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Inspection on 28/05/08 for Oldfield Residential Home

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

This inspection was carried out on 28th May 2008.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

Oldfield provides a homely environment for its current residents. The home has good systems in place for admitting people to the home so people are well informed and fully aware how the home will meet their needs. Comments we received as a result of our survey were unanimous to confirm the care and support offered to people living at the home was of a consistent good quality standard. The staff have a very good understanding of the individual needs of the people living at the home. One person commented, `All the staff I have met during the past 3 years work hard and show care and concern for all the residents. Everyone is friendly and courteous regardless of any pressures they may be dealing with.`

What has improved since the last inspection?

Findings as a result of this inspection confirms 4 out of 6 requirements which were made at our last inspection have been fully met. This means privacy has been enhanced for people using communal facilities as well as them having the option of locking their bedroom door. The addition of a new extension has improved bedroom and communal accommodation for some residents. However, finishing touches need to be completed in order for people to fully benefit from the improvements. The home have introduced an activities coordinator to its staff team in order to maximise the opportunities for individuals to engage in meaningful pastimes. Oldfield management are in the process of changing their care plan paperwork. The new style of forms will make it easier for the people who live at the home to read and understand. The newly appointed manager has already had an impact on the way the home is managed. Robust systems are already in place to monitor complaints and accidents. She has also completed a full audit of the home environment and negotiated a programme of redecoration and refurbishment with the home owners. Work has already started on this and as a result new laundry equipment has been installed.

CARE HOMES FOR OLDER PEOPLE Oldfield Residential Home Derrington Road Ditton Priors Bridgnorth Shropshire WV16 6SQ Lead Inspector Janet Adams Key Unannounced Inspection 28th May 2008 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Oldfield Residential Home DS0000020717.V363220.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.V363220.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 Care Home 45 Category(ies) of Dementia (15), Learning disability (1), Old age, registration, with number not falling within any other category (29) of places Oldfield Residential Home DS0000020717.V363220.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home only Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP (maximum number of places 45) Dementia Code DE (maximum number of places15) Learning Disability - Code LD (maximum number of places 1) The maximum number of service users who can be accommodated is 45. 10th October 2006 2. Date of last inspection 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 45 people. As the home is situated on the edge of the small Shropshire Village of Ditton Priors, which is in is in a rural location there is limited access to it by public transport. The Home is a purpose built single storey building, and offers both single and double bedroom accommodation, some of which have en suites. It has recently been extended in order to upgrade the living accommodation offered to people in the home. It has well-maintained grounds with shrubs, mature trees, flower borders, lawns and woodland walks. 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, and are readily available. This information states the weekly fees to range from £380 - £450 per week, although the reader may wish to obtain further up to date information from the care service itself about this matter. 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.V363220.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 2 star. This means the people who use this service experience good outcomes. This inspection was carried out by one inspector and lasted seven hours. Shortly before the inspection, we requested some up to date information from the home to assist with this process. This meant that although the Oldfield team knew the inspection was imminent, they were not aware of the date or time the inspection would take place. The inspection included observing activity within the home, inspecting the premises, and ‘in depth look’ at records for residents and staff, as well as observing, talking and listening to over half of the 34 people living there. Several of the staff on duty at the time of the inspection also shared their views about working at Oldfield. Discussions with people were carried out in private, with people on their own, or together in groups in the lounges. Everyone was happy to share their comments, which are included in the main body of the report. A total of 13 residents, 9 relatives and 8 staff members and 1 health professional also returned written comments about the home to us. Two of these individuals also requested the opportunity to talk to us about the home. Everyone, including residents and staff, was very welcoming and helpful throughout the inspection. A total of 25 out of a possible 38 National Minimum Standards for Older People were assessed on this occasion. Discussions with the newly appointed home manager took place throughout the day, and feedback about the conclusions of the inspection was given at the end of the inspection and upon receipt of all our survey information. What the service does well: Oldfield provides a homely environment for its current residents. The home has good systems in place for admitting people to the home so people are well informed and fully aware how the home will meet their needs. Comments we received as a result of our survey were unanimous to confirm the care and support offered to people living at the home was of a consistent good quality standard. The staff have a very good understanding of the individual needs of the people living at the home. One person commented, Oldfield Residential Home DS0000020717.V363220.R01.S.doc Version 5.2 Page 6 ‘All the staff I have met during the past 3 years work hard and show care and concern for all the residents. Everyone is friendly and courteous regardless of any pressures they may be dealing with.’ What has improved since the last inspection? What they could do better: A total of 3 statutory requirements were made as a result of this inspection. The content and detail in some of the individuals care plans needs to be further expanded to confirm all aspects of a person’s safety and well being has been identified and acted upon. Medication management systems need to demonstrate the safe receipt, storage and administration of all medication kept at the home. Bathing and shower facilities including those in the newly opened extension need further attention to make them safe and accessible for people who need to use them. Oldfield Residential Home DS0000020717.V363220.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. Oldfield Residential Home DS0000020717.V363220.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 Oldfield Residential Home DS0000020717.V363220.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 & 3. Standard 6 does not apply to this service. Quality in this outcome area is good. Admission and assessment procedures clearly demonstrate the home can meet needs of people thinking about moving into Oldfield care home. This makes sure that if people choose this home, it will meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Findings confirm the management team continues to make every effort to ensure safe and successful admissions to Oldfield care home. 85 of the people who live at the home responded to our survey to say that they received enough information about Oldfield before they moved in so they could decide if it was the right place for them. One person who wrote to us said, Oldfield Residential Home DS0000020717.V363220.R01.S.doc Version 5.2 Page 10 ‘We received a detailed brochure describing the facilities and services and were given a tour of the home.’ At the start of the inspection the care manager provided us with an up to date colourful ‘Oldfield Welcome Pack,’ which is given to all people thinking about living at the home. Included in this information is a statement of purpose and service user guide that is specific to Oldfield and the resident group they care for. It clearly sets out what you can expect when you live at the home. The information gives an account of the services provided, quality of the accommodation, qualifications and experience of staff, how to make a complaint, recent CSCI inspection findings and contains four comments about the experiences of residents living at the home. Admissions to the home only take place if the service is confident staff have the skills, ability and qualifications to meet the assessed needs of the prospective resident. In the information the care manager sent us before the inspection it was stated, ‘We carry out thorough pre-assessments on all prospective clients, either at Oldfield over tea or in their own homes. We encourage service users to visit the home for lunch/tea and spend some time with us to make sure they feel Oldfield is the place for them.’ An in depth look at the records of two people admitted to the home in recent weeks confirmed that good standards of recordkeeping are in place for this process. Details seen written down confirm staff collect as much information as is necessary for the home to decide whether they can meet the person’s personal care and support needs before they move in. This was also confirmed by additional comments we received :‘Two of the staff came to visit after my daughter had a look round’ ‘ Home staff came out to assess me’ Another relative wrote the following compliment, ‘Oldfield made things very easy for the family when my relative moved in. They did everything to make things easy for my family member. The care is very good’ Oldfield Residential Home DS0000020717.V363220.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 Quality in this outcome area is good. Staff are sensitive to the individual needs of the people who live at the home and meet these in a professional manner. The health and personal care that people receive is not fully based on their individual needs. The majority of medication at this home is safely managed to make sure it promotes good health for residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All comments received about the care and support provided at Oldfield provided was positive. Oldfield Residential Home DS0000020717.V363220.R01.S.doc Version 5.2 Page 12 People were unanimous to confirm that individuals received the care and support they needed, including medical support. One person wrote, ‘If we need any information the staff are always ready to help especially when it comes to healthcare.’ In addition, one of the community nurse wrote to tell us ‘I have always felt that our help, advice and support is always requested appropriately.’ The care staff were observed to be assisting people with their personal care discreetly and in a manner which promotes their dignity. Observation of the way staff were caring for people with dementia related conditions confirmed that the individuals showed feelings of well being in response to the way staff cared for them. Lots of chatter, conversations and interactions were observed between the people who live at the home, staff and visitors during the time of the inspection. All appeared to be very well at ease with each other. A relative of one person with this condition commented, ‘I am very happy that my mums needs are being met. She is well supervised but still has her freedom to walk around the home and mix with others .I feel she is safe and her personal needs are catered for.’ Other comments we received included, ‘At present I am very happy with the way the home support my mum’ ‘I have a very high opinion of the care my wife receives’ Examination of five sets of people’s records shows the home is in the process of improving care plans in line with a new system that has been introduced by the home owners. This paperwork changeover has addressed several shortfalls the home manager has identified to be improved including the provision of photographs. Whilst visiting people’s bedrooms good daily records were seen to make sure people were getting regular drinks and care they required. Although care records confirmed most care needs are accounted for, a review of accident records and the care paperwork showed some individuals lacked assessments to keep them safe. • Records for one person described how the individual had been aggressive towards staff on two occasions recently. However the person’s records did not clearly identify how staff were to manage this behaviour safely • The safety assessment paperwork of another person who had injured herself had not been fully looked at in order to minimise the chance of it happening again. These issues were discussed with the manager. We also found that the home is experiencing some challenges to get the right community nursing support for some of the people who live in the home with regards to insulin administration and constipation management prescribed by Oldfield Residential Home DS0000020717.V363220.R01.S.doc Version 5.2 Page 13 their doctors. This has had an impact on the lifestyle of at least one person. The home manager has the support of the company who owns the home to make sure people will receive the care they need by appropriately trained healthcare staff for this matter. On the inspection day a clinical nurse specialist was visiting two people who live at the home in response to an issue the home is dealing with regards to their diabetes conditions as part of finding a solution to some of these challenges. Review of the medication management systems in the home confirm the majority of systems in place ensure medications are managed satisfactorily. There was a good auditing of the way the home manages Controlled Drugs. However some areas of improvement are required with regards to, • The receipt of all medications received into the home. • Recordkeeping of the minimum and maximum temperatures of the drug fridge. • Medications stored in the home, which are used and administered by the district nurses. Although the home has recently received a pharmacy audit by a medicines management officer for the Primary Care Trust these issues were not identified. These issues were discussed during the inspection and the manager took immediate action to improve these issues. Oldfield Residential Home DS0000020717.V363220.R01.S.doc Version 5.2 Page 14 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. People who use services are able to make choices about their life style, and supported to develop their life skills. Social, educational, cultural and recreational activities meet individual’s expectations This judgement has been made using available evidence including a visit to this service. EVIDENCE: Comments received from people living at the home and their visitors all confirmed the home has a strong commitment to enabling residents to develop or maintain their skills, including social, emotional, communication, and independent living skills. Many people were at the home visiting friends and family, and stated that they are always offered a warm welcome when visiting. People spoke openly of the home’s good links with the local community. Oldfield Residential Home DS0000020717.V363220.R01.S.doc Version 5.2 Page 15 At present no one who lives at the home has expressed an interest to attend a local church service, although Holy Communion services continue to be popular and are held monthly in the home. The manager confirmed that no one with any specific spiritual needs currently lived at Oldfield. Staff were observed to be offering choices to residents throughout the day, the choices and options very much dependent on the capacity of the individual. One person was most complimentary about how her choice is respected in all aspects of her daily lifestyle. She commented one of the best things about living at the home being able to decide for herself what she wants to do and when. She stated, ‘We do what we like when we like, we are not restricted in any way.’ Discussion with the newly appointed activities coordinator confirmed plans for in-house and community based activities are being arranged on a weekly and monthly basis. The home has the use of a company car to get people out and about and staff informed us three people enjoyed a trip to the village tearooms the day before the inspection. Although over half of the residents commented that there were always activities arranged that they could take part in, we received four comments from people who would like this part of the service be improved. The home management are already aware of this and are acting upon it. The team have just started compiling life history books so more activities can be developed to focus on people’s past and present interests. These will be used alongside a new ‘recreation assessment form’ which has been implemented with the new care plan paperwork in order for future activity plans. In the coming year the home has plans to launch a monthly newsletter and involve residents and relatives in more meetings to make sure their suggestions and opinions are included in the home’s social diary. The lunchtime meal was seen served according to people’s choice in either of the two dining rooms, and in people’s bedrooms. Staff were observed to be serving and assisting with meals in a relaxed, unhurried and discreet manner. Staff on duty were knowledgeable about people’s dietary needs, and the best way to serve their residents’ food so they can dine independently. All residents who made comments about the meal provision were in agreement that the food was good. Samples of the menus which rotate on a 4 weekly basis are provided as part of the welcome pack the home provides for prospective residents. Over 80 of residents informed us they liked the meals in the home. Oldfield Residential Home DS0000020717.V363220.R01.S.doc Version 5.2 Page 16 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. People who use the service are able to express their concerns, and have access to a robust, effective complaints procedure, are protected from abuse, and have their rights protected EVIDENCE: Review of the complaints management system shows that Oldfield welcomes this type of issue in order to improve the service it provides. Information about making a complaint or comment is clearly outlined in the Oldfield information pack described earlier in this report, as well as being displayed in the home. Findings of our survey confirmed 90 of the people stated they always knew who to speak to if they were unhappy. All staff stated they knew what to do if anyone had concerns about the home. We have not received any complaints about this home since the last inspection, and the home manager stated no complaints have been received at the home since 2004.She has just recently carried out an in depth audit of the home’s records in order to create a complaint log book for the service. Oldfield Residential Home DS0000020717.V363220.R01.S.doc Version 5.2 Page 17 One to one and group interviews with staff confirmed they had a good working knowledge of safeguarding adult procedures. Examination of staff records also confirmed training is held regularly for this sensitive issue. Although the company policies and procedures for adult protection are available for staff reference the local authority procedures could not be located. The manager confirmed these would be obtained as priority. Staff demonstrated a good knowledge of the procedures for dealing with resident’s personal monies kept at the home for safekeeping. All transactions are recorded and two staff signatures are obtained to ensure security for this matter. Oldfield Residential Home DS0000020717.V363220.R01.S.doc Version 5.2 Page 18 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, 21, 24 & 26. Quality in this outcome area is adequate. The physical design and layout of the home enables people who use the service to live in a comfortable environment, which encourages independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home continues to offer comfortable accommodation for the people living at the home. On a tour of the home the new manager discussed the plans ahead to improve the home living accommodation. Since coming into post in March this year she has carried out a full audit of essential repairs and desirable refurbishment and has negotiated a programme of redecoration and improvements with the owners. This includes the provision of new soft Oldfield Residential Home DS0000020717.V363220.R01.S.doc Version 5.2 Page 19 furnishings, improved lighting in a lounge, repair and replacement of worn vanity units in bedrooms, and upgrade of the worn and chipped baths in the older part of the home. The home now employs a maintenance man to manage the day to day upkeep of the home. He was on hand to make the hot water supply to a resident’s en suite bath safe when it was found to be too high at 60 degrees Centigrade. Almost all parts of the home have had privacy locks installed and the manager has requested this job to be completed as priority. Since the last inspection a new extension has been added to the home to provide an improved reception area, additional bedrooms and communal living space. All eleven residents eating their lunch in the new dining room were in agreement they liked the new surroundings. People who have relocated to this part of the home were involved in the choice of colour scheme for their room. However, some parts of the building work has yet to be completed. Cables are exposed in the new kitchen area, and tiling has not been provided at the hand washing sink yet. Externally, fencing is in need of replacing for people who live at the home to have access to the designated ‘safe garden’. Paving slabs removed for builders access in this area are also in need of replacing. A large hole is cordoned off by garden furniture. The provision of the new bathing facilities has not been the success it was expected to be. A basic bath was installed against a wall making it impossible to use mobile hoisting equipment to assist people in and out of it. Handrails were not installed to the sides of the bath which means even the most mobile person cannot climb in and out of it safely. As a result it is not used. This is disappointing especially as the other baths in the home are in a worn condition and there is a need for this provision. In addition, the location of the shower in the wet room and lack of shower screening means the floor is a slip risk for anyone entering or leaving this room. Lack of screening also challenges an individual’s privacy when this facility is used. The home laundry facilities have been upgraded and new laundry equipment has been installed. This part of the home does not have any hand washing facilities and there are none close by. This was discussed with the manager and she confirmed a safety assessment of this area would be prioritised to improve this matter. The majority of people who completed our survey were happy to confirm the home is usually always fresh and clean. Oldfield Residential Home DS0000020717.V363220.R01.S.doc Version 5.2 Page 20 One person commented, The home is very welcoming and friendly- staff are very helpful. It is a very pleasant environment, which is very clean and fresh. The manager has just introduced new cleaning systems with colour-coded equipment in an effort to improve infection control practices in the home. She confirmed all staff have been trained in this matter alongside chemical safety since she took up her post. The premises were last inspected by the fire service in February 2007.No actions were identified as required at that time. The inspection visit by the Environmental Health Officer in February 2008 was also positive – again no actions were required. Oldfield Residential Home DS0000020717.V363220.R01.S.doc Version 5.2 Page 21 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 good. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Copies of ‘past, present and future’ team rotas were examined and confirmed the home has been satisfactorily staffed to meet the needs of the people who live at Oldfield. The new manager stated she felt the home was adequately staffed. It has not been necessary for the home to use agency staff for some time – which is commendable given its rural location. Comments from people who use the service were all complimentary. People wrote, ‘The staff are hard to fault’ ‘There appears to be an even mix of trained and untrained staff in the home. I am very happy with all members of staff in the home they are all very pleasant and friendly. Oldfield Residential Home DS0000020717.V363220.R01.S.doc Version 5.2 Page 22 100 of people thought the home met the differing needs of the people living at Oldfield and that the staff team had the right skills to look after people living at Oldfield properly. One person stated, ‘I visit the home on a regular basis and have absolutely no reason to believe that there is any form of discrimination. I am more than satisfied with the care my relative receives.’ Examination of the files of the home’s two latest recruits confirms the improvements the home manager told us about have been implemented to make this system more robust. However it is advised that further information is sought to make sure enough details have been collated with regards to equal opportunity employment for staff employed from overseas. In the information the home provided before the inspection it was confirmed that 60 of care staff have the minimum expected care qualification. The manager has already devised an ‘at a glance’ training needs form whilst she audited the training records of her team, and is fully aware of what training to plan for to keep her team updated. Review of the records for two other team members employed at the home for some time confirm they have all recently received mandatory refresher training in fire and chemical safety, moving and handling, and food hygiene, as well as medication training. Oldfield Residential Home DS0000020717.V363220.R01.S.doc Version 5.2 Page 23 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, 36 &38. Quality in this outcome area is good. The newly recruited home manager is committed to improving the quality of the service. Management systems to monitor the health, safety and welfare for residents, staff and visitors make sure that they are kept up to date, to meet people’s changing needs and safeguard their well being. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Oldfield Residential Home DS0000020717.V363220.R01.S.doc Version 5.2 Page 24 Amy Wall, the newly appointed manager is currently in the process submitting her application to us to be considered for her registration as the manager for Oldfield. She stated she has already attained her Registered Manager’s Award as part of her career development. Ms Wall has been previously employed at Oldfield care home in a deputy manager role and comments received indicate her return as manager to be most welcome. She is supported in her role by Simon Badlands one of the homeowners, who regularly visits the home. Although she had only been in post for a week when we requested information for the inspection, the details Ms Wall submitted in the pre inspection information ‘Annual Quality Assurance Assessment’ form contained clear, relevant facts about the home, supported by a wide range of evidence. It told us about changes made and where the home still needs to make improvements and how they are going to do this. Documentary evidence is available for promoting and protecting the health, safety and welfare of people living at the home, its visitors and staff. Review of the paperwork and records for the regular maintenance of equipment such as hoists and emergency call equipment shows this to be all in order. Several new systems the manager has implemented are robust. The new accident management system is an example of this improved practice. The home also has efficient systems to ensure effective safeguarding and management of residents’ money and valuables, including record keeping. Although a requirement was made at the last inspection to ensure a quality monitoring system was introduced and monitored, this has not yet been carried out. However the new manager was able to confirm that questionnaires have been produced and will be circulated in the near future. Part of her improvement plans for the forthcoming 12 months also account for more regular meetings with residents, relatives and the staff team. In line with these plans the manager has already devised a system to ensure staff supervision and monitoring of their roles and responsibilities is prioritised. Discussions with staff members confirmed this system to be to be organised and in place. Oldfield Residential Home DS0000020717.V363220.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 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 3 3 X 2 X X 3 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 3 X 3 Oldfield Residential Home DS0000020717.V363220.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? YES 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 kept under review in order to monitor alterations in people’s circumstances and effect changes in the care that they receive to keep them safe and well. The medication management systems for the people who use the service must be robust and accurate to demonstrate that all medication is safely received, stored and administered as prescribed by appropriately trained personnel. Adequate bathing and shower facilities that people can use without risk to their safety must be provided. The registered person must ensure a quality assurance and monitoring system is implemented. (Previous timescales of 31/12/06 not met.) Timescale for action 30/08/08 2 OP9 13(2) 30/08/08 3 OP21 23(2)(j) 30/08/08 4. OP33 24(1) 28/05/08 Oldfield Residential Home DS0000020717.V363220.R01.S.doc Version 5.2 Page 27 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 2 3 4 Refer to Standard OP18 Good Practice Recommendations It is advised an up to date copy of the local authority safeguarding adults policy is obtained and is located in the home for staff to access at any time. It is advised that all external parts of the home which people who live at the home have designated as accessible are made safe. It is recommended that a risk assessment is carried out to promote infection control standards for handling laundry. It is advised that suitable hand wash facilities (paper towels, liquid soap and a lidded disposal bin) are available in all high-risk areas including the laundry. OP19 OP26 OP26 Oldfield Residential Home DS0000020717.V363220.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Oldfield Residential Home DS0000020717.V363220.R01.S.doc Version 5.2 Page 29 - 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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