a good knowledge of the procedures for dealing with service users personal monies kept at the home for safekeeping. All transactions are recorded with signatures obtained; it was recommended that a procedure for giving and keeping receipts be adopted. Oldfield Residential Home DS0000020717.V297453.R01.S.doc Version 5.2 Page 15 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): OP 19,21,26 Quality in this area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable place in which to live, however, there are some areas of the environment that would benefit from further development to provide the people living at the home with improved facilities. EVIDENCE: The home offers comfortable accommodation for the people living at the home. Routine maintenance and redecoration of rooms continues. The manager stated that the carpet in the large lounge is due for replacement shortly. During the tour of the building some doors were being wedged open by wooden blocks or pieces of furniture. If it is a person’s preference or there is an assessed need for the doors to remain open then the appropriate door closures must be installed. This was discussed with the manager who confirmed that priority for fitting the door closures will be given to the people who stay mainly in their bedrooms and who like to have the door open. Oldfield Residential Home DS0000020717.V297453.R01.S.doc Version 5.2 Page 16 There are four bathrooms situated in various areas of the home of which only two are used on a regular basis, the manager explained that there are difficulties with the safe use of equipment and accessing the rooms. Consideration should be given to the possibility of installing a shower provision in these areas enabling a greater choice of bathing facilities for the people living at the home. During the tour of the premises it was observed that not all bedroom doors have been fitted with an appropriate locking facility, without this residents do not have a true choice of whether to lock their door or not. Not all bedrooms have been provided with a lockable storage space. Hand washing facilities have been provided for residents and staff in the communal areas of the home. Paper towels, liquid soap and a foot operated lidded bin must be provided in all areas at the point of care delivery. Most bedrooms contain a commode for nighttime use; sluice facilities are available for the disposal of bodily waste. It is highly recommended that consideration be given to the installation of automatic sluice disinfectors for infection control purposes and to reduce the risk of splash back incidents for staff. Oldfield Residential Home DS0000020717.V297453.R01.S.doc Version 5.2 Page 17 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): OP 27,28,29,30 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. There is an established staff group working positively and enthusiastically to provide service users with a quality of life that meets their individual requirements and aspirations. EVIDENCE: At the time of the inspection the manager and deputy manager were on the premises and were supported by six care staff. Catering and domestic staffs are additional. Duty rotas are maintained for the twenty hour period. The service user guide details the grade and qualifications of all staff working at the home. Two staff personnel files were selected for inspection, all the necessary identity checks have been carried out, with records kept. Training opportunities continue in the core and specialist topic areas for all staff. Certificates and records of achievement are retained in the personnel files. Two staff members discussed the training opportunities and the different courses that they had been on. Supervision and an appraisal of work performance continue to be arranged for all staff, records are kept in the personnel file. The statement of purpose details the organisational structure and the number, qualifications and experience of staff. Oldfield Residential Home DS0000020717.V297453.R01.S.doc Version 5.2 Page 18 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): OP 31,33,35,38 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. The Manager has the required qualifications and experience to run the home. She works to continuously improve services and provide an increased quality and stable life for residents. EVIDENCE: The manager demonstrated a good knowledge of the resident group and the conditions and dilemmas associated with the ageing process. Visitors and residents spoken with, commented positively on the management approach and stated that if they had any concerns they would not hesitate to discuss the issues with the manager. No formal quality assurance and monitoring systems are in place at present, the manager and deputy stating that this issue is being looked at by the company for implementation at a later date. Oldfield Residential Home DS0000020717.V297453.R01.S.doc Version 5.2 Page 19 A staff meeting had been previously arranged for the afternoon of the day of the inspection and appeared well attended by staff. Small amounts of cash are held on behalf of the residents, two staff members have been identified as being the designated key holders for the safe. They both demonstrated a good knowledge of the procedures for dealing with residents’ personal allowances. A record is made at the time of the transaction; it was recommended that a procedure for giving and keeping receipts be adopted. Documentary evidence is available for promoting and protecting the health, safety and welfare of service users, staff and visitors. Oldfield Residential Home DS0000020717.V297453.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 3 X X 2 X 2 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 2 X 3 X X 3 Oldfield Residential Home DS0000020717.V297453.R01.S.doc Version 5.2 Page 21 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 OP8 Regulation 17(1)(a) Schedule 3 (o) Requirement All assessments and interventions required to adequately meet a persons needs must be fully completed, recorded and reviewed at regular intervals. The registered person must ensure that the appropriate door closures (linked into the fire alarm system) are fitted to doors where there is a need or preference for the doors to remain open. Doors to service users private accommodation must be fitted with locks suited to service users capabilities. All bedrooms must be supplied with a lockable storage space. The registered person must ensure that suitable hand wash facilities (paper towels, liquid soap and a lidded disposal bin) are available in all areas at the point of delivery of care. The registered person must ensure a quality assurance and monitoring system is implemented. DS0000020717.V297453.R01.S.doc Timescale for action 30/11/06 2 OP19 23(4) 31/12/06 3 OP24 12(4) 31/12/06 4 5 OP24 OP26 16(1) 13(3) 31/12/06 30/11/06 6 OP33 24(1) 31/12/06 Oldfield Residential Home Version 5.2 Page 22 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 OP9 Good Practice Recommendations It is recommended that all external medications be dated upon opening, with tubs of creams/ointments discarded after one month of opening and tubes after 3 months of opening. It is recommended that protocols are devised and available for the use of ‘when required’ medications. It is recommended that consideration be given to the installation of a shower facility. It is recommended that consideration be given to the installation of automatic sluice disinfectors. It is recommended that receipts are given and obtained for each financial transaction relating to the safe keeping of a residents personal money 2 3 4 5 OP9 OP21 OP26 OP35 Oldfield Residential Home DS0000020717.V297453.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Oldfield Residential Home DS0000020717.V297453.R01.S.doc Version 5.2 Page 24 - 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!