Inspection on 21/10/05 for The Oaks Residential Care Home

This inspection was carried out on 21st October 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Oaks Residential Care Home 21/02/07

The Oaks Residential Care Home 28/02/06

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 Sara Naylor-Wild Unannounced Inspection 21st October 2005 10:30 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.V260733.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 Residential Care Home DS0000017971.V260733.R01.S.doc Version 5.0 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 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 Old age, not falling within any other category registration, with number (30) of places The Oaks Residential Care Home DS0000017971.V260733.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th March 2005 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 Oaks Residential Care Home DS0000017971.V260733.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out in one day on the 21st October 2005. The manager Ms Tidey, was available throughout the inspection day. During the inspection the inspector had opportunity to speak to service users and staff and their views have been incorporated in this report. Other information was gathered from a tour of the premises and reading of records and other documentary evidence. The visit was also used as an opportunity to assess the suitability of the services application for variation to register 6 placements in the category of dementia care. Examples of evidence to support the application were found in changes to the environment, staff training and care planning documents. Whilst ongoing development is required to expand the quality of provision there was sufficient evidence at this inspection to support the proposal. What the service does well: What has improved since the last inspection? Ongoing development of the person centred planning used in care plans has strengthened the understanding of how individuals’ care is delivered in the service. The commitment to staff training in delivering a specialist service as a developing process is positive. The Oaks Residential Care Home DS0000017971.V260733.R01.S.doc Version 5.0 Page 6 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 Oaks Residential Care Home DS0000017971.V260733.R01.S.doc Version 5.0 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.V260733.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Assessments of needs were carried out prior to prospective service users admission. The home does not provide intermediate care. EVIDENCE: The files of three service users were sampled during the inspection. These provided evidence of the assessment tool and processes used by the home. They contained a good breadth of information regarding the individual’s needs, strengths and preferences and the format included a yes/no style tick sheet and comment box in each consideration. It was noted that where the comment box was not completed there was much more limited knowledge of how the issue affected the service user, this was discussed with the manager and generally agreed that further development of staff skills in collecting the information and understanding its relevance would be beneficial. The Oaks Residential Care Home DS0000017971.V260733.R01.S.doc Version 5.0 Page 9 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, 9 and 10. Service users living at the home all had care plans where their individual needs were set out. Health care needs were monitored and recorded in care plans appropriately. Medication administration adhered to the home’s policy and procedure. Service users’ rights are upheld. EVIDENCE: The care plans of three service users whose care was tracked for the purposes of the inspection contained good levels of information in respect of individual needs. The action required by staff to meet these needs was broken down into specific elements of tasks, which would clearly identify the individual approach to care provision. Some further development of how strengths should be supported would ensure that the plans advocated a person centred approach and the maintenance of independence. Documents reported on health care needs and where health professionals’ advice was sought. Changes in medication or treatments were set out clearly. The Oaks Residential Care Home DS0000017971.V260733.R01.S.doc Version 5.0 Page 10 The administration of medication in the home continues to adhere to the home’s policy and established good practice and legislation. Service user rights to privacy and dignity were generally upheld in the home’s practices. This includes the right to private consultation with health professionals in service users’ own rooms. The issue relating to bedroom door locks has been considered and addressed in the home’s refurbishment planning. The Oaks Residential Care Home DS0000017971.V260733.R01.S.doc Version 5.0 Page 11 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, 14 and 15. The activities provision is in development, to engage more service users. The home supports family involvement and service users’ contact with the community. The service users have opportunity to exercise some choice and control in their lives. The home provides a varied and planned menu. EVIDENCE: Previous inspection reports had commented on the provision of activities and the staff’s skills in this area. In particular the provision for service users whose cognitive impairment required a more specialist approach. The inspector was pleased to note from discussions with the manager and staff and observations on the day of inspection that this was an area of ongoing development. The manager had carried out some research into activities initiatives and additional equipment purchased to facilitate these. Some staff spoken to felt that there was limited time outside of the practical tasks, such as personal care, to provide activities and that a coordinator would be beneficial, although on the day of the inspection visit staff were engaged in a lively and humorous quiz The Oaks Residential Care Home DS0000017971.V260733.R01.S.doc Version 5.0 Page 12 game with service users. This area of care provision will require ongoing development and focus. The home has developed good relationships with service users’ families and supporters, and this is upheld by the visiting policy. The visitors’ log records frequent visits undertaken and service users testify that the home’s staff make their friends and family welcome. There are no restrictions in service users’ movement within the home, and limitations placed on service users life outside the home are arranged following risk assessments. Service users’ comments on the quality of meal provision on the day of inspection were all positive. They were offered choices of meal according to their preferences. Although they were not generally able to comment on the overall provision, menus identify a variety of nutritious meals on offer with alternatives to the main menu if required. The Oaks Residential Care Home DS0000017971.V260733.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed. EVIDENCE: The Oaks Residential Care Home DS0000017971.V260733.R01.S.doc Version 5.0 Page 14 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): 19, 20 and 26. The premises are well maintained with suitable adaptation to the layout made. There is safe access to all communal areas. EVIDENCE: The proprietors had made application to the CSCI to include, within the existing category of care of older people, 6 places for service users with dementia. As part of the considerations for this application they had been asked to assess the suitability of the premises and how they would accommodate service users with differing needs. As a result, they had considered that a portion of the home should be separated out to provide dedicated space for service users with dementia and undertaken some alterations to the layout of communal premises and created division in the large L shaped lounge/diner. This provided opportunity for separation of the communal space if desirable, and effectively created an annexe with the 6 bedrooms and bathroom on that side of the building. The outside space had also been securely enclosed to provide a safe garden area. The Oaks Residential Care Home DS0000017971.V260733.R01.S.doc Version 5.0 Page 15 Decoration of the annexe was due to take place following the inspection and the manager discussed with the inspector the inclusion of dementia good practice guidance in relation to colour and signage planned for the home. Other areas of the home had also been updated with redecoration of communal areas and carpeting throughout the ground floor. These presented a clean and bright environment. Some works were still required to the first floor including a bathroom, and the manager was able to indicate how the maintenance programme was set out to address these. The Oaks Residential Care Home DS0000017971.V260733.R01.S.doc Version 5.0 Page 16 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, 28 and 30. The staffing arrangements were appropriately calculated. The staff training is to a sufficient level to enable staff to meet service users’ basic needs. EVIDENCE: The manager was aware that staffing numbers were calculated according to the assessed needs of service users, and the adjustments required when service users’ needs changed. Staff commented that they felt that the staffing numbers and increased needs of service users did not always provide sufficient time to spend providing activities to service users. They advised that this was discussed with the proprietor and manager at staff meetings. The manager and staff confirmed that regular training was undertaken including an introduction to dementia care. The manager had undertaken a more intensive course including person centred planning, which she had found beneficial and that she felt should be extended to the other supervisory staff. This would enable both the cascading of the information to the staff team and a greater understanding of the quality measurements in related good practice care planning. The Oaks Residential Care Home DS0000017971.V260733.R01.S.doc Version 5.0 Page 17 The inspector had agreed with the manager that the present level of dementia training provided some basic insight into the condition and that this should be further supplemented by additional training in other aspects of the care provision, for example nutrition, activities, communication, etc. The Oaks Residential Care Home DS0000017971.V260733.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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, 32 and 38. The registered manager is competent in fulfilling her role. The home is operated in a manner that benefits service users. EVIDENCE: The Manager, Caroline Tidey is appropriately experienced. She has attained the NVQ 4 Registered Managers Award, and has also undertaken training in dementia care and person centred planning. Based upon observation, discussion with Ms Tidey and care staff, the management regime, overall, enabled an open and positive atmosphere. Staff spoken with felt that the manager was fully established in the home and had developed a management style which supported them in their work. The Oaks Residential Care Home DS0000017971.V260733.R01.S.doc Version 5.0 Page 19 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 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X X X 3 The Oaks Residential Care Home DS0000017971.V260733.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? YES 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 Requirement The registered person must further develop the care planning system to ensure it records all service users’ abilities and needs. The registered person must ensure that staff’s skills and understanding in dementia care is further developed. Timescale for action 31/03/06 2 OP30 18 31/03/06 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 OP3 Good Practice Recommendations The registered person should ensure that the assessment format and staff skill in completing them provides the depth of knowledge required to understand service users’ holistic needs. 2 OP12 The registered person should further develop the DS0000017971.V260733.R01.S.doc Version 5.0 Page 21 The Oaks Residential Care Home opportunities for service users to be engaged in activities that suit their interests and capabilities. The Oaks Residential Care Home DS0000017971.V260733.R01.S.doc Version 5.0 Page 22 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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