Inspection on 22/11/06 for St Luke`s & The Oaks Residential Home

This inspection was carried out on 22nd November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

St Luke`s & The Oaks Residential... 28/11/05

St Luke`s & The Oaks Residential... 04/07/05

St Luke`s & The Oaks Residential... 04/11/04

St Luke`s & The Oaks Residential... 22/04/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE St Luke`s & The Oaks Residential Home Marshlands Square Caversham Reading Berkshire RG4 8RP Lead Inspector Ruth Lough Unannounced Inspection 22nd November 2006 10:00 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 St Luke`s & The Oaks Residential Home DS0000011065.V317968.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. St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Luke`s & The Oaks Residential Home Address Marshlands Square Caversham Reading Berkshire RG4 8RP 0118 946 1424 0118 947 1887 st.lukesbm@btopenworld.com www.bmcare.co.uk Colley Care Limited (Trading as B & M Care) 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) Ms Kim Franks Care Home 80 Category(ies) of Dementia (48), Old age, not falling within any registration, with number other category (37) of places St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users category DE not to be admitted under the age of 50 years. 28th November 2005 Date of last inspection Brief Description of the Service: St Luke’s and The Oaks are purpose built homes providing residential care for elderly people. The Oaks has 31 beds and is registered for those with diagnosed dementia and provides a more supportive environment. Neither home provides nursing care. The home is situated in a quiet residential area not far from the centre of Caversham and approximately 3 miles from Reading. St Luke’s & The Oaks are part of the Colleycare Ltd (trading as B&M Care) group. The fees range from £575.00 to £610.00 for accommodation and care. Service users pay extra costs for Hairdressing, Chiropody and Newspapers. St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection visit that took place over one day. The inspection included a review of information provided by the home and service user surveys returned prior to the visit. Fourteen service user questionnaires were returned to the commission. The documents and records that were available on the day were used as part of the information gathering. Service users and visitors opinions of the service were also obtained during the day visit. Discussion with and observation of the management and care staff was also included. What the service does well: 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. The summary of this inspection report can be made available in other formats on request. St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 Page 6 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 St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 Page 7 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): 3 Quality in this outcome area is good. The service users have a detail assessment of need before they are admitted to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users spoken to stated that they were consulted about entering the home to live. Some said that they were not provided with enough documentary information about the home before admission. The care files of 3 service users admitted to the home since the last visit were reviewed. The service users are assessed before admission to the home by a senior member of the homes staff. The assessment process includes information provided by the referring social services, the service user and families. Details of the service users physical and mental health and their interests are all used to identify that the home will be able to meet their needs. St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 Page 8 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 and 10 Quality in this outcome area is good. Service users are provided with the personal care and support that meets their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users gave various comments when asked if they felt their needs were being met. Such as “Staff are always caring, patient and understanding” and “There is always a shortage of staff so bells are often not answered for some time. The staff work very hard and are always cheerful”. Other comments were “I sometimes need to wait because of pressure on staff time but I have always been served in a reasonable time. In some difficult situations I have been served extremely fast (e.g. after a fall)” and “ I am fortunate that I do not need much ”looking after”. On the rare occasions that I do the staff make every effort to see that I have T.L.C” St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 Page 9 The service user plans have detail information about the individual including a profile of the service users relevent personal history, medical history, hobbies and interests. The staff are provided with information about the service users awareness of surroundings, ability to talk and interact with others and any special needs for them to have their medication. The planned care is accompanied with the necessary risk assessments and monitoring tools. Service users choices are recorded in detail and the plans are developed with the service users and their families. Service users gave information of how the felt their medical and healthcare needs were met by the home. These were “ I am happy with the help and support I receive” and “I have obviously changed surgery and doctors since I have been here (3.5 years). I don’t always see my own doctor but promptly one visits the next day (after surgery)” The service users are assisted to obtain medical support from visiting opticians, dentists and chiropodists. Staff also access further assistance through the service users own GP,s for district nursing service and any specialist healthcare that is required. All visits and appointments are recorded in detail by the visiting practitioners and the staff. The home review the care plans on a very regular basis and staff record in great detail the daily outcomes for each service user in a informative manner. The service users are provided with their prescibed medication by staff who have had specific training to be able to do this. The home use the services of a local pharmacy to supply the medication that is also responsible for regular audit checks. The manager has also instigated monitoring checks of the medication administration, storage and the recording processes as part of the quality assurrance activities in the home. Service users who wish to and are able to self administer their medication are provided with lockable space in their rooms for this. The service users care plans also include an assessment of their ablity to take their prescibed medication and how the staff are able to assist them in this and any special needs that they may have. Service users are supported with their personal care and any health consultation in their own rooms. Staff were seen to knock before entering a service users room. There are 3 double rooms that are currently used as a single occupancy. The documents used to record and plan care are under review and redevelopment by the company. St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. That service users are enabled to continue with an active social life should they wish and they are provided with a varied nutritional diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users were very complimentary about the support they are given to continue with their interests and activities whist living in the home. They stated “I am fortunate in being sufficiently able- bodied to be able to amuse myself, but there are often group activities that are very enjoyable and constructive. I would happily take part in outings if there were any offered” and “ Good range of activities”. Another service user commented, “ We have an excellent activities organiser and I enjoy everything she finds for us to do. I have learnt new skills (skills I didn’t know I had) such as patchwork, knitting etc. for the twice a year sales table, painting in oils and watercolours etc. We have fortnightly “music and Movement. A monthly church service. She also arranges local groups to entertain us. Choirs and hand bell ringing and arranges for an agency to send us very good entertainers.” St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 Page 11 One service user wrote “I have been given every possible help to keep up the academic and scholarly pursuits I followed in my main active life.” The service users interests are recorded in their care plans and they are supported to continue with their interests they had prior to admission to the home. There is a very active and varied activity programme in place that has been developed by the full time Activities Organiser who is supported by the care staff. Usually there are several activities going on the home at the same time in the various communal rooms. Some of more recent activities have included musical entertainment, movement and gentle exercise, craft and painting and cake making. The home staff actively support service users to develop new skills. Service users have been supported to go out on visits to local garden centres, shopping, lunch groups and meals out. During the warmer weather the home has had events for families to join in and for service users to have new experiences such as a mobile Zoo. Information about the programme of activities is displayed in various notice boards around the home. Service users are able to receive visitors as and when they wish in the privacy of their own rooms or in one of the various communal areas. They are enabled to bring their personal possessions which is reflected in the individualism of their rooms. Service users gave positive comments about the staff, that they felt they were listened to and that they acted upon what was requested. One comment was, “ I find all the staff listen even if I can’t always hear what they say!! I have an excellent “rapport” with the carers and kitchen workers and the cook goes out of the way to prepare me a tray when I need one.” The home has a rotational menu plan that is reviewed on a regular basis and provides routinely a choice of two at both the midday and evening meals. Service users are also able to have alternatives to the planned meals if requested. They are encouraged to take their meals in the dining rooms but are equally able to have them in their rooms should they wish. Each service users food preferences are recorded in their care plans and any special dietary needs are noted. The service users nutritional needs are assessed with ongoing monitoring of their weight and health. Service users are able to access hot drinks or make, if they are able, from the small kitchen areas that are in the various areas of the home. Service users gave these comments about the menu and meal provision in the home. “Mostly the meals are very good and we get a good variety” St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 Page 12 “The chef will always be willing to cook you something different is you dislike the menu choice” “We have recently had a meeting with the Chef/cook where we were able to air our grievances. It is impossible to please everyone but she tries to vary the menus. She listens to us and tries to introduce new dishes. Not easy when she is cooking for about 80 people split into 3 groups. If I had a complaint it is that I have too much food!!!!” St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. The service users concerns are listened to and acted upon. The service users are protected by the training provided to staff and the strategies in place to protect them from possible harm. These judgements have been made using available evidence including a visit to this service. EVIDENCE: The service users gave comments that they felt that they could approach staff if they had concerns about the home or service. One service user wrote “Very often staff notice problems and act before the need to ask for help” and another, “I am usually happy so not a fair comment.” “The senior staff will fall over backwards to help you and all the carers, if they have time, are happy to listen and sometimes to give a “hug” something that doesn’t happen very often when you are aver 80!” One service user stated, “ Any complaint I might have I take to the senior who are in a position to consider it and they try to give a sensible answer.” St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 Page 14 The home provides service users with a copy of the complaints procedure in the Service users Guide and it is also on display in the home. The home has had 2 complaints from service users and families since the last inspection process which were both partially substantiated. Included in this figure was concerns made to the CSCI from a relative about the service which was jointly investigated with the home. The home do not use a formal method of recording and monitoring concerns and complaints for quality assurrance purposes. They do keep copies of all corespondance and communications made during an investagation of any concerns raised. The home provides a comment book in the reception area for all to use should they wish. Staff are provided with training and information about protecting vulnerable people from abuse in their induction and training programme. The home has information about the local interagency procedure for staff to follow. The records show that staff used the homes procedures effectively when concerns were raised recently about one service user. Suitable action was taken by the local authority and the home to investigate and put strategies in place. St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. The home provides service users with a safe, clean and hygienic environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service users and visitors spoken to confirmed that the home is kept fresh and clean. One service user who completed the written survey noted “Cleaners are difficult to obtain. I find the women are best.” “Men are likely to miss corners” The home is purpose built with additional accommodation added at a later date to provide for service users who are less able to manage their own care in a secure and safe environment. There is a routine programme of maintenance and redecoration which is provided by a fulltime employee. St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 Page 16 Specialist contractors for more major work are brought in as and when required. The home has large and small garden areas for all the service users to use. Some of these with greater security than others in order for service users to have freedom to move around the home observed and protected by staff from harm. Recent improvements have been made to the home have been to provide a conservatory area for service users to use and enjoy during the winter months and better hairdressing facilities. There are also plans to alter kitchen, hairdressing and equipment storage in the ground floor accommodation that cares for those who are more mentally frail. The staff team keep the premises clean and fresh smelling. They have instigated hand hygiene procedures for visitors, staff and service users by the use of disinfectant hand gel in prominent places in the home. Liquid soap and paper towels are placed in all bathrooms and toilets. The laundry facilities are placed away from any catering or dining facilities. Service users and relatives confirmed that the service users clothing was cared for and usually returned in good time from the laundry. St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. The staff are recruited appropriately and provided with the training to support them in their roles. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service users spoken to expressed that they generally had confidence in the staff employed in the home. The home has a large staff team to meet the service users needs in the home. There are staff teams for the diffent areas of the home to provided continuity of care. But staff work flexibly through the home when sicknesss and annual leave dictates. There is a good provision of domestic services with a minimum of 2 domestic staff always on duty during the day. The rotas indicate the senior member of management on call for evenings, nights and weekends should the needs arise. The rotas provide information of the shift times of the staff on duty but does not indicate in what capacity. The home has 15 (31 ) staff who have achieved NVQ 2 or above and has a continuing programme of NVQ training all to do this. Domestic and catering staff have also been enabled to gain qualifications applicable to their roles. St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 Page 18 The recruitment and employment files of 3 staff were reviewed. All files supported that the pre employment information such as application form, work history, health declaration, identity, references and the Criminal Records/ POVA had been obtained. The staff files also showed that they have a staff profile, letters of employment, job descriptions and copies of qualifications and training. The job description for the night carers role does not indicate the personal care and support to be provided to service users - only the tasks to be completed during the night shift. One file had some documents missing such as the interview notes and a copy of the induction process of the staff member, but no other deficits found. The staff are provided with a company induction and core skills training programme that enusres that they have the key skills to carry out their work. There is a rolling programme of training that is provided by the trained trainers that are working in the home and some that is accessed externally through local authorities and specialist providers. Some of the training the staff have attained has included infection control, intermediate food hygiene, first aid, equality and diversity, nutrition and health, and dementia awareness. The home has also supported staff to attend a customer care and communication skills training. St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 Page 19 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 and 38 Quality in this outcome area is good. The home is managed well. Service users, visitors and staff are protected by the health and safety systems in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has been working in care for over 16 years, of which, 6 have been as management responsiblities in the home. She has NVQ 4, RMA 4 and is a trainer for moving and handling. She has undertaken updates that have been provided by the company in employment law, disciplinary procedures and management. The manager is supported by 2 deputy managers, senior care workers and care workers. St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 Page 20 The service users are consulted regularly about the service provided. This is carried out through service users meetings, comments and suggestions book and periodic surveys. The next formal process is planned for the new year. The manager has implemented audit checks for some of the administration, care provision and management processes. These include sampling care plans, accident recording, medication and controlled drugs administration and storage, petty cash and water temperatures. Service users are supported with their personal monies if they wish or need, by the home. They are also provided with a lockable space for their valuables. The home has systems in place for the safekeeping and management of service users monies, with written details of all transactions made. The manager has ensured that the staff are provided with a rolling programme of training for safe working practices. The service users, staff and visitors are protected by the systems in place to promote health and safety with records for fire and water safety, COSHH are kept. There are safety checks for equipment, lifts and utlities used in the home. St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 X X X X X 3 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 3 X 3 X X 3 St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 2 Refer to Standard OP16 OP27 Good Practice Recommendations That the manager develops a system for monitoring and analysing the concerns and complaints made to the home. That the rotas provide information of the role/responsiblities of the staff on duty such as care or senior carer. St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 St Luke`s & The Oaks Residential Home DS0000011065.V317968.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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