Inspection on 21/11/05 for Three Oaks

This inspection was carried out on 21st November 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 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

Three Oaks 02/02/07

Three Oaks 20/12/04

Three Oaks 23/07/04

Three Oaks 22/03/04

Three Oaks 08/01/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Three Oaks Southwick Road North Boarhunt Wickham Hampshire PO17 6JF Lead Inspector Mr Rodney Martin Unannounced Inspection 21st November 2005 10:50a 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 Three Oaks DS0000046208.V268178.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. Three Oaks DS0000046208.V268178.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Three Oaks Address Southwick Road North Boarhunt Wickham Hampshire PO17 6JF 01329 833412 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) Camellia Care (Three Oaks) Limited Mrs Julie Jacobs Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Three Oaks DS0000046208.V268178.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5/07/05 Brief Description of the Service: Three Oaks is a twenty-bedded residential care home, situated on the Southwick Road in North Boarhunt, providing care for older persons. The property is well maintained, double glazed throughout and a well-developed garden with pleasant views of the countryside. The home is privately owned. Three Oaks has sixteen single bedrooms and two double bedrooms, with six bedrooms provided with en suite facilities. There is ample communal space in the home, with three lounges, a separate dining room and a large conservatory, overlooking the garden. Three Oaks DS0000046208.V268178.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over two days from 10.50am to 1.40pm on 21 November and 9am until 10.40am on 22 November 2005 as Julie Jacobs, registered manager was not available on 22 November. There were no requirements or recommendations in the two previous inspection reports and again there were none on this occasion. The inspector was able to tour the building as well as speak to all the staff members on duty as well as two visitors. The inspector had a meal with residents at lunchtime. Residents were appreciative of the care they received, had no complaints and stated that the food served was very good. The inspector received four comment cards from service users, prior to the inspection and four comment cards from relatives/visitors. One relative wrote, “Thank you for all you do, it’s greatly appreciated”. On the day of the visit the home was accommodating twenty female residents, which included a service user in hospital. Since the last inspection, on 5 July 2005, there have been one discharge and two admissions. A day-care client came in for the day on Tuesday, 22 November. Three Oaks is currently full. It is confirmed that the key standards have been inspected over this inspection year. What the service does well: Residents, spoken to, were quick to praise the staff team, who do their utmost to provide a friendly environment, with a caring attitude, providing support and encouragement. One resident commented, “All staff are marvellous”. The home provides a happy environment for residents. Residents are supported and encouraged in all aspects of individual health care and personal needs. They are able to participate in appropriate age related activities. Residents are settled in Three Oaks and were appreciative of the care they received and had no complaints. The home has a dedicated and caring staff team. Three Oaks has a group of staff that have worked in the home a long time. The home has a comprehensive training programme for staff. Three Oaks DS0000046208.V268178.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Three Oaks DS0000046208.V268178.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 Three Oaks DS0000046208.V268178.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): 1, 3, 4, 5 Residents assessed needs and aspirations are being met within Three Oaks. Prospective residents are able to make an informed choice about whether or not the home is able to meet their particular needs. EVIDENCE: The home has an appropriate statement of purpose and service users guide, which is available for service users. Following a referral to the home the relative normally visits first and then the prospective service user is invited to view the home. The prospective service user can also be visited in hospital or in his or her own home. Since the last inspection there were two admissions, on 24 August 2005 and 29 October 2005. The inspector met two relatives of one of the new service users. They stated that, “it’s the next best thing to home”. The service user said that, Three Oaks is a “very nice home” – the staff are all marvellous”. The files of the new residents were seen. These were up to date and contained the necessary assessments to determine the resident’s needs and strengths. Three Oaks DS0000046208.V268178.R01.S.doc Version 5.0 Page 9 From discussions with residents and evidence from residents’ files it was confirmed that Three Oaks is meeting the needs of residents. Three Oaks DS0000046208.V268178.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, 9, 10 and 11 The arrangements for planning care are good, ensuring that the residents’ physical and emotional health needs are met. Working practices within the home ensure the promotion of privacy and independence for service users. The home has clear arrangements in place for supporting terminally ill residents in the way they prefer. EVIDENCE: Each service user has an individual file, kept in the format used by Camellia Care, in their three homes. The file contained the service user’s particulars, the pre-admission assessment and the care plan, which detailed the care needs, the objective of the care required and how the plan should be carried out. Daily information about the resident is recorded and these were found to be up to date. The care plan is comprehensive and is easy to read. The files also contained various risk assessments as well as a night care plan and hobbies care plan. The home has a policy on death and dying, as well as a care plan in the event of the death of the resident. However, the funeral arrangements and the hobby care plan had not been completed for the last two residents admitted. Three Oaks DS0000046208.V268178.R01.S.doc Version 5.0 Page 11 It was also noted that there was no night care plan completed for the last resident admitted on 29 October 2005. These need to be completed. The personal and oral hygiene of each service user is maintained and this is recorded in their individual file. An individual record is kept of all health professional visits. Residents have a choice of attending surgery or other medical services. On the day of the inspection a service user’s daughter took her mother out for a medical appointment. However, the majority; prefer to have domiciliary visits to the home. Residents have access to all other health professionals on an as needs basis. Residents are registered with a GP practice in Wickham. The manager discussed an issue that had occurred recently involving the surgery. Details had been satisfactorily recorded in the home’s Kardex and a notification of the incident had been sent to the Commission the same day on 16 November 2005 [Regulation 37 notification]. It was agreed that the manager had acted appropriately. On the day of the inspection, on 21 November, the home changed over from the Nomad dosage system to a monitored dosage system, with a blister pack for each individual tablet rather than having all the tablets a resident was due to take, for the specific time of day, all together. It was confirmed that staff had received training from the local pharmacist. The manager discussed putting the photograph of the service user on the medication sheets. Residents are supported and encouraged in all aspects of individual health care and personal care needs. Specialist advice is available from health care professionals. There was evidence of this in the Kardex. The four service users, who had returned a comment card, answered, “yes” to the question, “Is your privacy respected”. Three Oaks DS0000046208.V268178.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 and 15 The daily routines and activities are flexible and varied to suit the needs of service users. Involvement in the local community and with service users’ families is actively encouraged. The quality and quantity of food provided is sufficient to meet the needs of the residents. EVIDENCE: Each resident has a hobbies care plan and the home endeavours to provide relevant, appropriate and meaningful activities. Three Oaks has three lounges, as well as a large conservatory so there ample room for residents to sit and read, watch television or entertain visitors. There is a large attractive garden with superb views of the countryside, including wildlife, for residents to enjoy. The inspector received comment cards from service users, prior to the inspection. Three had ticked that the home provides suitable activities, two ticked; “sometimes” and one had ticked, “no”. However, the staff on duty stated that there is a balance of outside entertainers coming in along with inhouse activities. The home had conducted its own quality assurance survey in May 2005, when twelve residents responded. According to the surveys none of the residents were dissatisfied with the activities the home were providing. The library bus visits the home and is next due to visit on 23 November 2005. Three Oaks DS0000046208.V268178.R01.S.doc Version 5.0 Page 13 There are no restrictions on visiting times. Visitors can see the resident in the privacy of their own room or in the relative peace of one of the quiet lounges. The inspector was able to speak to two visitors, on the day of the inspection. They confirmed that the resident was happily placed in Three Oaks, “It’s the next best thing to home” and there were no issues. Several residents go out to local clubs. The inspector was able to have lunch with the residents. Residents are not offered a choice of the main course unless they do like what is on the menu. However residents were given a choice of four desserts. Residents told the inspector that they enjoyed the meal. The majority of comment cards had ticked “yes” to “do you like the food”? One service user ticked, “sometimes” and another had written, that “the food is very repetitive and often quite bland”. However, the historic menus indicated that meals were well balanced and nutritious with fresh vegetables and there was a variety built into the menu. The meal was not rushed and there was a lot of friendly banter going over the meal. The environmental health officer had visited on 18 November 2005. Issues relating to the kitchen are mentioned in Standards 31 to 38. Three Oaks DS0000046208.V268178.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 and 18 The home has a satisfactory complaints procedure, which residents feel able to use and an adult protection procedure, to safeguard residents from abuse. EVIDENCE: The home has a detailed and relevant complaints procedure. Residents, spoken to, were aware of whom to complain should they have a need to. The inspector spoke to two visitors who were of whom to contact should they need to complain. The home has a complaints’ log. There were no complaints recorded. The Commission has not received any complaints, since the last inspection. All the residents had ticked “yes” to the question on the comment card, “if you are unhappy with your care, do you know who to speak to”? The relatives had also ticked “no” to the question had they ever made a complaint. The home has an adult protection policy and procedure as well as a policy and procedure on “whistle blowing. Staff, spoken to, were aware of what constitutes abusive practices. Staff have received adult protection training. There have been no incidents of abuse recorded in the home. Three Oaks DS0000046208.V268178.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): 19, 20, 21, 22, 23, 24, 25 and 26 A very good standard of accommodation is provided ensuring residents live in a clean, safe and very pleasant spacious environment, where they have individualised their bedrooms, to meet their needs. EVIDENCE: Three Oaks DS0000046208.V268178.R01.S.doc Version 5.0 Page 16 Three Oaks is a chalet bungalow, with an extension, providing residential care for up to twenty permanent service users. The building is in a good decorative state and double-glazed throughout. There is sufficient room for service users to sit communally, as well as sit quietly. The home has a large garden, with patio area, which is enjoyed by service users in the summer months. All bedrooms are of a good size and six are provided with an en suite toilet facility. The furnishings and fittings are to a good standard. There is easy access around the home and ample car parking. There are sufficient bathrooms and communal toilets for the residents to use. Three Oaks has two chair lifts installed, which are serviced on contract. It was noted that the spring was not working on one of the stair lifts and this was a potential health and safety risk when the footplate and the lift is at the top of the stairs. The inspector received an email from the responsible individual the same day as the inspection stating that a new lift had been ordered. There is easy access to all floors. Grab rails are provided, where appropriate, on a risk assessment basis. Some radiators have been covered and the others are on a risk assessment basis. Sufficient aids and adaptations are available for residents. All bedrooms are bright and in a good decorative state. The rooms are naturally ventilated. Several bedrooms have French doors and a patio. Window restrictors are provided on first floor windows. The home is centrally heated. Radiators are thermostatically controlled and, where appropriate, are to have covers fitted. It was noted that the radiator in the far small lounge was not on, on the day of the inspection. Again, the responsible individual informed the inspector by email that, the home had requested a visit from a plumber. However, it was sunny on the day of the visit and the room did not feel cold. Residents are able to bring items of furniture to personalise their bedrooms. Residents can lock their bedroom door as well as store items under lock and key. The home has a separate laundry, which is situated at the end of the extension and is away from the kitchen and food preparation. Policies are in place for the control of infection, including safe handling and the disposal of clinical waste. Disposable gloves and aprons are available and there was evidence of this, on the day of the inspection. Soap and towels are available in the toilets. The home was found to be clean and free from offensive smells. Three Oaks DS0000046208.V268178.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 30 Residents are well supported by an effective staff team, offering consistency of care within the home. EVIDENCE: Three Oaks DS0000046208.V268178.R01.S.doc Version 5.0 Page 18 On the day of the inspection there were three care assistants on duty, a cook and a domestic. The manager is supernumerary to the main duty rota. The inspector met two new carers. They confirmed that they had received induction training and enjoyed working in Three Oaks. The home has a full compliment of staff. Two carers had obtained NVQ level 2 [National Vocational Qualification] but unfortunately they had left. The manager reported that six to eight staff members are interested in starting NVQ training. From the information given and the observations made by the inspector during the inspection the staffing meets the present needs of the current service users in the home. The home has a comprehensive induction-training programme for new staff. Three Oaks has seven core training videos on health and safety, fire safety, infection control, food hygiene, essential first aid, manual handling and medication. The other three core-training subjects are on adult protection, dementia and death. The manager has taken advantage of the training offered by PACT [Partnership in care training, an organisation which is in partnership with Hampshire County Council, Hampshire Care Association and Hampshire Domiciliary Care Association providing social care training for care providers in Hampshire]. She attended a train the trainer course on infection control on 3 November and dementia on 17 November 2005. Medicine management has been rescheduled for January 2006. The manager and a carer are also validated until 30 November 2007 for manual handling training within Three Oaks. Three Oaks DS0000046208.V268178.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37 and 38 The manager provides good leadership, which ensures staff are supported and residents’ health, safety, finances and welfare are promoted through the home’s practices. EVIDENCE: Three Oaks DS0000046208.V268178.R01.S.doc Version 5.0 Page 20 The manager has worked in Three Oaks since September 1999. She has obtained NVQ at levels 2 and 3 and has just finished the registered managers award for NVQ level 4 in management and care course and is waiting for confirmation that she has passed. She is also a trainer for manual handling within Three Oaks. There is a clear line of accountability between the registered person and the manager, each with their separate functions within the home. In discussion with staff the manager communicates a clear sense of direction and leadership through regular informal meeting with the staff, staff supervision and education. The manager is supernumerary to the main duty rota and as such is available to meet visitors; visiting health professionals and can also step in at short notice if there is a gap on the duty rota. Staff were appreciative of her style of management and made complimentary comments about her. The home has copies of the policies and procedures and/or codes of practice, which reflect the Regulations and Standards laid down in the Care Standards Act 2000. The home uses these and the inspection report as part of the quality assurance monitoring. A service user’s survey and questionnaire is to be given out in January 2006. There is a business and financial plan and the home’s accountant audits the accounts each year. The home is financially viable and there is sufficient insurance in place. There is a current certificate of employers liability insurance. The manager is not agent or appointee for any service user. Service users and/or their relative/representative manage their finances. The home does not manage any service user’s money or hold cash for them. For additional services such as hairdressing, chiropody, newspapers/magazines, the service provider bills the home. This is then billed every three months, to the person who pays the fees by standing order, by the registered person. The supervision record was available. The record confirmed that all staff have regular supervision session and the staff on duty verified this. Samples of records seen on the day of the visit were satisfactorily maintained, including medication records, food records, fire records and service users’ case notes. The manager ensures the safe working practices by planning courses on health and safety within Three Oaks, including first aid, manual handling, food hygiene, fire and medication. Risk assessments are in place. There are current and up to date contracts on electrical equipment as well as kitchen and domestic appliances et cetera. COSHH policies and procedures are in place. Three Oaks DS0000046208.V268178.R01.S.doc Version 5.0 Page 21 Window restrictors are in place on the windows above ground level, to ensure safety for residents. The environmental health officer last visited the home on 118 November 2005. The report indicated there were several minor points requiring attention, including a tear in the vinyl kitchen floor. The latter needs seeing to and the manager confirmed that the responsible individual was aware of this and that this was in hand. The fire log was inspected and the records indicated that the fire safety equipment had been tested and serviced within the guidelines. It was confirmed that staff have received twice yearly fire instruction and Three Oaks had two fire drills this year on 23 March and 5 September 2005. Three Oaks DS0000046208.V268178.R01.S.doc Version 5.0 Page 22 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 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 13 14 15 3 4 3 3 3 3 3 3 STAFFING Standard No Score 27 4 28 3 29 X 30 3 3 3 X 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 Three Oaks DS0000046208.V268178.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Three Oaks DS0000046208.V268178.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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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