Inspection on 21/02/07 for The Oaks Residential Care Home

This inspection was carried out on 21st February 2007.

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

The Oaks Residential Care Home 28/02/06

The Oaks Residential Care Home 21/10/05

The Oaks Residential Care Home 16/03/05

The Oaks Residential Care Home 30/09/04

The Oaks Residential Care Home 05/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE The Oaks Residential Care Home 14 St Mary`s Road Aingers Green Great Bentley, Colchester Essex CO7 8NL Lead Inspector Ray Finney Unannounced Inspection 21st February 2007 09:30 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 Residential Care Home DS0000017971.V331084.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. The Oaks Residential Care Home DS0000017971.V331084.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Oaks Residential Care Home Address 14 St Mary`s Road Aingers Green Great Bentley, Colchester Essex CO7 8NL 01206 250415 01473 785062 ffch@talktalk.net 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) Florence Care Homes Limited Ms Caroline Tidey Care Home 30 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (30) of places The Oaks Residential Care Home DS0000017971.V331084.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 30 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 6 persons) The total number of service users accommodated in the home must not exceed 30 persons 28th February 2006 Date of last inspection Brief Description of the Service: The Oaks is a two storey detached property, situated in a quiet residential area, approximately 1 mile from the village of Great Bentley. The home provides care and accommodation for 30 older people. A good-sized garden surrounds the home, with additional seating and patio areas. Parking can be found to the front of the property. Mrs Caroline Tidey, who has been in post since March 2002, manages the home. The home is owned by Florence Care Homes Limited, the Directors being Mr and Mrs Malhotra. The home charges between £357.15 and £495.00 per week for the service they provide. There are additional charges at normal retail prices for items such as newspapers, toiletries and chiropodist or hairdresser services. This information was provided to the commission in February 2007. The Oaks Residential Care Home DS0000017971.V331084.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was looked at when compiling this report. The manager of the home provided information in a pre-inspection questionnaire. Documentary evidence was examined, such as menus, staff rotas, care plans and staff files. A visit to the home took place on 21st February 2007; this included a tour of the premises, discussions with the manager and members of staff, conversations with relatives and observations of interactions between service users and members of staff. On the day of the inspector’s visit the atmosphere in the home was relaxed and welcoming and the inspector was given every assistance from the registered manager and her staff team. What the service does well: What has improved since the last inspection? What they could do better: The Oaks Residential Care Home DS0000017971.V331084.R01.S.doc Version 5.2 Page 6 Although there is a supervision process in place, the manager needs to ensure that supervisions are carried out in a timely manner and that team meetings take place on a regular basis. The home needs to continue with the improvements it has made in developing the programme of activities 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. The Oaks Residential Care Home DS0000017971.V331084.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection The Oaks Residential Care Home DS0000017971.V331084.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. (Standard 6 is not applicable.) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures the needs of prospective service users are assessed. The home does not provide intermediate care. EVIDENCE: As previously reported, the home continues to carry out a comprehensive assessment before new service users are admitted. The manager has developed the process by introducing a new assessment format for service users with dementia. Records examined show that assessments cover a wide range of areas and include strengths and preferences as well as care needs. A Social History is documented as well as a ‘needs assessment’ covering areas such as communication, physical needs, continence, daily living skills and abilities. A ‘Mental Status Questionnaire’ is completed before admission to the The Oaks Residential Care Home DS0000017971.V331084.R01.S.doc Version 5.2 Page 9 home and is reviewed regularly. nutritional needs is also carried out. An assessment of the service user’s The Oaks Residential Care Home DS0000017971.V331084.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures that the service user’s health, personal and social care needs are set out in a plan of care. Service users are supported to make decisions about their lives with assistance. Service users are protected by the home’s policies and procedures for dealing with medicines. The home ensures that service users are treated with dignity and respect and their right to privacy is upheld. EVIDENCE: Discussions with the manager indicate that care plans have been reviewed and amended taking recommendations from the previous inspection into account, The Oaks Residential Care Home DS0000017971.V331084.R01.S.doc Version 5.2 Page 11 identifying strengths as well as needs. Records examined during the visit show that care plans are compiled using information from the assessments. Care plans show sufficient detail to ensure staff are able to provide care in the way service users want. Staff spoken with demonstrate an awareness of service users’ needs. The home continues to meet the healthcare needs of service users. The manager and staff spoken with are knowledgeable about service users healthcare needs. Care plans examined contain evidence that service users are supported to access healthcare professionals such as the G.P., dentist and Community Psychiatric Nurse as necessary. Records examined show that there are risk assessments in place. On the day of the inspection visit procedures around the administration of medication were examined. The home operates a monitored dose system. Storage of medication is good and Medication Administration Record (MAR) sheets are completed appropriately. There is a process in place for appropriate storage and recording for controlled drugs. The manager is able to demonstrate an understanding of good practices around medication. Staff files examined contain evidence of staff training around administration of medication. Service user records examined contain evidence of medication reviews. As previously reported, the home continues to ensure that service users’ rights to privacy and dignity are upheld. Service users’ wishes around privacy are well documented in care plans. Observations of interactions between staff and service users show that staff maintain a calm and respectful approach to providing care. One service user who showed some signs of being confused was well supported by staff displaying patience and understanding. Bedroom doors are fitted with locks but manager said that only few service users choose to use them. The Oaks Residential Care Home DS0000017971.V331084.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The lifestyle experienced by service users in the home satisfies their interests and needs. The home ensures service users are supported to maintain contact with family and friends. The home supports service users to exercise choice and control over their lives. Service users are provided with a wholesome, appealing diet that they enjoy. EVIDENCE: There have been improvements in the activities provided for service users in the home. Discussion with the manager indicated that developing activities is an ongoing process in the home. Individual activities are recorded in service user records. Notices are on display about social activities that are taking The Oaks Residential Care Home DS0000017971.V331084.R01.S.doc Version 5.2 Page 13 place. Staff spoken with said they like to invite relatives to social activities as well. On the day of the inspection visit three relatives were spoken with. All confirmed that the home welcomes visitors and keeps them informed of any issues concerning their relatives. All maintain close links with the home and visit regularly. The manager said that relatives living some distance from the home usually keep in regular contact by telephone. Service users spoken with who were able to express a preference said they choose what they want to do. There is information available on the notice board about advocacy services. During a tour of the premises the kitchen was examined and the inspector discussed menus with the cook. The home operates a four weekly rotational menu. Although there is only one main meal documented, in practice if service users would prefer something different they are offered alternatives and this is stated on menu planners. The cook was able to demonstrate a good awareness of individual service users’ likes, dislikes and nutritional needs. Specialist nutritional needs such as diabetes are catered for. The food is traditional style home cooking with plenty of fresh fruit and vegetables being used. Relatives and service users spoken with said the food is good. The Oaks Residential Care Home DS0000017971.V331084.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure that ensures complaints will be taken seriously, listened to and acted upon. Procedures in the home ensure service users are protected from abuse. EVIDENCE: As previously documented, the home has an appropriate policy and procedure for dealing with complaints. Discussion with the manager indicated that the home encourages open discussion with service users and visitors and any concerns are taken seriously and dealt with promptly. Relatives spoken with all said they are confident that any concerns would be dealt with. A copy of the complaints procedure is prominently displayed on the notice board. There is a complaints log in place, although no complaints had been recorded at time of the inspection visit. The inspector and the manager discussed documenting minor concerns in the log as well as complaints. Service user records examined show that there are risk assessments in place. Staff records contain evidence of Protection of Vulnerable Adults (POVA) training. Staff spoken with are aware of their responsibilities around protecting vulnerable service users. The Oaks Residential Care Home DS0000017971.V331084.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. This judgement has been made using available evidence including a visit to this service. The home provides a safe and well-maintained environment for service users that is clean and pleasant. EVIDENCE: A tour of the premises showed that rooms throughout the home are clean and tidy. Service users’ bedrooms are decorated to a good standard. Since the last inspection there has been redecoration throughout communal areas of the home. The home is well-maintained both indoors and outside. Maintenance of driveway was being carried out on day of visit with new gravel being laid. Health & Safety and maintenance records were examined. Fire alarms and water temperatures in all rooms are checked weekly. Portable Appliance testing (PAT) has been carried out. Maintenance checks have been carried out The Oaks Residential Care Home DS0000017971.V331084.R01.S.doc Version 5.2 Page 16 on the lift, gas installation, mobile hoists and bath hoists, 5 yearly electrical testing, yearly testing of fire extinguishers, lighting and Legionella testing on water outlets. General maintenance checks are also carried out regularly, including windows, radiator covers, kitchen flytrap, light bulbs and de-scaling kettles. The standard of cleanliness around the home remains good with no evidence of odours. The Oaks Residential Care Home DS0000017971.V331084.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. This judgement has been made using available evidence including a visit to this service. The needs of service users are met by the numbers and skill mix of staff. The home’s recruitment policy and procedures ensures the protection of service users. Service users are in safe hands and the home ensures staff are trained and competent to do their jobs. EVIDENCE: Staffing levels in the home continue to be calculated according to the assessed needs of service users. On the day of the unannounced inspection staffing levels were seen to be sufficient and service users were being well supported. Since the last inspection there have been some improvements in the number of care staff with a National Vocational Qualification (NVQ) at level 2 of above. Information provided in a Pre-inspection Questionnaire and discussion with the manager confirms that 50 of carers in the home now have obtained an NVQ award. The Oaks Residential Care Home DS0000017971.V331084.R01.S.doc Version 5.2 Page 18 The records of three members of staff were examined and all contain evidence that the home operates an appropriate recruitment process. Two references are sought for new members of staff; enhanced Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (PoVA) checks are carried out. Appropriate identification documents are on file, including passport, driver’s licence and birth certificates. There was a discussion with the manager regarding CRB certificates; the originals are kept by the providers and the manager is given a photocopy. The manager needs to ensure she is provided with the complete certificate and not just the first page. Records examined indicate that there is a training programme in place that includes dementia awareness (one day course and level 2), Protection of Vulnerable Adults (POVA), Moving & Handling, Fire training, Managing Personal Safety in the Workplace, Food Hygiene, Health & Safety, Incontinence Management, Falls Prevention and Time for Action on Elder Abuse. The Oaks Residential Care Home DS0000017971.V331084.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, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a home that is well managed. The home is run in the best interests of service users and their views are taken into account through the Quality Assurance process. The home ensures the financial interests of service users are protected. Although there is a supervision process in place it needs to be implemented more regularly to ensure service users benefit from well-supported staff. The home ensures the health, safety and welfare of service users and staff are promoted and protected. The Oaks Residential Care Home DS0000017971.V331084.R01.S.doc Version 5.2 Page 20 EVIDENCE: As previously reported, the Manager, Caroline Tidey is appropriately experienced and holds NVQ Level 4 Registered Managers Award. She has also undertaken training in dementia care and person centred planning. Discussions with the manager show that she is committed to undertake ongoing training and development to increase and update her skills. The home operates a quality assurance system that takes the views of service users and others into account. At the time of the inspection visit further surveys for the current year were being collated. Relatives spoken with confirmed that their views are listened to. The home continues to protect service users by maintaining a robust system for recording finances. Discussion with the manager indicates that there is a process in place for carrying out staff supervisions. Staff also receive annual appraisals of their performance. However, recent staff shortages and sickness has diverted much of the manager’s time to ‘hands on care’. This has resulted in shortfalls in the regularity of staff supervisions and team meetings. The manager is aware of the need to implement the supervision process more regularly and is going to address the issue. Staff spoken with feel well supported but say there has not been a team meeting recently. The manager ensures safe working practices that includes appropriate staff training (see evidence for National Minimum Standard 30). The home is maintained to a standard that ensures the health and safety of service users and staff (see evidence for NMS 19 and 26). The home records any accidents, injuries and incidents of illness and reports them to the Commission for Social Care Inspection. Risk assessments are in place to ensure service users are supported in a way that minimises risk (see evidence for NMS 8). The Oaks Residential Care Home DS0000017971.V331084.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 2 X 3 The Oaks Residential Care Home DS0000017971.V331084.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. 1. Standard OP36 Regulation 18(2) Requirement The registered person shall ensure that persons working at the care home are appropriately supervised. Timescale for action 31/05/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Oaks Residential Care Home DS0000017971.V331084.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 The Oaks Residential Care Home DS0000017971.V331084.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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