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Inspection on 31/08/05 for Oxford House Nursing Home

Also see our care home review for Oxford House Nursing Home for more information

This inspection was carried out on 31st August 2005.

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 high standard of nursing care within a friendly caring establishment. All staff are focussed on ensuring that the experience of the service users of living in the home are very positive and that they are valued members of the community.

What has improved since the last inspection?

The service users commented that the quality and variety of the meals had improved and that the staff continued to be friendly, cheerful and very supportive. The activities and social life in the home that are provided are constantly reviewed and developed.

What the care home could do better:

The documentation to evidence some of the recruitment practices need to be developed further to support that the service users are protected from possible harm.

CARE HOMES FOR OLDER PEOPLE Oxford House Nursing Home 204 Stoke Road Slough Berkshire SL2 5AY Lead Inspector Ruth Lough Unannounced Inspection 31/08/05 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 Oxford House Nursing Home DS0000011008.V249899.R01.S.doc Version 5.0 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. Oxford House Nursing Home DS0000011008.V249899.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Oxford House Nursing Home Address 204 Stoke Road Slough Berkshire SL2 5AY 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) 01753 536842 info@oxfordhousenursinghome.co.uk Mr Edward Millar Johnston Mrs Abina Teresa Johnston Miss Clare Frances Glennerster Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Oxford House Nursing Home DS0000011008.V249899.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th January 2005 Brief Description of the Service: Oxford House Nursing Home was opened in 1980 and is owned by independent proprietors Mr and Mrs Johnston. It has the facilities for 34 service users (OP) who require Nursing and Care needs and is situated in a quiet residential close on the northern outskirts of Slough. The home offers views over adjoining school playing fields and residential properties. The establishment was originally an Edwardian family home and has many original features and décor. Oxford House Nursing Home DS0000011008.V249899.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The visit to the home was a planned unannounced inspection to review the quality and outcomes for the service users living there. The inspection took place over 6 hours and involved the inspector reviewing specific care and employment records and observing the interaction between service users and staff. The inspector took the opportunity to consult with service users, relatives and staff. What the service does well: What has improved since the last inspection? What they could do better: The documentation to evidence some of the recruitment practices need to be developed further to support that the service users are protected from possible harm. Oxford House Nursing Home DS0000011008.V249899.R01.S.doc Version 5.0 Page 6 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. Oxford House Nursing Home DS0000011008.V249899.R01.S.doc Version 5.0 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 Oxford House Nursing Home DS0000011008.V249899.R01.S.doc Version 5.0 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): 3 and 5 A very detailed assessment process inclusive of input from other healthcare professionals is carried out before a service user is admitted to the home. Service users and relatives are welcomed to the home for trial visits. EVIDENCE: The senior nurse and the manager are jointly responsible for the assessment of need and the decision that the home is able to offer a place to a service user. The assessment process is detailed and if possible involves other health care professionals such as physiotherapists, GP’s, hospital and clinical specialists. The assessment documents used highlight the medical and nursing needs and also records the individual choices of how they wish to live. Oxford House Nursing Home DS0000011008.V249899.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 8 The service users care plans are detailed informative documents that ensure that all their health, personal and social needs will be met. EVIDENCE: The service users care plans reviewed supported that detailed comprehensive nursing care packages are in place that ensure that a holistic approach is given to meeting the individuals needs and wishes. All parts of the care plan are reviewed on a monthly basis and supporting documentation is kept of the reviews carried out annually by the placing authority if applicable. Nutritional, skin integrity and assessments for those at risk of pressure sores are carried out routinely and service users are regularly seen by their chosen GP. The staff enable service users to access other health care providers inclusive of hearing, sight and dental treatment and record accordingly in the care plans. Visiting professionals are encouraged to document in the care plan the outcomes of their consultation with the service users. Oxford House Nursing Home DS0000011008.V249899.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13 and 14 The service users are supported to be able to conduct their lives as they wish and are enabled to maintain their interests and have and active social life within the limitations of their capacity and health status. EVIDENCE: The service users were able to comment that they enjoyed living in the home and that staff supported them to have a good quality of life and to continue with their interests and activities. The care plans reflected that the individual’s choice of how they wish to live is recorded and carried out and that staff are flexible to changes in the planned care. The home has ensured that service users interests are encouraged and maintained and has employed an experienced Activities Coordinator who is present in the home for five mornings a week. She also supports the staff to carry out activities at other times and major social events for the service users at different times through the year. Each service users is consulted in regard to their interests and planned and unplanned activities are carried out individually and in small groups. The daily activities and outcomes for these are recorded well and indicate that service users are encouraged to take up new interests as well as continue with their current choices. A good programme of musical, educational and social events occur inclusive of inviting to the home singing groups, talks by the local museum and visits by the local ‘Pat a Dog’ scheme. Oxford House Nursing Home DS0000011008.V249899.R01.S.doc Version 5.0 Page 11 Service users are able to receive visitors as and when they wish either in the privacy of their own room or in one of the communal rooms. Service users are able to bring personal possessions into the home within the limitations of their bedrooms and physical needs. Oxford House Nursing Home DS0000011008.V249899.R01.S.doc Version 5.0 Page 12 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): Complaints and concerns are handled in accordance to the complaints policy and procedure and appropriate actions taken. EVIDENCE: The home has a complaints policy and procedure that meets the National Minimum Standards and is made available to service users and others through the Statement of Purpose and Service User Guide. A record of all complaints, concerns and compliments are kept and made available for inspection purposes. The inspector advised the home to develop further the present system to enable a better monitoring system for their quality assurance programme. The home has received one complaint since the last inspection visit that according to the documents held was managed well and suitable action taken. Many compliments have been received by the home and the management team ensure that these are passed back to all the staff and records kept on the individual staff member’s employment records. Oxford House Nursing Home DS0000011008.V249899.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The home is maintained well and is suitable for its purpose. EVIDENCE: The home is very well maintained and has an attractive homely atmosphere and manages to deliver good nursing care whist still retaining a domestic character. The majority of the rooms are not uniform in size and some offer features original to the period the home was built. There is a routine planned programme of maintenance that is recorded in detail and carried out to a high standard. It was evident that renewal of the fabric and decoration of the home occurs and staff confirmed that the proprietors were very willing to provide suitable finances to repair and develop the home. Oxford House Nursing Home DS0000011008.V249899.R01.S.doc Version 5.0 Page 14 The grounds, although small, are well kept and give service users to enjoy an outside space in secure and safe surroundings. The home has a good team of domestic and housekeeping staff who keep the home very clean, tidy and free from offensive odours. The laundry facilities are sited separately to the side of the building and the suitable equipment is provided to manage the quantity of laundry produced by the home. The area is very clean and well kept. Hand-washing facilities, with liquid soap and paper towels, are prominently sited throughout the home. Oxford House Nursing Home DS0000011008.V249899.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 29 The home is very well staffed and has suitable skill mix to meet the service users needs. Some of the recruitment processes could put service users at risk. EVIDENCE: The home has a high level of staff employed in the home during the 24 hour period. The registered nurses are all skilled and experienced and the majority have been working in the home for some time. Additional care and nursing staff are employed on duty at peak periods of activity during the day and domestic and catering staff are employed throughout the week and at weekends. Two staff files for the most recently employed care staff indicated that some of the processes to evidence a robust recruitment practice had not been recorded. One staff members application form had not been completed in full and the gaps in employment not explored. Evidence of the interview meetings has been kept but the decision to employ has not been recorded. Criminal Records Bureau checks, and proof of identity are carried out and copies of any relevant training or qualifications taken. Service users expressed to the inspector that all the staff were very friendly, kind and supportive. Oxford House Nursing Home DS0000011008.V249899.R01.S.doc Version 5.0 Page 16 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): 38 The home has suitable safe working practices in the home to protect service users, staff and visitors. EVIDENCE: This standard was partially inspected. The home has suitable information and is implementing safe practices for the storage for the Control of Substances Hazardous to Health, fire safety and infection control. PAT testing and regular servicing of mechanical, electrical and gas equipment occurs. Oxford House Nursing Home DS0000011008.V249899.R01.S.doc Version 5.0 Page 17 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 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 3 Oxford House Nursing Home DS0000011008.V249899.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? 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 OP29 Regulation 19 Requirement That the recording mechanisms to evidence that robust recruitment practices are carried out. Timescale for action 31/10/05 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 OP16 Good Practice Recommendations To develop further the present system for logging complaints to enable a better monitoring system for their quality assurance programme. Oxford House Nursing Home DS0000011008.V249899.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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 Oxford House Nursing Home DS0000011008.V249899.R01.S.doc Version 5.0 Page 20 - 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. 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