Inspection on 15/07/05 for Queens Oak Care Centre

This inspection was carried out on 15th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

Other inspections for this house

Queens Oak Care Centre 18/11/08

Queens Oak Care Centre 29/11/07

Queens Oak Care Centre 12/05/06

Queens Oak Care Centre 01/12/05

Queens Oak Care Centre 04/02/05

Queens Oak Care Centre 19/08/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Queens Oak Care Centre 64-72 Queens Road Peckham London SE15 2EP Lead Inspector Pam Cohen Unannounced 15 July 2005 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 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. Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Queens Oak Care Centre Address 64-72 Queens Road Peckham London SE15 2EP 020 7277 9283 020 7277 9263 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Excelcare Holdings Ms Smomo Grace Mboto CRH care home N care home with nursing 88 Category(ies) of DE(E) dementia - over 65 years registration, with number OP old age of places Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 To include no more than 34 service users with dementia at any one time. 2 The service users at Queens Oak Care Centre can be approached as to whether they would like to move to another bedroom, though must be moved at their own will Date of last inspection 4 February, 2005 Brief Description of the Service: Queens Oak Care Centre is a care home with nursing for older people which was built in 2001. It is owned by Excel Care, a large care provider with homes in London and other parts of the country. There are four floors. Services to people suffering from dementia are provided on two of them. One floor provides care to people with physical frailty and one floor for people requiring nursing care. The home is near Peckham town centre, close to shops and all community amenities. There are train and bus routes near the home and some parking space in front of it. All bedrooms are single and all but four are fully en-suite; the remaining four have wash basins only in the room. There is a secure garden at the back. On the day of inspection there were six vacancies. Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and the inspector also followed up progress on two complaints which the CSCI had received concerning Queen’s Oak. The manager was on leave but her deputy facilitated the inspection. In addition the inspector spoke to staff and service users and was able to speak to two relatives. What the service does well: What has improved since the last inspection? What they could do better: The home cares for 38 service users with dementia and needs to put into place environmental changes, stimulating activities and training, so that appropriate care can be assured for this group. Care plans need to be better for this group as well as for other service users. Dementia sufferers must always be treated with dignity and the privacy of all service users’ care needs must be assured. Some details of medication administration need to be addressed. There is an activities programme but sufficient opportunity for social activities should be provided for all service users, and there should be a congenial atmosphere at meal times. All complaints should be recorded and the complainant informed of what is happening. Maintenance and repairs should be regularly and promptly dealt with and all areas of service users’ rooms should be cleaned regularly. Staff should routinely have appropriate induction and foundation training and there should be a plan to ensure that staff skills meet service users’ needs. All staff must also be checked for criminal backgrounds and protection of vulnerable adults before they start working at the home. A quality assurance programme should be in place to monitor how the service is meeting its aims and an annual development plan should plan for change. Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 Page 6 The safety of service users must be assured by a full and safe system of moving and handling risk assessment and training. 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. Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 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 standard(s) 4 The home is not equipped to offer specialist care to people suffering from dementia which means that service users needs for stimulation, orientation and understanding cannot be guaranteed to be met. EVIDENCE: The home is registered for and offers care to 35 people suffering from dementia. However neither the two unit managers nor their staff have training in caring for this group of people, although one night carer is taking a course. The environment on the floors for dementia sufferers has not been geared towards their needs although there is awareness that this is needed. Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 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 standard(s) 7,8,9,10 The home’s care plan format is good but the work of planning care for service users is not being done in a way which guarantees that all of a service user’s needs will be met. Service users can feel confident that their health care needs are met and medication administration is generally good. Examples seen of the way a service user was treated, and documentation which was not individualised, mean that service users are not always treated with privacy or dignity. EVIDENCE: The quality of care plans varied between floors. The basic format is good and one floor had good night care plans in place. However in general care plans were not detailed enough in terms of the personal care needed and in terms of the effect of dementia on service users’ functioning. Life histories were not taken and the social needs of people were not well addressed. Service users and their relatives were not part of the care planning process and reviews were not always up-to-date. The care plans did show good assessment of people’s health care needs and there was evidence of satisfactory liaison with health care professionals. Medication administration was generally well dealt with although instructions for administration could be made clearer to ensure proper administration. The home also needs a system for doctors to sign Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 Page 10 changes that they order in medication administration. There also needs to be a thorough audit of creams for external application. These are not included on the administration charts and the inspector found creams prescribed for one service user in other service users rooms, as well as out of date creams. There was evidence from service users and their relatives that staff treat people with respect. However whilst walking round the home the inspector heard staff shouting angrily at a service user with dementia and found three staff clustered round him. She also saw evidence of recording that did not demonstrate individualised care. Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 Page 11 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 standard(s) 12,15 Insufficient resources means that not all service users benefit from appropriate social stimulation. Food is nutritious but service users mealtime experience is not always pleasant. EVIDENCE: The inspector talked to the activities officer who works 35 hours a week. She showed that she is working hard to build up an activities programme based on the interests of the service users. She is also involving staff and on the day of inspection staff were seen knitting with service users, talking and playing dominoes. The activities organiser has had training in reminiscence and there is one reminiscence group a week. However, whilst not wishing to detract from the activities organiser’s efforts, she cannot provide a service for a home for 88 people. This means that neither the consultation with service users about their interests, nor the activities inside and outside the home was sufficient. This is especially so for service users with dementia. There is a small room for religious worship in the home and chaplains visit. There is a nutritious menu and there was evidence that service users can eat in their rooms if that is their wish. Three of the dining rooms were pleasant but the one on the top floor was unpleasantly crowded and chaotic. Lunch was seen to be over very quickly with most of the food thrown away. On the first floor there were six or seven service users who needed feeding, with only two Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 Page 12 carers to help them. Food was served to all at the same time and was clearly getting cold while people were waiting to be fed. Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 Page 13 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 standard(s) 16 Response to complaints was seen to be varied, so that service users and their relatives cannot always feel confident that their concerns will be responded to. EVIDENCE: The home has a complaints policy which is freely available. When speaking to the relatives of a service user, they did not feel that their complaints about the cleanliness and maintenance of his room had been properly responded to. Evidence was seen of a good response to two complaints that had been made to the CSCI in the past three months. However, in the absence of the manager the complaints book could not be found and so recording could not be checked. Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 Page 14 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 standard(s) 19, 20,21,24,26 The home offers a good standard of accommodation to its service users, although thought has to be given to the suitability of the ground floor as a unit for people with dementia. Service users and their relatives are not at the moment, always assured of a clean and well maintained environment. EVIDENCE: The home was purpose built in 2001. It offers safe and spacious space for service users and is well sited for access to transport and local facilities. In most respects it meets the needs of the people who live there. However, one of the dementia units is on the ground floor. Although this offers good access to the walled garden it is also a confusing and busy space and thought needs to be given to its suitability for this service user group. There is a good amount of communal space in the home as a whole and on each unit. The garden is safe and accessible, although on the day of inspection it had an untended look. Bedrooms are of a good size and all but four are ensuite; those that are not are close to bathrooms and toilets. However these bathrooms were being used to store some items. Most bedrooms did not have two comfortable chairs which meant visitors have to sit Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 Page 15 on the bed. Several maintenance issues were seen or reported by relatives; a cracked wall and ceiling, stain on ceiling, tiles and ceiling tiles missing from a sluice room and unusable furniture. Although the communal areas were clean, bedrooms were not cleaned to a high standard. Relatives pointed this out and the manager confirmed that this was an issue. Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30. Service users benefit from sufficient numbers of staff at day and night, who are well inducted into the routines of the home, and of whom a good percentage have NVQ training. The lack of further induction, foundation training and a training and development plan means that staff may not always have the skills to meet the specialist needs of service users. Recruitment practices do not offer sufficient security to service users. EVIDENCE: Rotas showed that the hours for day and night staff are suitable for the needs of the service users. The home has a good, basic, in-house induction programme but it is not to a TOPSS skills for care certified level. Staff are also not receiving foundation training. Once the members of staff who are now waiting to start an NVQ course have completed it, the home will exceed the 50 level for this form of training. However, a full staff training and development plan is needed, and this should address amongst other issues, that of staff training in dementia. Although most documentation needed for staffing purposes was good, the records of two newly appointed staff showed that they had been taken on before proper checks had been done, concerning protection of vulnerable adults. Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,36,38 A supportive atmosphere and regular supervision means that there is a stable staff group to give care to service users. Systems to ensure service users’ safety are generally met but there is not a safe moving and handling system in place. EVIDENCE: Staff spoke of a supportive atmosphere, where communication with management is good and problems are heard and “sorted”. There are regular management meetings and a programme has started for unit managers to “cascade” these down to their staff. There is also regular supervision and appraisal of staff and staff confirmed that they have access to notes on their file. The home does not yet have a full system of quality monitoring or an annual development plan. Health and Safety systems were generally in place with the major exception of safety around moving and handling of service users. Moving and handling risk assessments are not being done, moving and handling training is not up to date, and staff were starting work with service Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 Page 18 users without having had satisfactory moving and handling training. The inspector was told that two members of staff have been trained to become moving and handling trainers and are intending to set up systems to ensure safety. This must be seen as a matter of urgency. Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x 1 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 1 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 2 3 3 x 3 2 x 2 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x x 3 2 x x 3 x 1 Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 Page 20 YES 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 4 Regulation 12 (1) Requirement The registered person must ensure that staff caring for people with dementia have training in this area. A timescale for action must be drawn up and sent to the CSCI Southwark Office. The registered person must ensure that environmental adaptations to orientate service users with adaption are put in place. The registered person must ensure that care plans are up-todate, drawn up and reviewed with the service user and their representative and include details of all aspects of a service users needs. The registered person must ensure that instructions for medication administration are clear, that any changes ordered by the GP are signed by him/her. The registered person must ensure that creams prescribed for external use are in-date, are used only by the person for whom they are prescibed and that administaration is recorded. The registered person must Timescale for action 31st December 2005 2. 4 12 (1) 31st December 2005 31st October 2005 3. 7 15(1)(2)( b,c) 4. 9 13(2) 31st October 2005 31st october 2005 5. 9 Sch 3 (k) 6. 10 12(4) 30th Page 21 Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 7. 12 16(2)(m) 8. 15 16(2)(1) 12(1)(a) 9. 15 12(1)(a) 10. 16 22(3)(4) 11. 19 23(1)(a) 12. 19 23(2)(b) 13. 24 16(2)(c) make suitable arrangements to ensure that the home is conducted in a manner that respects the privacy and dignity of service users. (Previous timescale of 30th June 2005 not met). The registered person must consult service users about their social interests and make arrangements to enable them to engage in local, social and community activities. (Previous timescale of 30th June 2005 not met). The registered person must ensure that the service users on the top floor have a congenial setting in which to eat meals and that mealtimes are unhurried. The registered person must ensure that when service users need feeding, their food does not go cold while they are waiting for assistance. The registered person must ensure that action is taken on all complaints and a response provided to the complainant. The registered person must ensure that professional advice is taken as to whether the ground floor is a suitable environment for a unit for people suffering from dementia. This advice, and any decision taken, should be furnished to the CSCI Southwark Office The registered person must ensure that there is a planned maintenance programme and that all areas of the home are kept in good repair. The registered person must ensure that there are two comfortable chairs in each bedroom. September 2005 31st December 2005 30th November 2005 30th September 2005 30th September 2005 30th November 2005 31st October 2005 31st October 2005 Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 Page 22 14. 26 23(1)(d) 15. 28 18(1)(c) 16. 29 19(1) 17. 30 18(1)(c) 18. 33 24(1)(a) (b) (3) 19. 20. 33 38 24(1)(a) (b) 13(5) The registered person must ensure that all parts of the home are cleaned to a proper standard. The registered person must ensure that the home has an induction programme that meets TOPSS new skills for care standards. The registered person must not employ a person to work at the home unless the person is fit to work at that home and information specified in paras 17 of Schedule 2 has been received. (Previous time scales of 29th October 2004 and 30th June 2005 not met. Continued failure to comply could result in consideration being given to enforcment action) The registered manager must ensure that persons employed at the home receive training appropriate to the work they are to perform (Previous timescale of 30th June 2005 not met). The registered must ensure that there is a system of quality assurance which takes into account the views of service users, their relatives and other stake holders. The registered manager must ensure that there is an annual development plan. The registered manager must make suitable arrangements to provide a safe system of moving and handling service users.(Previous timescale of 30th June 2005 not met). 31st October 2005 31st December 2005 31st October 2005 31st December 2005 31st December 2005 31st December 2005 31st October 2005 Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 Page 23 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. Refer to Standard 16 19 Good Practice Recommendations The registered person should ensure that the complaints book is always availablein the home. The registered person should ensure that the garden is well tended at all times. Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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 Queens Oak Care Centre G52-G02 S7045 QueensOakCareCentre V238839 150705 Stage 4.doc Version 1.40 Page 25 - 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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