Random inspection report
Care homes for older people
Name: Address: The Oaks 114 Western Road Mickleover Derby DE3 6GR one star adequate service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Brian Marks Date: 1 5 0 2 2 0 1 0 Information about the care home
Name of care home: Address: The Oaks 114 Western Road Mickleover Derby DE3 6GR 01332510447 01332519786 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Hassan Khan,Ms Teresa Clare Boyce care home 28 Number of places (if applicable): Under 65 Over 65 28 dementia Conditions of registration: 0 The home accommodates both service users outside the current age category and current registration Older People (OP) for the duration of their stay. Date of last inspection Brief description of the care home The Oaks is a detached home, which has been adapted and extended to provide nursing care for up to 28 older people with dementia. The home is situated in the residential area of Mickleover. The home has 26 single bedrooms all with an en-suite facility and 1 double bedroom. The home is set within its own well kept, pleasant gardens, which are secure. There are registered nurses on duty 24 hours per day. The fees charged at the time of this inspection visit ranged from GBP 456 to GBP 725 a week. Care Homes for Older People Page 2 of 9 What we found:
The purpose of this Random Unannounced Inspection was to check compliance with the requirements set out in the inspection report for the last Key Unannounced Inspection that took place on 15th July 2009. We also planned to assess the homes performance in the light of information that had been made available by officers of the Derby City Council Adult Social Care Department in relation to the safety of people living at the home. This inspection was made against the backdrop of concerns, shared with at a recent meeting held under Safeguarding Procedures, about the homes capability to properly meet the needs of and to protect the people in its care. We met with the homes registered manager who is also one of the registered providers, Ms Teresa Boyce, during this inspection and she was accompanied by the senior nursing staff on duty for the day. At this inspection, we looked at the care records of four people in residence, specifically at the range of risk assessments that were in place to help staff work safely. All four records had a Waterlow assessment in place, which helps staff to assess the level of risk that the person concerned may have poor skin viability and be at risk of developing pressure ulcers. Two of the records looked at indicated that the level of risks for the person concerned were high. All had care plans in place to indicate to staff the steps they should take to ensure protection and the two previously mentioned were subject to a programme of weekly reviews of their condition and management, carried out by the homes senior staff. We feel that there is sufficient evidence to support that requirement one of the last inspection report has been met. Within the care records looked at, two of the people had bed safety rails in place to ensure that they did not suffer falls at night. Both records had a care plan in place to indicate how staff should manage this and in neither case was there any evidence that the person concerned had had any difficulty with the arrangements. Both were subject to a review every two months and in both cases the continued use of bed rails was appropriate and satisfactory. We feel that there is sufficient evidence to support that requirement two of the last inspection report has been met. The care records of a further two people we looked at indicated that the persons concerned had high mobility needs and that staff required the assistance of a hoist to safely move them. Both had detailed risk assessments in relation to this and detailed instructions for the use of hoists and accompanying slings. Both were subject to regular review. We examined the records for accidents and incidents that had occurred at the home during December, January and February. These indicated that the incidence of falls were being audited weekly to analyse trends, and the records were subject to further review by the manager on a monthly basis. We noted that in January there had been 13 accidents involving people living at the home and 6 of these had resulted in a minor injury, but no attention of any professionals from outside the home. We feel that there is sufficient evidence to support that requirement three of the last inspection report has been met. We carried out a brief tour of the building with the manager and found that arrangements in communal rooms and bedrooms were generally satisfactory and everywhere was clean, tidy and free of bad odours. One of the issues that had been raised at the recent Safeguarding meeting had been the apparent failure of heating in one of the bedrooms,
Care Homes for Older People Page 3 of 9 and complaints had been raised by the persons family that the bedroom was cold over an extended period due to failures of the homes central heating system. We found satisfactory temperatures throughout the home apart from the ground floor corridor and six bedrooms in the rear extension. The manager identified that the thermostat had been wrongly adjusted and the boiler that supplied that area had automatically shut down. The radiators in the corridor and six bedooms were not working but staff had not reported this to the manager. The homes maintenance person rectified the situation by the end of the inspection but we have made a new requirement as a result of this. We looked at a number of documents related to the staffing arrangements at the home and examined the recruitment files of two recently appointed staff. These were in generally good order and indicated that the right checks about background, specifically in relation to the Criminal Records Bureau and previous employment histories, had been made. However one of the two records that we looked at was for somebody who qualified as a nurse in China and recently came to this country for work experience. This person exposed the difficulties of this type of recruitment, as all the necessary checks and permissions were carried out by a specialist agency, and the documentation from that agency had not been retained on file. The homes manager described how this could be rectified through communication with the relevant agency and, although we feel that there is sufficient evidence to support that requirement four of the last inspection report has been met, we have made a rewritten requirement as a result of this. In addition we looked at other staff files and spoke to one of the senior carers who holds responsibility for staff matters. We found that although there was clear evidence that formal supervison meetings had been taking place for established staff, these had not been taking place with the regularity required by the National Minimum Standards. For this reason we have rewritten requirement five from the last inspection report as a good quality recommendation. As a result of the recent multi agency meetings, a health and safety advisor from the Derby City Council has carried out an audit of moving and handling activities of the home. He recorded a score of 50 per cent as result of this audit and a number of recommendations were made for the homes compliance. As requirement six from the last inspection report related to staff practices in safe moving and handling, we have rewritten this to reflect this. Subsequent to the recent multi disciplinary meeting about safeguarding people living at the home, we received information about a resident going missing from the home. From examination of our records that we maintain about the home, we were unable to confirm that the homes management had written to us under Regulation 37 of the Care Homes Regulations 2001, as they are legally required to do. Examination of the relevant care records at the home confirmed a completed notice, but the manager indicated that she thought this had been sent to the Commissions previous Regional Office rather than the national Processing Centre. The contents of the notice and other records indicated that the home had acted appropriately at the time to secure the persons safety but we have made a new requirement as a result of this. From our discussions with the homes manager it was clear that the proprietors are concerned to get things right in the way that the home is operating and as reported above we have noted some compliance with the requirements made at the last inspection and as a result of the recent multi agency safeguarding meetings. Further compliance with the requirements made at this inspection will be asessed at a future inspection of the home. Care Homes for Older People Page 4 of 9 What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 5 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 6 of 9 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 25 23 The heating systems of the 31/05/2010 home must be kept in proper working order and any control mechanisms must be made safe from adjustment by unauthorised persons. This is so that the heating of areas in use by the people living at the home meets their comfort and welfare needs. 2 29 19 All documents related to the 31/05/2010 identity of people working at the home must be kept on individual staff files, including correspondence and evidence provided by any specialist recruitment agencies. Copies of the missing documentation identified at this inspection must be forwarded to the Commission for examination. This is so that the homes management can be sure that everybody working at the home is suitable for the employment they are to Care Homes for Older People Page 7 of 9 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action carry out. 3 31 37 The homes manager must 31/05/2010 inform the Commission of any event at the home that adversly affects the well being or safety of anybody living there, and should do so in writing in a timely way. This is to ensure that the health, safety and welfare of those people is promoted and safeguarded. 4 38 13 All care and nursing staff 31/05/2010 working at the home must achieve competence regarding their skills in safe moving and handling, and in compliance with the requirements of Derby City Councils recent audit. This is to ensure that all staff are following the correct moving and handling procedures. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 36 All staff should receive formal 1 to 1 supervision from the homes senior staff, at intervals of every two months. This will ensure the opportunity for regular consultation about and monitoring of their work. Care Homes for Older People Page 8 of 9 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 9 of 9 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
