Care Home: Forest Oaks Home For The Elderly

Similar services:

• St Vincents
• The Cotswold Home
• Winton House
• Rush Court
• Hillyfield Rest Home
• The Maypole Nursing Centre
• The Briars

What the care home does well What has improved since the last inspection? What the care home could do better: Several avenues are provided for the residents to express their views about aspects of the service and the home is therefore aware of most of their attitudes and aspirations. Regular and varied activities inside the home are limited in nature and frequency. The arrangement of both organised and informal trips out would be a priority for the residents. Generally the food at Forest Oaks offers a good selection with well balanced menus and the Home realises that it is of utmost importance to ensure dietary needs are equally well catered for and they will continue to address this. Only one requirement has been made at the conclusion of this report to do with record keeping and their availability i.e. night care plans particularly for those prone to fall who may be in the residential wing. CARE HOMES FOR OLDER PEOPLE Forest Oaks Home For The Elderly The Rise Brockenhurst Hampshire SO42 7SJ Lead Inspector Joy Bingham Unannounced Inspection 21/05/08 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Forest Oaks Home For The Elderly DS0000011426.V363387.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. Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Forest Oaks Home For The Elderly Address The Rise Brockenhurst Hampshire SO42 7SJ 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) 01590 622424 01590 622424 ggarman@wilverley.org.uk The Wilverley Association Limited Glynis Anne Garman Care Home with Nursing 46 Category(ies) of Old age, not falling within any other category registration, with number (46) of places Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th August 2006 Brief Description of the Service: Forest Oaks is a care home providing personal care and accommodation for thirty service users and sixteen service users in need of nursing care. The home is registered to accommodate a total of 46 service users in the old age category of over 65 years. Forest Oaks is one of two care homes that is administered by the Wilverley Association Ltd, which is a registered charity and as such all the members of the governing committee are volunteers. The home was purpose built some years ago and is surrounded by pleasant well-maintained gardens. The home is divided into two distinctive areas. Residents in the residential rooms are accommodated in single rooms on all three floors of one wing of the home. The sixteen service users in need of nursing care are accommodated on the ground floor in single rooms. Forty-two of the forty-six rooms are fitted with en-suite facilities. Forest Oaks is situated in the New Forest Village of Brockenhurst and is a short step to the village centre and its amenities that are widely used by the residents. The registered manager informed us during the inspection that fees were in the range of £374 per week for service users in the residential wing in a banding up to £699 for those requiring nursing care. Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service continue to experience good quality outcomes. The purpose of the inspection was to find out how well the home is doing in meeting the key National Minimum Standards and Regulations. The findings of this report are based on several different sources of evidence. These included the Annual Quality Assurance Assessment (AQAA) completed by the home, and comments from residents and staff. An unannounced visit to the home was carried out over two days, 21 and 22 May, lasting a total of nine hours. During this time we were able to have a partial tour of the premises, including several bedrooms, two lounges, kitchen, and kitchenettes, dining room, drug room and bathrooms and toilets. We had private discussions with four staff, and contact with a large number of the residents of the home. Comments were obtained from professional stakeholders. We sampled staff and care records, and policies and procedures that relate to the running of the home. All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the Commission for Social Care Inspection (CSCI). What the service does well: The home offers individual person centred support to the residents in a very comfortable domestic setting, with the facility of a nursing wing. The home encourages service users to remain as independent as possible for as long as possible and the residents expressed appreciation of the availability of care and support from experienced nurses if they became unwell. The manager and staff team are motivated and experienced in working with older people and express a desire for continual improvement. The home provides an accepting family atmosphere where the staff are kind. • Everyone is wonderfully kind and helpful • The staff couldn’t be nicer • You’d have to comb the country to find a more agreeable chef • The home is very open and free • Its all very free and easy, no rules and regulations as long as we are not annoying our neighbours. Comments from stakeholders include: • There are no problems there Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 6 • • • They rarely have a vacancy It all seems very nice Everyone is very amenable Each section of the report has drawn a ‘good’ rating and only minor shortfalls have been identified. 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. The summary of this inspection report can be made available in other formats on request. Forest Oaks Home For The Elderly DS0000011426.V363387.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 Forest Oaks Home For The Elderly DS0000011426.V363387.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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users’ needs and aspirations are assessed before admission. They are given opportunity and information to visit and test out the home before they are admitted. EVIDENCE: Three service user assessment records were inspected. These had been comprehensively completed, signed and dated. The assessment for each individual led to a number of support plans, and relevant risk assessments. Contracts of residence were available on file, held separately by the manager. A service users’ handbook was provided and the manager said that she continually updates it and prints one off each time one is needed to ensure all the information is up to date. It incorporates all necessary information. Copies Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 9 of the last two inspection reports were available for anyone from the home or a visitor to read, displayed in the entrance hallway. The AQAA informed us that there is a range of fees (3 bands) for residential and one for nursing patients. Managers assess which band residents’ needing care should be in. The residents are able to move in and out of bands as their care needs change. The AQAA also states that residents who wish to, are able to come into the Home on a trial basis. Three people had been admitted to the home recently and we spoke with them to verify that what were told had been their experience. They told us they had the opportunity to visit the home but were unclear about the paperwork. ‘I’m sure it all happens’ was one smiling comment. However they said the staff and the manager spoke with them and/or their family to make sure they understood how Forest Oaks operates and to be available for their questions. They were unable to think of any way this could have been improved for them and spoke well of the support they had received. Others spoken with said: • I had my name down a long time ago and I think I’m very lucky to have got in here. • I really don’t know how I came here but I think everyone is very kind. • Everyone is awfully kind and helpful • I am disappointed everyone is old! • What impressed me when I came is that the residents are not mixed in with sick people. The manager told us that respite care is offered only at times when there is a vacancy and when it can be easily fitted in. Intermediate care (rehabilitation) is not provided at Forest Oaks. Forest Oaks Home For The Elderly DS0000011426.V363387.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 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents contribute to the production of a care plan; they know their needs and wishes are reflected in this and they are supported in making decisions and taking appropriate risks in order to live as independent a life as possible. EVIDENCE: We saw that person centred care plans were established for each resident even if it identified a fully independent lifestyle. We discussed with the manager the unusual nature of Forest Oaks in admitting people more in need of sheltered housing and semi-independent living than residential care. Some residents drive their own car and frequently eat out. They object to signing in and out of the home when they are popping to the shops. Some residents are fully self-caring apart from taking their meals in the dining room. Three of the files were audited. There was recognition made of their personal needs, and wishes, with appropriate risk assessments dealing with moving and Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 11 handling, continence management, self administering of medicines. Signatures of agreement were noted on file. Personal cabinets that are lockable are provided in each en-suite bathroom for each resident and these are used for storing medicines when people self medicate. Assessments were on file and reassessments and details of changes to the arrangements were agreed with the residents when they could no longer handle their own medicines, through frailty or confusion. The AQAA told us that each resident has a named nurse including who is responsible for ensuring accurate records relating to risk assessments and care needs are fully maintained. Registered nurses who work at night are responsible for auditing the nursing records and audit residential care plans each month. The manager undertakes a further audit of care plans approximately every 3 months. However, we noted that the night care plan for one resident who had only been admitted for a month and had fallen on a number of occasions could not be located, so it was impossible to verify that an appropriate risk assessment and care plan was in place to meet his needs. We confirmed that individual care plans are normally reviewed and updated each month for those residents and patients with higher needs but were unable to confirm that written records were kept of each person who is accommodated. It was recommended that all plans are reviewed each month and the fact dated and initialled even if people are not in receipt of regular personal care. We noted that some residents made their own appointments to consult with a doctor and made their own way to the surgery. On the day of the inspection the home had called for a doctor’s visit to four residents, and the files were left ready for them in the nursing wing. Residents said: • A member of staff took me to the dentist, gave me her arm and collected me when I had finished. They couldn’t be nicer. • I think twice about calling for help—we are reticent. • I’m on the second floor so I don’t like to call for help. Permission to share information is sought from some residents where appropriate. They told us they are aware of the documentation held by the home about them. • I’m sure it all happens • It all happens very satisfactorily Individual colour coded files are kept in the nursing office which is not routinely accessed by the public. The risk assessment process appears generally to be an enabling one, which seeks to support residents in their independent activities in a planned and safe manner. However, in one of the files it was not possible to locate a specific Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 12 night care plan for one resident who had been subject to recent falls. This omission was drawn to the manager’s attention. The drug cupboards were inspected and the records were sampled. Two sets of controlled drugs were still in store after people had died. One was within the seven day holding period, and the other was waiting for a ‘doom’ kit to dispose of them. The random sample of the drug sheet identified two gaps in ramopril administration for one resident, and this was drawn to the managers’ attention who agreed to follow up and regularly monitor staff practice in this area. We observed packets of eye drops stored in the domestic fridges in the kitchenettes around the home that were designated for residents’ use. The manager agreed to ensure these were placed in a sealable container and clearly labelled with the name of the user and its content. House meetings are held bi-monthly. Copies of the minutes were available on the notice board. Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 13 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The more able residents are able to take part in peer, age and culturally relevant activities, and participate in the local community, mainly at their own initiation. They retain the links they wish to have with family members. More stimulation and programmed activities both in–house and external could be provided for the less able residents and patients. They are provided with home cooked, wholesome and balanced nourishment. EVIDENCE: Eight of the residents were spoken with and they told us that the home is free from regimentation and rules. They are enabled to come and go as they wish, get up and retire when they choose. They have their own private rooms and as long as they do not make excessive noise to disturb neighbours they are enabled to play music and watch the television whenever they choose. • I don’t settle down until 11pm. It’s completely free • It’s all very free and easy • There are no rules and regulations as long as we are not annoying our Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 14 neighbours • It’s very open and free • They don’t make my bed properly, they just pull the sheets up. They haven’t time really. A number of residents and staff commented that they would like more activities in-house, and would like trips somewhere interesting to look forward to. We were told that a charge is levied if you attend the monthly ‘extend’ exercise group, costing £2:50. The joining together for morning coffee, lunch and afternoon tea provided opportunity for the residents to meet informally together. This was seen to be quite an interactive time for people, with warm exchanges and happy banter, and also opportunity for people to be supportive if some were less contented. Use was made of the garden area between the two wings. Summer furniture provides seating in sunny and also shaded areas. The close proximity of Brockenhurst High street, just a short step away, was considered by residents to be a great advantage. While we were present in the home a number of service users went out, some accompanied and some not, to go for a walk and to attend appointments. They are provided with a key to their own room and also to the home. A number of the residents have their own cars. The AQAA informed us that community activities are advertised on notice boards i.e. local theatre, visiting speakers to the village hall, church events. Staff will assist residents in obtaining tickets and or transport if needed. It also states that staff are encouraged to conduct 1:1 activities for those residents who do not like or are unable to link in with group activities, and this may include a hand massage, a newspaper read to them, an assisted walk to the village. During the inspection staff did express the desire to engage a little more in these activities, time permitting. The AQAA acknowledges that more in depth social plans could be established and the home could increase the level of small daily activities especially for those residents who do not have strong family support or friends nearby. We looked in the kitchen and dining room while lunch was being prepared and later, served. The chef readily explained to us the process of menu design taking account of ideas and views expressed by the residents, until a full month’s menus is printed and displayed in the coffee lounge area. Menus were varied and interesting. Although employed by an external catering company the chef prepares and cooks all food freshly on the premises. On inspection day the lunch was a cold buffet, with ample salad items including cold chicken and ham. The residents said they looked forward to this meal and Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 15 appreciated the variety. The hot alternative was haddock and duchesse potatoes with parsley sauce, braised celery, and cauliflower. The meal was followed by home made apple pie and custard or milk pudding. Salads and/or omelettes are always available as an alternative. We saw that meals requiring to be processed had each item pureed separately, and the meals presented well. The menu for later was a choice of cream of vegetable soup, ham and egg with chips, macaroni cheese and summer fruit flan with cream. Comments about the food included: • The meals are wholesome • Really they are very good, but not like you’d make yourself • You’d have to comb the country to find a chef who is more agreeable • Meals are definitely improving • Sometimes the food is very institutionalised • I think they’re improving, trying to vary it more • We enjoy the buffet salad once a week and if the salads routinely were more interesting we would make this choice more often We were told that breakfast is served in the dining room from 08:30 am or residents can prepare their own in the kitchenettes. We saw these were amply stocked with a range of cereals and breakfast items. Coffee is served in the coffee lounges at 10:30 am and we noted this was a good social point for many of the residents. There was supportive conversation happening between them and they readily engaged in discussion with us about the inspection. The staff did raise a question about the occasional low priority afforded to those with food allergies or special nutritional demands in the nursing wing e.g hard apple in a fruit salad when softer fruit is needed. This was raised with the manager and the particular case was checked on the day of the inspection. An alternative and appropriate meal had been arranged. Notices boards in the home indicate that residents can invite friends and family for a meal for a small amount and guests can be accommodated overnight (B and B) in the guest room. Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 16 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. Residents know that all complaints will be taken seriously and acted upon. They are protected by staff training and awareness of the need for the protection of vulnerable adults. EVIDENCE: The home has a complaints policy in place that indicates who will investigate the complaint and time scales for the process. This is included in the service user guide issued to all residents. The AQAA states that staff are trained to value complaints as a tool for improvement, and the manager operates an open door policy for residents, family members or friends who may wish to talk through any concerns. At the time of the inspection the complaints records did not contain any recorded complaint. There had been two complaints that the CSCI had been aware of. These had been dealt with but needed to be recorded in the home’s file. The question of when a concern or comment becomes a formal complaint was discussed with the manager and it was agreed that any complaint that required her investigation and action should be included in the complaints log. We spoke with several residents about the method for expressing concerns or complaints and we were told that without exception they would speak to either Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 17 the manager or one of her deputies. They were confident that any issue would be attended to promptly and felt that they would be taken seriously and any matter investigated. • • • • We can air our views We could go to matron anytime, or the deputy matron All the staff are very good I have nothing to complain about Records seen indicated that staff received training in abuse awareness and the home has procedures in place to be followed should abuse be suspected, including whistle blowing. Two staff members spoken with confirmed that they had received training and knew about the procedures. Security within the home was identified at the previous inspection as an area for review and improvement as residents come and go freely and side doors were left unlocked in what is an extensive building with large areas unmanned. Since then the home has installed 2 extra CCTV cameras, totalling 4, with an updated video system, and additional movement controlled security lighting in the grounds. A new electronic key fob system is being introduced. Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 18 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 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Forest Oaks provides a clean, pleasant, homely environment for all who live there. EVIDENCE: The opportunity was taken to walk around the home, and we were invited into three bedrooms in the residential wing and looked into the majority of rooms in the nursing wing. The home was purpose built and provides accommodation over three floors accessed by stairs and a passenger lift. There are 30 rooms designated for residents and 16 in the nursing wing. Resident’s rooms are fully furnished by the residents and therefore they are surrounded by their own possessions and furniture. They determine the colour scheme, carpeting and layout of the rooms also. Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 19 In the nursing wing furniture and fittings are provided by the Wilverley Association. People in the nursing wing are able to bring some of their personal possessions if they wish. Keys are provided for residents to their own rooms and the front door of the home and we saw that during the inspection some residents lock their room doors when they were not in the room. Residents spoken with said that they liked their rooms and thought them very suitable for their needs: • I have all that I need • Its very nice to have everything of your own around you-some places let you take in just a bed but here its all our own • It’s as near to being ‘at home’ as you can have it, but with all the help you need added on • It suits us -we had to downsize a lot but you have to come to terms with that when you get older We noted that there were a number of couples who were resident. They had made one room into the lounge and shared the other as a bedroom. There is a separate dining room on the ground floor and coffee and tea is served in a lounge area nearby and in the main lounges. Residents may also have drinks and meals served in their rooms if they wish. A small kitchenette equipped with fridge, microwave, toaster, kettle etc is provided on each floor for residents and their visitors to make drinks and snacks. Some residents, who have been risk assessed as able to do so, also have the equipment in their rooms to make drinks as they wish. The kitchenettes are also equipped with washing machines. Other facilities include a quiet/hobbies room, a TV room, and a library for general use. A call alarm system is available throughout the home and call alarms were seen to be available and accessible to residents, including those sitting in chairs in their rooms. Specialist equipment such as hoists is provided for residents assessed as requiring it. Sufficient bathroom and toilet facilities are provided on each floor. 42 out of 46 rooms have en-suite facilities. Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents and patients needs are met by a professionally recruited and well trained staff team. EVIDENCE: Three of the care staff members were spoken with in private and they told us about their role and place in the team. They each scored the morale amongst the team quite high and expressed positive attitudes about working at Forest Oaks. They had provided all the necessary documentation including references and police record checks were completed before they could start work. They had been supervised recently and had experienced an annual appraisal also. Staff records were checked and found to be comprehensive and up-to-date. • • It’s a really happy atmosphere I love working here The manager told us that the Association employs a training manager who is responsible for the training programme for staff in each of its homes. Records seen indicated that all staff received induction training that was in line with the requirements of Skills for Care. All staff received training in moving and handling, health and safety, protection of vulnerable adults, infection control and first aid. New staff members were expected to complete the induction course and then commence NVQ training. We looked at the staff training Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 21 matrix and it demonstrated that the home keeps on-going record of the level of training of each member of staff. Staff spoke highly of the induction they had received on starting work and of the on-going training which they enjoyed and found very motivating. • It was very thorough • It left me feeling confidant • We can do the training we want, there is no restriction and it is very good • There are always courses going on we can put our names down for. Comment was made by some staff about staff shortages through sickness, jury service and holidays and it was stated that it can be difficult when there are less staff on duty, particularly at weekends. However the recent staff duty rosters were inspected and back- up appears to have been made with bank staff and where necessary agency staff have been called in. (Sundays usually have 5 auxiliaries and one trained in the mornings and 3 auxiliaries and one trained in the afternoons). Two of the domestic staff were also spoken with and they confirmed they felt very much part of the team and said they would not want to work anywhere else. The residents spoke very highly of the staff: • They are wonderful • They couldn’t be more kind • They’re all very nice • Everyone is awfully kind and helpful • There are wonderful staff here and kitchen people • You’d have to comb the country to find a cook who is more agreeable • They couldn’t be nicer Some of the more independent residents said they can feel a little isolated at times. They indicated that when you live on the second floor, and other new residents need help ‘you can feel like you almost function as a member of staff, directing someone else and clearing up after others in the kitchen’. One or two said they would like to see the manager more often as she can seem to be remote when they have no particular need to talk with her. Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 22 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 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents benefit from a well run home, where their financial interests are safeguarded and their health, safety and wellbeing are promoted. EVIDENCE: We were assisted throughout the inspection by Glynis Garman, who has been the manager of the home since January 2006, and was registered with the CSCI in May 2006. Mrs Garman is a trained nurse with many years nursing experience and has completed the Registered Managers Award. She has specialised and gained experience in care of the elderly, palliative care, rehabilitation nursing and teaching and assessing in clinical practice. She expressed a very open, transparent and helpful attitude to the inspection Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 23 process. The staff spoke highly of her leadership and the residents were also confidant in her ability to lead the team. Since the last inspection there has been a change in the Responsible Individual named on the certificate of registration. This is now Mr P F Cousins. The AQAA informed us that there are clear lines of accountability in the Association, with the manager having responsibility for the whole home and the deputy being responsible for care. There is also a full time administrator who is responsible for business, the building and maintenance. The home has a housekeeper with responsibility for all the domestic staff and a catering manager/chef who line manages the kitchen staff. Mrs Garman explained that there are three committees that operate regularly at Forest Oaks. The first is the House Committee, involving volunteers from the community. CRB checks are completed on all volunteers. They organise some events for the residents and create an opportunity for residents to feedback their views of the home and the way it functions. There is also a Finance Committee and an Association Council meeting dealing with more legal operational issues. The House Committee meetings are held every other month and minutes are taken. Mrs Garman herself has an open door approach to management and residents spoken with said that they were able to speak with the registered manager or the deputy manager as they wished. We were told that staff meetings take place to inform and consult with staff on current issues and changes and developments. The home has a procedure in place for handling residents’ personal money and we were informed that small amounts of money are held for some residents. This is stored in the internal lockable room where the drugs are securely kept. The AQAA informed us that the home does not act as appointee for residents. In relation to health and safety the AQAA informed us that risk assessments of all areas of the home are completed and reassessed annually on a formal basis. All rooms are risk assessed annually or whenever a room is vacated. Staff receive training in health and safety including moving and handling and fire safety. The fire log book is kept available for inspection and any necessary action in the entrance hallway of the premises. Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 24 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 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 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 X X 3 Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 13 (6) Schedule 3 (m) Requirement Night care plans must be completed and available and include a risk assessment with a particular attention to the prevention of falls. Timescale for action 31/07/08 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 Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Forest Oaks Home For The Elderly DS0000011426.V363387.R01.S.doc Version 5.2 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!