Inspection on 28/10/05 for The Oaks Care Home

This inspection was carried out on 28th October 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 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

The Oaks Care Home 05/08/09

The Oaks Care Home 23/08/07

The Oaks Care Home 28/02/06

The Oaks Care Home 21/03/05

The Oaks Care Home 27/04/04

The Oaks Care Home 18/12/03

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE The Oaks Care Home 15 - 25 Oaks Drive Lexden Colchester Essex CO3 3PR Lead Inspector 3Diana Green Unannounced Inspection 28th October 2005 09:00 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 The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Oaks Care Home Address 15 - 25 Oaks Drive Lexden Colchester Essex CO3 3PR 01206 764469 01206 764468 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) New Century Care (Colchester) Limited Ms Helen Elizabeth Bennett Care Home 61 Category(ies) of Old age, not falling within any other category registration, with number (34), Physical disability over 65 years of age of places (61), Terminally ill (3) The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Persons of either sex, aged 65 years and over, who require nursing care by reason of a physical disability (not to exceed 61 persons) Persons of either sex, aged 65 years and over, only falling within the category of old age (not to exceed 34 persons) Persons of either sex, aged 60 years and over, who require general palliative care (not to exceed 3 persons) The total number of service users accommodated must not exceed 61 persons All new staff to undertake training in palliative care by a recognised authority within three months of appointment. Details of training must be recorded on their individual training and development profile One service user under the age of 60 years who requires general palliative care, whose name was made known to the Commission in July 2004 21st March 2005 6. Date of last inspection Brief Description of the Service: The Oaks Care Home provides nursing and personal care with accommodation for up to 61 older people, including 3 service users aged 60 years and over with a terminal illness. The Oaks is owned by a private organisation named New Century Care (Colchester) Limited. The home is located in a residential area within walking distance from the centre of Colchester. The home was opened in 1995 and the building was formerly a purpose built private hospital and consists of single storey accommodation on the ground floor. There are 55 single en-suite bedrooms and 3 double en-suite bedrooms. The home has surrounding gardens that are attractive and only partially accessible to wheelchair users. The Oaks is accessible by road and rail and the nearest station is in Colchester. Parking is available in the adjacent car park. The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on the 28/10/05, lasting 7 hours. The inspection process included: discussions with the registered manager, deputy manager, second chef, activities coordinator, three care staff, thirteen residents, seven relatives and feedback from health and social care professionals; a partial tour of the premises, four bathrooms, three sluicerooms, communal areas, the kitchen and the laundry; and inspection of a sample of policies and records (including any records of notifications or complaints sent to the CSCI since the last inspection). Nineteen standards were covered, and twelve requirements and one recommendation made. The inspection found that action had been taken promptly to address previous requirements and recommendations. The registered manager and staff were welcoming and helpful throughout the inspection. What the service does well: Despite being a large home, the atmosphere in most communal rooms is homely. Efforts are made to provide a pleasant and friendly environment with residents being encouraged to personalise individual rooms. The staff are friendly, respectful and most were held in high regard by residents for being kind and caring towards them. The standard of care was generally good but sometimes compromised by staffing levels and shortfalls in equipment. Residents’ health care needs are met appropriately and well monitored and prompt referrals are made to GP’s and relevant health professionals where required. There is a regular training programme in place for all staff and supervision by the manager and senior nursing staff. There is a varied activities and entertainment programme organised. Residents and their relatives spoke highly of the activities coordinator who arranged daily activities and some outings. The premises are generally clean, well decorated and well maintained. Risk assessment for fire safety has been undertaken and there are good monitoring practices for fire safety in place. Residents spoke with were very positive about the laundry. One resident said there had been problems with the laundry that The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 Page 6 were now addressed and the standard was good. Another resident said “the laundry is spotless”. What has improved since the last inspection? What they could do better: Care plans require review to ensure they are contemporaneous to residents’ care needs and new care plans developed where there are significant changes evident. There needs to be an ongoing evaluation of staffing levels and levels increased accordingly to ensure residents’ needs are appropriately met at all times and they are not required to wait unduly to receive personal care. Some residents had to wait to receive assistance as there were too few hoists. However a review had been undertaken and an additional hoist ordered. The menus require review in consultation with residents to ensure they are varied and include their preferences. A dietician should be consulted for advice on specialist diets and the nutritional balance of meals. There needs to be a more consistent method of monitoring of fluid and nutritional intake to ensure residents receive a nourishing diet and appropriate action is taken without delay to provide additional supplements as necessary. The kitchen requires thorough cleaning and schedules need review with ongoing monitoring to ensure this is in place. The heating problem in one area of the home needs to be addressed without further delay. The malodorous smells evident in the dining room also required urgent action. Please contact the provider for advice of actions taken in response to this The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 Page 8 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 The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 The admission procedure ensures all residents are assessed on admission ensuring their care needs can be met. The home does not provide intermediate care. EVIDENCE: From discussion with the manager it was evident that assessment of prospective residents was undertaken either at home or hospital wherever possible. Three care files were inspected. Assessments covered all care needs as detailed under this standard including a detailed oral assessment and choice of lifestyle. Risk assessments for manual handling, falls, nutritional needs, tissue viability and use of bedrails were undertaken and comprehensively recorded. Copies of care management assessments were held on file where relevant. Three residents spoken with confirmed their needs were fully discussed prior to admission. This home does not provide intermediate care. The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 10 Initial care plans provide good information for care staff to meet residents’ needs but reviews are not satisfactorily or regularly undertaken. Without care plans that are contemporaneous to care needs there is no guarantee that residents’ needs are being appropriately met. Residents have good access to health care services. Staff have a caring approach towards residents, but privacy and dignity are not always upheld. EVIDENCE: Three care files were inspected. All three contained care plans that covered all key needs (physical and social) and provided good detail of the action required of staff to meet residents’ needs. Care plans were recorded as having been reviewed monthly. However one care plan dated 3/11/04 was not contemporaneous to current care needs and there had been no care plan recorded. A risk assessment for manual handling for the same resident indicated they walked with the aid of a stick when in fact their mobility had reduced and they now used a wheelchair. The reviewed risk assessment for The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 Page 11 tissue viability for the same resident indicated a much higher risk but there had been no change to the care plan. Daily records were detailed but not always accurate and fluid balance charts were not consistently recorded. For instance the daily record of one resident stated “good diet and fluids taken” but the fluid balance chart was incomplete. General feedback from residents was that whilst staff were kind and caring, they worked very hard and sometimes rushed them or they had to wait as staff were always busy. Residents spoken with said they saw their GP when needed and had access to chiropody, opticians, hearing clinics and attended hospital outpatient appointments as needed. Access to district nurses and specialist nurses was evidenced from the records. Nutritional screening was undertaken on admission, with weights recorded. However monitoring of fluid and nutritional intake was inconsistent on those records sampled. Residents were provided with equipment to aid mobility and tissue viability needs. However one resident’s walking frame and other equipment to aid independence was not left within their reach. The standard for medication was not assessed at this inspection. However the medication trolley was unlocked and unsupervised for several minutes during the medication round. Feedback from residents was generally positive in that care staff treated them with respect and preserved their dignity. However one member of care was observed to walk into a resident’s room without knocking and the resident said that happened regularly and staff rushed them when providing personal care. Another resident said that care staff always knocked before entering their room. Care staff were observed to treat residents sensitively and spoke politely to them, although some used terms of endearment such as ‘darling’ and ‘sweetheart’ rather than their preferred name. The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 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 the following standard(s): 12, 13 & 15 The daily routines are flexible and choices are actively promoted. A good range of social and therapeutic activities and interaction takes place in the home. Residents are enabled to maintain contact with the people important to them. The meals in the home are not sufficiently varied and nutritious to cater for individual residents’ dietary needs. Monitoring of fluid and nutritional intake is not sufficiently robust potentially placing residents at risk. EVIDENCE: The home employed an activities coordinator from Monday to Friday, working 33 hours per week. The records detailed residents’ choice of lifestyle and activities were arranged to suit their needs. Social activities comprised individual and group activities with some outings. Physical activities such as floor games and movement to music were said to be encouraged. The dining room was decorated for a Halloween party that was planned and staff were to be dressed up in fancy dress for the occasion. Daily records of activities undertaken were recorded on an individual basis and positive feedback was received from residents. One resident said that they looked forward to bingo and other activities and said something is arranged every day. The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 Page 13 Several relatives were spoken with at inspection and confirmed they were able to visit at times to suit them and were always made welcome. Some were observed to assist in the care of their relative and said they were encouraged to do so. Residents spoken with said their relatives and friends could visit at different times of the day and evening. Staff confirmed that residents were enabled to attend local facilities such as the stroke club. Relatives spoken with were mainly critical of the food provided. One relative said that the food had recently improved but the quality of food was still not good. For instance the fish fillets provided were thin. Another relative said that they did not feel that residents had enough to eat and felt the meal provided at supper was not adequate, especially as this was provided at 6pm and was the last meal of the day. Residents spoken with were inconsistent in their feedback. Some said they found the food satisfactory and there was enough whist others said they did not like the food. Residents said they were not offered a snack in the evening, only a milky drink and did not have a cup of tea until breakfast time. The manager and chef had received adverse feedback on the food from residents and were attempting to improve the meals to their liking. The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 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 the following standard(s): 16 & 18 Appropriate policies, procedures and practices were in place to promote the protection of residents from abuse. The manager actively promoted awareness of protection issues through staff training, recruitment practices and respecting individual rights. EVIDENCE: The home had a complaints procedure that included the timescales within which complainants can expect a response. There had been four complaints since the previous inspection. The investigation and outcome of each was recorded and included action taken as a result. The home had an adult protection policy and a copy of the DH publication ‘No Secrets’. The manager was clear on the local procedures to follow in the event of an allegation of abuse and copies of the Essex Procedures for the Protection of Vulnerable Adults was available. Whistle blowing procedures were available for staff guidance. The manager and six staff had attended training organised by the Essex Protection of Vulnerable Adults Committee. The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 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 the following standard(s): The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 Page 16 19, 22, 25 & 26 The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 Page 17 The Oaks Nursing & Residential Home is safe and well maintained, however some shortfalls with heating do not ensure the comfort of residents. The home was clean and safe infection control practices were evident but this was compromised by malodorous smells present in the dining room and two residents rooms. Appropriate equipment is provided to aid mobility and clinical need but sufficient hoists are not available to always ensure residents personal care needs are met without delay. EVIDENCE: A partial inspection of the premises was made that included a number of residents’ rooms, communal rooms, bathrooms, the sluices, the kitchen and the laundry. The home was in a good state of maintenance and decoration, a programme of refurbishment completed in the last year. There was a programme of regular maintenance in place. Communal rooms were clean and well decorated and furnished to provide a homely environment for residents. Residents spoken with said their rooms were always kept clean. However the relatives of one resident said that their room had not been adequately cleaned since the former resident had left the home. The gardens on one side of the home, although not large were attractive and well maintained and provided some access for residents and wheelchair users. Records provided evidence that the building complied with the requirements of the local fire and environmental health department. Equipment was provided for mobility and a variety of pressure relieving aids were observed on residents’ beds. Residents spoken with said they were required to wait to receive personal care as the hoist was being used for other residents. The home had two standing hoists and three full body hoists, which is not adequate for the number and dependency of residents. The manager advised that another hoist had been ordered. The heating, lighting, water supply and ventilation met the relevant environmental requirements as evidenced from the home’s records. Checks to minimise the risks from legionella were undertaken annually and confirmed from the records. Rooms were centrally heated with controls in individual rooms and radiators were guarded as part of a risk assessment. The home was clean and hygienic throughout but there was a malodorous smell in the dining room. The infection control practices in the home place were observed to be safe, with exception that an external clinical waste bin was unlocked. The home had three sluice disinfectors, two on the ground floor and one on the first floor of the premises that were well maintained. The laundry was equipped as required and well organised. Laundry and sluice The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 Page 18 facilities were located away from areas where food was prepared or eaten. Positive feedback was received from residents on the standard of the laundry. The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 & 30 The staffing levels (skill mix, number and competence) are not always sufficient to adequately meet the needs of residents. Recruitment practices were thorough and promoted the protection of service users. Staff receive training to develop their skills and qualifications through an established training programme. EVIDENCE: There were sixty residents at the home including three in hospital and one with palliative care needs. There were three registered nurses (including the deputy manager) and eleven care assistants on duty for sixty residents. The manager stated that care staff had recently been increased from eleven to twelve in the morning but one care staff was off sick. Whist these levels appeared adequate on the day, residents reported they had to wait for call bells to be answered and staff sometimes rushed them. Typical comments included ”they’re too busy” “you have to wait” “they’re kind and good but work very hard”. Some rooms were left in disarray following personal care indicating that staff were having to rush. This included clothing hanging out of drawers and soiled clothing left on the floor of en-suites and bathrooms. Three staff files of staff recently recruited were inspected. All had the required checks undertaken with evidence held on file. This included two satisfactory The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 Page 20 references, evidence of identification, enhanced CRB disclosures and POVA first checks. All had received a statement of terms and conditions of employment. Individual training records and evidence of induction training were not inspected on this occasion. Records summarising training were seen, and showed that most staff were up-to-date with all mandatory training including health and safety, fire safety, basic first aid and moving and handling. An ongoing training programme was in place. Training provided since the last inspection included syringe driver updates, infection control, wound care advice, COSHH, malnutrition in the elderly, death, dying & bereavement, medication training, moving & handling, fire safety and first aid. The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 & 38 The manager is skilled and experienced and has a clear understanding of her role and responsibilities. The perceived lack of her support by some residents and relatives should be addressed by the support of the deputy manager recently appointed. The manager aimed to ensure good health and safety standards but some practices were evident that pose risks to service users. EVIDENCE: The registered manager, who is a registered nurse, has managed the home for several years. There was evidence of regular updated training having been undertaken by the manager and confirmed from an inspection of records. Regular meetings were organised with residents and most said they knew the manager. However some residents and relatives said they did not see much of the manager. The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 Page 22 The home was in the main safe, well managed and had the relevant health and safety practices in place. There was evidence from observation, inspection of the records and in discussion with staff and residents that the manager aimed to ensure the health and safety of staff and residents. The premises were secure and there was evidence of risk assessments of the premises having been undertaken and appropriate action taken. Some health and safety issues were evident. Several residents had no footplates on their wheelchairs and not all had risk assessments recorded. The medication trolley was left unlocked and unsupervised during the medication round. There was a smell evident in the dining room and two residents’ rooms that require urgent attention. The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 Page 23 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 2 8 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x 2 x x 2 2 STAFFING Standard No Score 27 2 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x x x x 2 The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 Page 24 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. 1 Standard OP7 Regulation 15(2) Requirement The registered person must ensure that care plans are regularly reviewed and are contemporaneous to residents’ needs. This may require a new plan of care. The registered person must ensure that residents’ nutritional and fluid intake is closely monitored and appropriate action taken. The registered person must ensure that the medication trolley is kept locked when not supervised. The registered person must ensure that residents’ privacy is respected at all times. Staff must knock before entering residents’ rooms. The registered person must ensure that residents are addressed by their preferred name. The registered person must ensure that residents are offered a snack in the evening. The registered person must ensure that action is taken to DS0000015338.V268921.R01.S.doc Timescale for action 31/12/05 2 OP15OP8 14 30/11/05 3 OP9 13(2) 30/11/05 4 OP10 12(4) 30/11/05 5 OP10 12(3) 15/12/05 6 7 OP15 OP38OP25 16(2) & 16(4) 23 30/11/05 31/12/05 The Oaks Care Home Version 5.0 Page 25 8 9 OP38OP26 OP26 13(3) 13(3) 10 OP27 18(1) 11 OP38 13(4) address the lack of adequate heating in parts of the home. The registered person must ensure that malodorous smells are removed from the home. The registered person must ensure that the kitchen is thoroughly cleaned and monitored for compliance. The registered person must ensure that staffing levels are reviewed and satisfactorily meet residents’ needs at all times. The registered person must ensure that risk assessment are recorded where residents do not have wheelchair footplates. 31/12/05 30/11/05 30/11/05 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP15 Good Practice Recommendations The registered person should review the menus and seek guidance from a dietician. The Oaks Care Home DS0000015338.V268921.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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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