Care Home: Haywood Oaks Care Home

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What the care home does well Prospective residents and their families are given the information they need to make an informed decision about moving to the home. Staff are aware of individual needs and ensure they are met in an environment that supports and respects them Maintenance is carried out to ensure residents live in a safe environment. Activities are arranged that are suitable to the needs and abilities of the residents. The meals provided are nutritious and appetising and residents are given a choice. There is a consistent staff group who have time to spend with residents and get to know them. The manager is organised and very aware of her responsibilities as a registered manager and understands what the national minimum standards are and how they impact on the care residents receive. Residents are protected from abuse and feel able to complain to any member of staff knowing it will be dealt with. What has improved since the last inspection? As there is a new provider this home is classed as a new service. However the provider has started a refurbishment plan. New windows and doors have already been put into 50% of the home and a new more efficient laundry system has been obtained as well as a new dishwasher. There are new carpets to parts of the building and outside the garden has been improved. What the care home could do better: The manager could check the needs of residents against staffing numbers on the afternoon shift. CARE HOMES FOR OLDER PEOPLE Haywood Oaks Care Home Kirby Close Blidworth Mansfield Nottinghamshire NG21 0TT Lead Inspector Susan Lewis Unannounced Inspection 7th November 2007 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 DS0000069949.V352263.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. DS0000069949.V352263.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Haywood Oaks Care Home Address Kirby Close Blidworth Mansfield Nottinghamshire NG21 0TT 01623 795085 01623 795085 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) Haywood Oaks Ltd Mrs Dawn Ellis Care Home 20 Category(ies) of Dementia (20), Old age, not falling within any registration, with number other category (20) of places DS0000069949.V352263.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered persons may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission are within the following category: Old age, not falling within any other category - Code OP. Dementia - Code DE. The maximum number of service users who can be accommodated is 20. New Service 2. Date of last inspection Brief Description of the Service: The fees for 2007/08 are £290-£344. The fees do not cover hairdressing or chiropody. Copies of inspection reports can be found in Statement of Purpose, which is kept in the reception area. The service is a purpose built home and is located on a housing estate near the centre of Blidworth and its facilities. Bedrooms are on two floors; the upper floor can be accessed via stairs or a passenger lift. The service offers pleasant accommodation with a large lounge and dining room and a pleasant reception area. There are two toilets near the dining room/lounge as well as others located round the building and bathrooms with suitable aids to enable residents with mobility issues to use the facilities. There is a pleasant accessible garden to the front of the building with a walkway around the service itself. A small car park is located to the side of the property. DS0000069949.V352263.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This inspection involved one inspector; it was unannounced and took place over 6.5 hours, including lunchtime. The main method of inspection used was called ‘case tracking’ which involved selecting three residents and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. Some of the people who live at this home have a limited ability to understand and communicate. Therefore some judgements in this report are from observation of staff and resident interactions One member of staff and five relatives were spoken with as part of this inspection. In addition the views of two other residents who were not part of the “case tracking” were sought to form an opinion about the quality of the service. Documents were read as part of this visit and medication was inspected to form an opinion about the health and safety of residents at the home. A partial tour of the building was undertaken, all communal areas were seen and a sample of bedrooms to make sure that the environment is safe and homely. A review of all the information we have received about the home since the last inspection was considered in planning this visit and this helped decide what areas were looked at. Relatives interviewed said they were given a brochure about the home to help make a decision before their loved one moved in. The registration document was viewed as part of this inspection and it has recently been amended to include the new registered providers details. What the service does well: Prospective residents and their families are given the information they need to make an informed decision about moving to the home. Staff are aware of individual needs and ensure they are met in an environment that supports and respects them DS0000069949.V352263.R01.S.doc Version 5.2 Page 6 Maintenance is carried out to ensure residents live in a safe environment. Activities are arranged that are suitable to the needs and abilities of the residents. The meals provided are nutritious and appetising and residents are given a choice. There is a consistent staff group who have time to spend with residents and get to know them. The manager is organised and very aware of her responsibilities as a registered manager and understands what the national minimum standards are and how they impact on the care residents receive. Residents are protected from abuse and feel able to complain to any member of staff knowing it will be dealt with. 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. DS0000069949.V352263.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 DS0000069949.V352263.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. Prospective residents are provided with the information they need to make an informed choice and are assured that staff have the skills to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three care plans were looked at and all three showed evidence that the manager had obtained a copy of the Community Care Assessment from social services and had carried out an assessment prior to the person coming to the home. This was confirmed in discussion with staff who said that the manager visited residents prior to them moving to the home. The manager said that DS0000069949.V352263.R01.S.doc Version 5.2 Page 9 prospective residents could visit the home for a trial period before making a decision to move in. Relatives spoken with said that although their loved ones hadn’t been able to visit they had visited prior to them moving in and had felt welcomed by the staff and staff had been very supportive in helping to settle their loved one into the home. Clear information about contracts/terms and conditions, fees and extra charges is available for families and prospective residents. The staff and manager see there is a high value in responding to individual needs for information, reassurance and support. Care plans are drawn up from the assessment and are sensitive to the persons cultural needs and reflect the individuals choices. Intermediate care is not provided in this service. DS0000069949.V352263.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. Resident’s personal and health care needs are met and they are treated with respect and dignity. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three care plans were viewed and provided information about the person care needs including how the person wanted to spend their day their likes and dislikes as well as what care was needed to maintain the persons health and wellbeing. Risk assessments were in place to ensure their safety was maintained including where bedrails were needed. DS0000069949.V352263.R01.S.doc Version 5.2 Page 11 Where residents had higher care needs care plans reflected this and diary notes confirmed that where necessary doctors and district nurses were called. A visiting health care professional was spoken with and said that staff contacted the team when they needed advice and followed any advice given. Staff spoken with said they found the care plans useful and helped determine what care each resident was provided with. Residents spoken with were not always familiar with care plans but family spoken with were and said that they were involved in reviews and in the creation of care plans. Specialist equipment was used to support residents where needed such as where a resident was at risk of falls in the night a pressure mat was used to indicate to staff if they had got out of bed without calling for assistance and then could ensure they remained safe. The medication round was observed and the person administering the medication understood that she must sign the medication administration records after giving the medication to the person. The manager said the person administering was due to be retrained and was currently being observed due to a long period of sickness to ensure her practice remained safe. The medication administration records showed no unexplained gaps. Medication is stored in a locked room, in a locked trolley and locked to the wall. The community pharmacy inspector had been twice and had not found any concerns. The manager has set up a very good audit system where by she records all medication coming in and their expiry dates, any close to their expiry date get returned to the pharmacy and returns records were all in order. Risk assessments are available for those residents who are able to self medicate. Staff were observed throughout the day working with residents. There was a pleasant atmosphere in the home and residents clearly felt at ease with staff and staff treated residents with respect and courtesy but also with friendliness. Staff were seen to have time to just sit and talk to residents as their time was not all task focussed. Residents were all well groomed and wearing their own clothes. Residents spoken with said that staff were always lovely and they always treated them well. Relatives spoken with said they felt the staff were also excellent. DS0000069949.V352263.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. Activities are provided that are suitable to the needs and abilities of the residents. Appetising and nutritious meals are provided at times convenient to residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Activities are seen very positively in the service. The manager provided information in the pre inspection information on the type of activities that take place these include monthly visiting entertainers as well as the local vicar who takes a communion service. Information was widely available about forthcoming activities such as the Christmas Fair and residents spoken with told me about the Halloween party they had last week, which they all enjoyed. DS0000069949.V352263.R01.S.doc Version 5.2 Page 13 Pre inspection relative surveys received also spoke positively of the activities and relatives spoken with on the day said that they were encouraged to come to any party held at the home. Care Plans detailed residents preferences and staff were aware of this and said they did what they could to ensure residents spent the day as they wanted to. A resident spoken with said that he always did what he wanted to this was confirmed by relatives. Relatives were clearly welcomed to the home by staff and there was a pleasant rapport and atmosphere in the home amongst staff, residents and relatives. Residents were supported to remain as independent as possible. This was seen with the chiropodist he confirmed that some residents paid him directly whilst the manager paid for others out of their personal allowance. Information was available in diary notes about residents going out with their family and on occasions with staff. Bedrooms were personalised and pleasant. The manager also encourages residents to help where possible around the home and after a risk assessment to be involved in domestic activities such as washing the pots or wiping tables. The midday meal was observed it was braised steak and vegetable with potatoes. There was an alternative for those who wanted, Residents spoken with said they liked the food and had a choice. Relatives spoken with said that they thought the food was very good from what they had seen. The cook was on leave but the person covering understood about special dietary needs and ensuring people with pureed diets had it presented correctly. All fridge temps and records were up to date the manager has know introduced the Environmental Health Office audit system. Drinks were seen being served throughout the day. DS0000069949.V352263.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. Residents’ and relatives feel able to raise concerns, feel they would be listened to and any concern would be acted upon. Staff understand their responsibilities in protecting residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From pre inspection information the manager reports that there has been no complaint received about the service. The Commission has not received any complaints regarding this service. Resident spoken with said that they would complain to any of the staff if they needed to but hadn’t needed to. Relatives spoken with said that they would either speak to the manager or if she wasn’t available any of the staff as they felt it would be dealt with. Staff said that if a resident raised any concerns they would try to deal with it straight away but also inform the manager. DS0000069949.V352263.R01.S.doc Version 5.2 Page 15 Staff were aware of what was abuse and from staff training records it was clear that they had received Safeguarding adults training which covered what constituted abuse how to recognise it and what to do should they suspect it. Staff were aware of the whistle blowing policy and what their duty of care was. Policies were in place to protect residents from financial abuse and procedures for looking after their personal possessions and money were strictly adhered to. DS0000069949.V352263.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. Residents live in a homely, clean environment, which is being refurbished and maintained to a good standard. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Although the home is in need of some refurbishment it was clear both from the pre inspection information and from discussion with the manager that the provider is aware that this needs doing and has started a programme of refurbishment by putting new carpets in part of the service, new windows and doors in 50 of the Care Home. There are improvements in the garden and roof maintainence has been carried out as well as a new dishwasher has been purchased. DS0000069949.V352263.R01.S.doc Version 5.2 Page 17 The manager also discussed plans to make the garden more secure so residents with dementia can go outside unrestricted in the warmer weather. The laundry is separate to the communal areas and soiled laundry is not carried through areas where food is prepared or eaten. A new and more efficent laundry service has been bought as part of the refurbishment. The new tumble drier has a safety mechanism that if it overheats and catches on fire it self extinguishes. All areas of the service viewed were clean and free from unpleasant odours. Preinspection surveys indicated that residents and relatives felt the home was always kept clean and fresh DS0000069949.V352263.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. Residents are supported by well-trained and competent staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents and relatives spoken with and pre inspection surveys indicated that they felt there were always staff available when they needed them. Staff rotas were available and indicated that during peak times such as morning and evening staff were available in sufficient numbers to meet residents needs. In the afternoon there are only two care staff on duty for twenty residents. There was no indication from diary notes or excessive accident records that this staffing ratio caused poor outcomes for residents; observation also showed that staff had time to sit with residents and chat. However there is a resident who is confined to bed who requires two care staff if transferred at any time. If staff were needed to assist this person during the afternoon it would mean that residents in the rest of the building were potentially alone for that period of time. There is potential for residents to be at risk during this time. DS0000069949.V352263.R01.S.doc Version 5.2 Page 19 This was discussed with the manager who said that this had never been an issue due to the needs of the person. There are currently 50 of staff with National Vocational Qualification level 2 in care and a further two staff either part way through or just started. With a new member of staff due to start after he has completed his induction. Staff files were viewed to check the correct process for recruitment had been followed they were well ordered with all the information easily accessible. Each new member of staff had a Criminal Records Bureau and two references prior to starting work ensuring that they are suitable to work with vulnerable adults. Equality and diversity was discussed and there are policies and procedures for anti discriminatory behaviour as well equal opportunity employment policies Staff training records indicated that staff had access to a wide range of training including specialist training to work with people with dementia as well as all mandatory training such as fire, moving an handling infection control, it was clear from evidence seen in supervision notes that each member of staffs training needs was discussed in supervision. Staff spoken with said that the manager supported them to attend training. DS0000069949.V352263.R01.S.doc Version 5.2 Page 20 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 and 38 Quality in this outcome area is good. The home is well run in the interests of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Pre inspection information showed that the manager attends regular training to maintain her knowledge and skills level. Residents, staff and relatives spoke highly of the manager saying she was approachable, caring and hardworking. Pre inspection relative surveys also DS0000069949.V352263.R01.S.doc Version 5.2 Page 21 commented that she always willing to help and listen treating everyone with respect and dignity. The manager carries out regular quality assurance surveys with residents and the results of these can be found in the statement of purpose, which can be found in the reception area. Staff and manager also spend time getting to know what residents’ want and those spoken with said that they felt consulted about what happened in the home. Resident’s finances are well maintained and stored securely with two signatures required to show what the money is used for ensuring residents finances are protected. Documents were viewed to show that the home is well maintained and fire checks are carried out regularly and staff have all mandatory training such as infection control, manual handling and fire safety. DS0000069949.V352263.R01.S.doc Version 5.2 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 DS0000069949.V352263.R01.S.doc Version 5.2 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. 1 Refer to Standard OP27 Good Practice Recommendations Staff are available at all times to meet the dependency levels of the residents particularly where two carers are required to care for a resident. DS0000069949.V352263.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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. 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