Inspection on 12/09/05 for Red Oaks

This inspection was carried out on 12th September 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.

Other inspections for this house

Red Oaks 05/12/05

Red Oaks 29/11/04

Red Oaks 05/07/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Red Oaks The Hooks Henfield West Sussex BN5 9UY Lead Inspector Mrs J Farrell Announced Monday, 12 September 2005, 09.00am,V241400 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. Red Oaks H60-H11 S60415 Red Oaks V241400 120905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Red Oaks Address The Hooks, Henfield, West Sussex, BN5 9UY 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) 01273 493043 Barchester Healthcare Mrs Jacqueline Ann Welch Care Home 54 Category(ies) of Old age, not falling within any other category registration, with number (OP) - 54 Both, Physical disability (PD) - 10 of places Both, Physical disability over 65 years of age (PD(E)) - 2 Both Red Oaks H60-H11 S60415 Red Oaks V241400 120905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1, A Maximum of 54 Service Users may be accommodated at any one time. 2, 10 Service Users will be in the age range of 50-65 years of age. Date of last inspection 29/11/04 Brief Description of the Service: Red Oaks is a care home providing nursing care . The home was opened in 1986 and consists of three floors. All rooms except one provide single accommodation and en suite facilities. All parts of the home are accesible for wheelchair users. there is a passenger lift to all floors. The home has extensive gardens that are well maintained and accessible to service users. The home is located close to the local amenities. Red Oaks H60-H11 S60415 Red Oaks V241400 120905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on the 12th September 2005 and lasted seven hours. There were 50 residents living at the home at the time of inspection. During this inspection the inspector had lunch with 4 residents in the dining area. The overall impression of this home is that there is clear strong leadership, which is consistently looking to improve the high quality of care already received by the residents at Red Oaks. This is the first statutory inspection of this year. Prior to the inspection the inspector read information held on the service file since the last inspection in October 2004, and read the previous two inspection reports. A tour of the premises took place, rotas and care records were inspected. Ten residents and seven staff members were spoken with. Prior to the inspection the Inspector received 17 relatives comment cards from residents and 3 from relatives, which had very positive comments about the home. The residents have different levels of communication ability and therefore it was difficult to ascertain all their views on how their needs are met. However all comments by residents who were able to contribute were very positive. Comments such as ‘it is wonderful here’ ‘the staff will do anything for you’. Relatives comments included ‘staff are always there to help if I need them’ ‘I looked all over the country until I found this home and I am very happy I chose this one’ ‘I feel I am always listened to’ ‘I am very impressed with the activities which happen most morning’. No requirements were made following this inspection. What the service does well: At the time of this inspection the home was being efficiently managed. Systems are in place to ensure residents are safeguarded and their health and social care needs are being met. This home has a history of being well managed and has required very few recommendations over the years. The home has an experienced team of staff who enjoy their work and have a good understanding of the needs of the people living at the home. Relatives spoke highly of the support their relatives receive from staff and positive relationships were observed between staff and residents. The environment is relaxed and friendly and residents have use of a range of communal areas in addition to their individual rooms. Meals are varied, balanced and well presented, offering both choice and variety. Mealtimes are flexible, particularly breakfast and lunch, which was noticed being continually served over several hours to accommodate the differing times people were getting up and to cater to their individual needs. Residents are supported with their personal routines and this support was seen to be offered and carried out with dignity and respect. Red Oaks H60-H11 S60415 Red Oaks V241400 120905 Stage 4.doc Version 1.40 Page 6 All records and files were found to be neat and easily assessable. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Red Oaks H60-H11 S60415 Red Oaks V241400 120905 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 Red Oaks H60-H11 S60415 Red Oaks V241400 120905 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) 1,2,3,4,5 There are systems in place to ensure residents and their representatives’ make an informed choice about the home. No resident moves into the home without having had a thorough assessment of their needs discussed with them. Residents confirmed that their varying care needs were being met. EVIDENCE: Ten residents spoken with in private were able to provide a copy of the Service Users Guide. They said they had visited the home prior to being admitted on a trial short stay. A review of their care needs was discussed with them during the first two weeks of their stay. One resident said she thought her health had considerably improved since entering the home. Residents said they found it particularly helpful to have met with the manager prior to entering the home. A relative said her Mother’s care needs and preferences had been discussed in detail during this initial assessment, which she said made her feel more confident about placing her Mother in the home. The Statement of Purpose states the qualification details of the staff. The Statement is being changed to individualise it to Red Oak as at present it is a generic to Barchester Healthcare Homes Ltd. Red Oaks H60-H11 S60415 Red Oaks V241400 120905 Stage 4.doc Version 1.40 Page 9 Red Oaks H60-H11 S60415 Red Oaks V241400 120905 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 Arrangements are in place to ensure that the health care needs of residents are identified and met. The home demonstrated good medication handling practices. EVIDENCE: The care needs of residents are set out in their individual files. The inspector examined five files at random including two new residents. Residents said they were aware that information is recorded about them and that staff members refer to it in order to meet their varying needs. Individual files contained all relevant information, including risk assessments for moving and handling and special dietary needs. From discussion with the residents they gave a clear and concise pen picture of the person. The inspector observed staff members entering resident’s bedrooms. They knocked the door and waited for permission before entering. Staff members said that there was strict guidance about respecting resident’s privacy. Residents said when they use their call bell, staff members respond quickly in a friendly respectful manner. One resident said she was lifted using a hoist, which at first she had been fearful of. However because staff members had been thoroughly trained she now felt relaxed and not so anxious. She also started that when her husband Red Oaks H60-H11 S60415 Red Oaks V241400 120905 Stage 4.doc Version 1.40 Page 11 died at the home recently she was well supported and the staff ‘went out of their way to help her and her family’ The manager advised that there is a now a very good working relationship with the residents GPs, the district nurse service and specialist nurses. The resident’s can choose which GP they wish to register with, in the locality. Relatives spoken with discussed how their relatives are assisted to attend all hospital outpatients, dentist, eye, and hearing appointments. A General Practitioner who visits the home said that staff members were very good about carrying out his instructions and therefore he considered that Resident’s health care needs were very well met in the home. Medication storage had been improved. Medication administration record charts are printed in the pharmacy every four weeks, with the information on the medicines dispensed. Medicines that needed to be handwritten, were initialled by two nurses. The home operates a homely remedy policy. Red Oaks H60-H11 S60415 Red Oaks V241400 120905 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15 Residents said that their social needs were met as far as possible taking into account their increased physical frailty. Residents receive a wholesome appealing diet in pleasant surroundings at times convenient to them. EVIDENCE: Conversations with relatives highlighted that community presence and participation in social activities was varied across the home. Some residents are able to go out in the garden and do so frequently. For others, staff support is required for all parts of daily living The home provides entertainment on most mornings, one resident particularly like’s the cooking sessions discussing the jam tarts they had made. The inspector was impressed with a small walled garden which residents have made their own. Red Oaks promotes an open door policy during the day. Residents spoke of visitors they had received and the home maintains a record of the contact each resident has with his or her relatives and friends. Two relatives spoken with commented that ‘they always make sure my mother is ready when I come to take her out, with all the equipment she might need’ ‘when I call the home no matter what the time is they are always helpful and I don’t feel as if I am causing a problem’ ‘I can see my friend when ever I want to’ ‘I always feel welcome. All relatives and friends spoken with reinforced with the inspector the Red Oaks H60-H11 S60415 Red Oaks V241400 120905 Stage 4.doc Version 1.40 Page 13 feeling of being welcomed and that the home was open and they felt they could ask staff anything. A lunchtime meal was taken with residents and it was evident that choice and flexibility are paramount. Residents, if able, choose where to take their meals; this is seen as a social time by staff and relatives. The dining rooms are arranged into small tables and lots of positive interaction was noticed at this time. The food itself was appetising and nicely presented. Comments from residents were all very positive and included ‘the food is great’ ‘there is always lots of it’ the chef always comes to see us after a meal to make sure it is Ok’ relatives commented that what impressed them was the way the residents were encouraged to eat and the amount of fresh fruit and vegetables always available at the home. Good practice was noted in the way food was presented to residents who need to be encouraged to eat. Within the assessment process and care plans it was clear that nutrition of the residents is of high priority. The assistant chef was interviewed and had a great deal of knowledge regarding the special diets which some resident require. Red Oaks H60-H11 S60415 Red Oaks V241400 120905 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Residents and relatives are assured that their complaints would be taken seriously and dealt with promptly. Recruitment policies and records were up to date, easily accessible and protect the residents from possible abuse. Staff have had training on the correct way to respond to any suspicion or allegation of abuse and this safeguards the residents. EVIDENCE: There is a clear complaints procedure, which is included in the Service Users Guide. Relatives said the manager re-iterates the need to inform him if they have any complaints. The complaints record was examined and the outcomes were discussed with some of the residents. It was apparent that any sign of dissatisfaction is taken seriously and acted on. A relative visiting the home said she could not imagine ever having cause to complain, but that she would not hesitate if the need arose. Robust procedures are in place for responding to any allegations or suspicions of abuse. Staff members told the inspector that they had received training in recognising the different forms of abuse. Each member of staff has an enhanced Criminal Record Bureau check. Residents said they the home had no dealings with their personal finances. Red Oaks H60-H11 S60415 Red Oaks V241400 120905 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25,26 Service users benefit from a clean, comfortable and well-maintained home. EVIDENCE: The establishment is situated on rising ground close to Henfield village centre. It is well maintained and a programme of regular maintenance is undertaken. It is comfortably furnished and has a homely atmosphere. The front and rear gardens are large and well maintained and laid to lawn, patio area and flowerbeds. The home has a vertical passenger lift that serves all floors. Grab rails have been fitted so that service users can move about the home independently. The establishment does not use CCTV cameras. The requirements of the local fire service and environmental health department are well met. At the time of the inspection, all communal areas and the ten bedrooms seen by the Inspector were found to be clean, tidy and well maintained. All residents and relatives spoken with confirmed that the home was always clean and free from odour. The staff interviewed stated that they take pride in maintaining a very clean environment and all were very clear regarding the issues of infection control. A Legionella policy is in place, and regular health Red Oaks H60-H11 S60415 Red Oaks V241400 120905 Stage 4.doc Version 1.40 Page 16 and safety checks are carried out. Water temperature checks are regularly recorded. Since the last inspection the home has continued with the redecoration and refurbishment programme. There were numerous pleasant floral displays in the walled garden. These were planted as part of the gardening club. Some residents were using a pleasant lounge on the day of the inspection. Outdoor space is a safe environment and was easily accessible to residents and staff confirmed that a number of residents enjoy being taken outside if the weather is fine. Red Oaks H60-H11 S60415 Red Oaks V241400 120905 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 The procedures for the recruitment of staff are robust and ensure that sufficient competent staff are on duty throughout the day and night. EVIDENCE: There is a cohesive staff group who have worked in the home for several years. Staff file checked at random showed that the home had undertaken all the necessary checks to ensure protection of residents. Staff members spoken with said that they had been asked to complete an application form and obtain a Criminal Records Bureau checks before starting work in the home. Visitors said that staff were kind and attentive whenever they visited the home. During the inspection staff were seen to go about their duties in an unhurried manner. The resident and relatives spoken with, who provided feedback about the home, said they were happy with the number of staff at the home and found them to be kind and knowledgeable. There is a sound induction process for new staff and well over 50 of staff now hold their NVQ in care level 2 or 3 qualifications. Staff interviewed talked about the benefit of undertaking these awards and how resident’s help them to achieve these qualifications. Resident’s spoken to also were aware of the staff who have achieved these awards and talked about the staff wearing the badges. Red Oaks H60-H11 S60415 Red Oaks V241400 120905 Stage 4.doc Version 1.40 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 31,32,33,35,36,38 Residents 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 her responsibilities fully. Service users are protected by the management systems in the home. EVIDENCE: The manager is very experienced having worked in this nursing home for many years. Ms Walch informed the Inspector that she is hoping to complete the RMA award at the end of this year. The award has been delayed due to Ms Walsh being seconded to assist part time in the management of a failing home. She has now successfully turned that home around, which is more evidence of her effective management abilities. Relatives and residents said the home is run efficiently and they said that this they thought was down to strong leadership. Staff made positive comments about the management and gave good examples of best practice. Including a nurse who confirmed that there is a positive and proactive approach to equal opportunities. Red Oaks H60-H11 S60415 Red Oaks V241400 120905 Stage 4.doc Version 1.40 Page 19 Residents confirmed that the manager holds a number of meetings a year so that they can discuss issues that they feel are important. They also confirmed that action takes place when they identify a problem. Residents talked about the manager’s open door policy and how they will see her ‘on the floor at least once a week but most times more often’. Staff confirmed that regular meeting, handovers and one-to ones were held where the manager informed them of any changes in legislation. Staff interviewed confirmed that supervision takes place at least 6 times a year. There are clear records of these supervision and a clear audit trail leading to training and development for staff. This also identifies the changing needs of the residents. A great deal of evidence was gathered to prove that quality assurance in this home was of the utmost importance. Red Oaks H60-H11 S60415 Red Oaks V241400 120905 Stage 4.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 4 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 x 15 4 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 4 3 x 3 4 x 3 Red Oaks H60-H11 S60415 Red Oaks V241400 120905 Stage 4.doc Version 1.40 Page 21 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 Regulation Requirement Timescale for action 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 Good Practice Recommendations Red Oaks H60-H11 S60415 Red Oaks V241400 120905 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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. 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