Inspection on 22/03/06 for Twin Oaks

This inspection was carried out on 22nd March 2006.

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

Twin Oaks 15/10/09

Twin Oaks 17/03/09

Twin Oaks 16/03/07

Twin Oaks 20/09/05

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

CARE HOMES FOR OLDER PEOPLE Twin Oaks Victoria Road Windermere Cumbria LA23 2DL Lead Inspector Elaine Brayton Unannounced Inspection 22nd March 2006 12:30 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 Twin Oaks DS0000064043.V284275.R01.S.doc Version 5.1 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. Twin Oaks DS0000064043.V284275.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Twin Oaks Address Victoria Road Windermere Cumbria LA23 2DL 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) 015394 48994 015394 48994 Heathwaite Care Homes Limited Miss Margaret Palling Care Home 6 Category(ies) of Old age, not falling within any other category registration, with number (6) of places Twin Oaks DS0000064043.V284275.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 6 service users to include: up to 6 service users in the category of OP (Older People not falling within any other category) 20th September 2005 Date of last inspection Brief Description of the Service: Twin Oaks is a domestic style property which has been equipped to provide accommodation and care for up to six older people. The home is furnished and decorated to a good standard, and provides a very comfortable and pleasant environment for the people who live there. The accommodation is on two floors, on the ground floor there is a spacious lounge, dining room, bathroom, toilet and kitchen, and on the first floor there are six bedrooms each with an en-suite shower and toilet. There is a small car park, and gardens with level access and seating. The home is situated in the town of Windermere, close to all of the usual amenities. Twin Oaks DS0000064043.V284275.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the home, which took place during the middle of the day. During the inspection time was spent talking to the people living in the home and to the proprietors. Communal areas and private bedrooms were looked at, and a selection of records relating to the care of residents were examined. What the service does well: What has improved since the last inspection? What they could do better: The care planning systems must be improved so that they provide information about all of the resident’s health and social care needs and how these needs are to be met. Appropriate medication records must always be kept, and medication must always be stored securely. Everyone working in the home must complete training in the protection of vulnerable adults. New staff must have had an up to date and satisfactory criminal record bureau check before they commence work in the home. Twin Oaks DS0000064043.V284275.R01.S.doc Version 5.1 Page 6 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. Twin Oaks DS0000064043.V284275.R01.S.doc Version 5.1 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 Twin Oaks DS0000064043.V284275.R01.S.doc Version 5.1 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 A thorough assessment is completed before a new resident is admitted to the home ensuring that the persons needs can be met. EVIDENCE: The proprietor visits prospective residents before they are admitted to the home, to assess their care needs. Information is also provided by social services where appropriate, and by health care professionals. Completed assessments were seen on individual residents personal files, and these contained information about the person’s health and social care needs. Twin Oaks DS0000064043.V284275.R01.S.doc Version 5.1 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, 10 There is a care planning system in place, but would be improved with more detailed information recorded about residents needs and how these were to be met. Residents in this home are treated in a way that respects their privacy and dignity at all times. EVIDENCE: The care plans and related records were examined as part of the inspection. The care plans contained some information about the resident’s health and social care needs, but this was not sufficient to provide a clear picture of the person’s day to day needs and how they were met. Health care needs were documented, and information was kept about all health related appointments. The storage arrangements for some medication in the home was not suitable, and the proprietor agreed to attend to this. Residents said they were treated in a respectful way and their privacy maintained. Twin Oaks DS0000064043.V284275.R01.S.doc Version 5.1 Page 10 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, 14 Residents were provided with opportunities to participate in a variety of activities on a daily basis, as they preferred. People living in the home had choice and control over all aspects of their daily life. EVIDENCE: The residents in the home lived their life very much as they chose to. They said that they made their own decisions about the shape of their day. People could stay in their own private room or spend time in the communal areas of the home, received a choice of menu at mealtimes and chose where to take their meals. Residents received the daily newspaper of their choice, and the proprietors ensured that people participated in social and personal activities as they wanted to. Twin Oaks DS0000064043.V284275.R01.S.doc Version 5.1 Page 11 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): 18 There are systems in place to protect service users from all forms of abuse, however this would be strengthened by everyone working in the home completing the protection of vulnerable adult training. EVIDENCE: There were suitable procedures in place to protect residents should there ever be any suspicion of mistreatment of a vulnerable person. The proprietors and staff member should all complete training about the protection of vulnerable adults to further strengthen the systems in the home and protect the people living there. Twin Oaks DS0000064043.V284275.R01.S.doc Version 5.1 Page 12 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): 20, 21, 26 Residents live in a safe, clean and very comfortable environment which is suitable for their needs. EVIDENCE: The home provides residents with accommodation which is decorated and furnished to a high standard. The communal areas are pleasant and very comfortable. All of the bedrooms have en-suite toilet and shower facilities, and in addition to this there is a communal toilet and bathroom. A stair lift has recently been installed, and this will assist people in moving around the home. The home was very clean and tidy on the day of the inspection, and the residents said they found the accommodation very comfortable and always extremely clean. Twin Oaks DS0000064043.V284275.R01.S.doc Version 5.1 Page 13 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 The homes recruitment procedures must be improved to ensure that any staff employed are suitable and experienced. EVIDENCE: There is one member of staff employed to work in the home. Two references had been sought, but an up top date criminal record bureau check had not been carried out. The proprietor must ensure that a CRB check is carried out before a new member of staff commences work in the home. A requirement has been made about this. Twin Oaks DS0000064043.V284275.R01.S.doc Version 5.1 Page 14 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, 33, 38 This home operates in the best interests of residents. EVIDENCE: The proprietor, who has a nursing qualification is responsible for the day-today running of the home, and intends completing the Registered Managers Award during the next 12 months. There are some systems in place to check the quality of the services and care provided, and the proprietor will be developing these systems in future months. Twin Oaks DS0000064043.V284275.R01.S.doc Version 5.1 Page 15 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 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 X 3 3 X X X X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X X X X Twin Oaks DS0000064043.V284275.R01.S.doc Version 5.1 Page 16 Are there any outstanding requirements from the last inspection? 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 Each resident must have a care plan, including risk assessments, which includes details of the person’s health and social care needs and how those needs are to be met. All medication in the home must be stored securely, and records must be kept of the arrangements in place for the administration of medication. All staff working in the home must complete Protection of Vulnerable Adult training. All staff must have a satisfactory Criminal Record Bureau check before they commence work in the home. Timescale for action 30/04/06 2 OP9 13.-(2) 30/04/06 3 4 OP18 OP29 18.-( c ) 19.-4 (b) 30/06/06 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Twin Oaks DS0000064043.V284275.R01.S.doc Version 5.1 Page 17 1 2 OP31 OP33 The proprietor should make suitable plans to complete the Registered Managers Award. The quality assurance systems in the home should be developed and improved Twin Oaks DS0000064043.V284275.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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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