Care Home: Oak House

Similar services:

• The Shelley
• Springfield House
• Sutton Lodge Nursing Home
• St Helier`s Residential Hotel
• St Joseph`s
• Ridgemount
• Wingham Court
• Old Hastings House

What the care home does well The home is now providing a good service to the service users living at the home. Contact with family and friends are encouraged and residents are able to entertain their visitors in the privacy of their bedroom if they so wish. The manager complies with given requirements under the Care Homes Regulations 2001 within the given timescales. The documentation of individual care plans is easy to read, gives the reader a full picture of the residents` likes and dislikes, communication needs and risk assessments and care needs. The manager has demonstrated that she has researched and tried out a number of Nutrition Assessment tools and have decided on the one that is most suitable for the service users, linking this to a well known tool for Body mass Index (BMI) measurements. Observations of care staff interaction with residents indicated that residents are treated with dignity and respect. It was also observed that great care was taken in respect of the residents` personal belongings and standard of cleanliness in bedrooms ensured residents lived in a well-maintained environment. The home has demonstrated its preparation to cater for residents from ethnic minority by ensuring each member of staff attend the Equality and Diversity course which the home provided with an outside trainer. What has improved since the last inspection? All requirements issued on the last inspection have been actioned within the given timescales. CARE HOMES FOR OLDER PEOPLE Oak House 19 Queens Road Weybridge Surrey KT13 9UE Lead Inspector Mavis Clahar Unannounced Inspection 4th February 2008 09:25 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 Oak House DS0000049203.V358012.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. Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oak House Address 19 Queens Road Weybridge Surrey KT13 9UE 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) 01932 851925 mandie@surreyresthomesltd.co.uk Surrey Rest Homes Ltd Mrs Yvonne Connock Care Home 16 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (3), Old age, not falling within any other of places category (16) Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age range of the persons to be accommodated will be over 65 years of age with the exception of one resident aged 60 - 65 years. 18th December 2007 Date of last inspection Brief Description of the Service: Oak House is a large detached property situated within walking distance of Weybridge town centre. The home provides accommodation and care for up to 16 older people, 4 of who may also have dementia. The home has a large TV lounge, a smaller quiet lounge and a separate spacious dining room. All bedrooms are single occupancy and are arranged over two floors, all except one have en-suite facilities. Bathrooms are situated on the ground and first floor and both have a chair hoist fitted. There is also a further toilet on the ground floor. A passenger lift or stairs is available to service users to reach the first floor. The home has a good sized, enclosed and well- maintained rear garden that is accessible to the service users. The current fees range from £450 - £593 per person per week. Oak House DS0000049203.V358012.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 stars. This means that people who use this service experience good quality care. A Random Focus Inspection was carried out on the 18th December 2007, which generated three requirements, which were actioned within the agreed time scale. Safeguarding issues are being investigated by Surrey County Council Safeguarding Adults Team. This unannounced site visit, which forms part of the key inspection undertaken by the Commission for Social Care Inspection, (CSCI) was completed by Mrs Mavis Clahar on the 4th February 2008 and lasted for six hours and twentyfive minutes, commencing at 09:25 hours and concluding at 15:00 hours. The first part of the visit was spent with the registered manager of the home, discussing and agreeing how the inspection process would be conducted. This was followed by discussion about the Annual Quality Assurance Assessment (AQAA) she submitted to CSCI in August 2007, the training needs of the care workers and how these needs were being identified and met, and employment and induction of new care staff. A review of the requirements given at the last key inspection and Random Focus Inspection was undertaken and these were all completed within the agreed time scale. A review of service users’ files and care workers records was undertaken and all found to be in good order. A management decision was made not to request a second AQAA The second part of the visit was spent reviewing service users’ notes, which were up to date and sampling selected policies and procedures. The information contained in this report is gathered from service users’ notes and records kept by the home, from information contained in the AQAA, from relatives’ feedback in the pre inspection questionnaires and from discussions with service users. Information was also gathered from direct observation by us (the commission), along with discussions with care workers. Time was spent visiting and discussing with service users and observing lunchtime activities. Service users were enthusiastic about their home and the service they receive. Service users spoken to said they enjoyed their lunch, which was prepared freshly in the home’s kitchen. Time was spent observing the presentation of the meal, care workers and service users’ interactions and Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 6 to obtain feedback on the meal, its suitability, taste, texture and amount. The inspector observed that portions were varied to suit the appetite of the service users and that they all ate their meal in a very social gathering, all sitting at tables which were laid for four, with a small vase of flowers and condiments. Service users commented positively on their meal, and the food served at the home in general. Many service users spoke highly of the choice of beverages they were offered during the mid-day meal, and it would appear that the glass of sherry with their meal was very much appreciated. A tour of the home was undertaken and it was observed that service users’ bedrooms were kept in good condition, both decorative and clean and tidy. Generally, the home presents as clean and tidy. However, it was noticed that the kitchen needs cleaning and safe storage of dry food and two requirements were made to rectify this. Also the home must reassess their method of storing medication during administration of medicines to ensure the safety of the service users. A requirement was also issued. The inspector would like to thank all the residents and care staff that made the visit so productive and pleasant on the day. The final part of the visit was spent giving feedback to the manager about the findings of the visit What the service does well: The home is now providing a good service to the service users living at the home. Contact with family and friends are encouraged and residents are able to entertain their visitors in the privacy of their bedroom if they so wish. The manager complies with given requirements under the Care Homes Regulations 2001 within the given timescales. The documentation of individual care plans is easy to read, gives the reader a full picture of the residents’ likes and dislikes, communication needs and risk assessments and care needs. The manager has demonstrated that she has researched and tried out a number of Nutrition Assessment tools and have decided on the one that is most suitable for the service users, linking this to a well known tool for Body mass Index (BMI) measurements. Observations of care staff interaction with residents indicated that residents are treated with dignity and respect. It was also observed that great care was taken in respect of the residents’ personal belongings and standard of cleanliness in bedrooms ensured residents lived in a well-maintained environment. The home has demonstrated its preparation to cater for residents from ethnic minority by ensuring each member of staff attend the Equality and Diversity course which the home provided with an outside trainer. Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 7 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. Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 8 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 Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 9 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): Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. Prospective service users and their relatives have the information needed to choose a home, which will meet their needs and service users are being assessed to ensure the home is capable to meet the needs of the service users prior to being admitted into the home. EVIDENCE: Review of service users documents, Annual Quality Assurance Assessment (AQAA) and identified policies demonstrated the home has a policy and procedure on admission and discharge of service users. Within the admission policy all service users must have an assessment prior to being admitted into the home. The manager who is trained in the principles of assessment of service users’ needs based on what the care the home says it will provide carries out all pre admission assessments of service users prior to them being admitted into the Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 10 home. Where the service user is assessed by social services a copy of the assessment and care plan is received into the home prior to them making a decision to admit the service user. Review of a random sample of service user’s files including one recently admitted service user, demonstrated that pre admission assessments are being carried out. Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 11 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a good and clear care plan in place for service users, which also includes appropriate risks assessments. This forms the basis for care based on the agreed care needs of the service users and demonstrated that health and personal care needs were met. Care staff receives training to meet the assessed care needs of the service users ensuring that competent staff supports service users and their health and care needs are met. The home’s medication policy on receiving, storing and administering of medication was in place But not being adhered to in the storage area, thereby not ensuring the safety and protection of the service users during administration of medicines. Care workers treated service users with respect and maintain their dignity and privacy when delivering personal care. EVIDENCE: Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 12 The randomly selected care plans were clear and easy to read, identifying potential and actual risks to service users and detailing how these risks would be managed. The daily work sheet along with discussion with service users and care workers demonstrated that service users care needs are met. The service user or relative and the Carer in charge sign all care plans reviewed. Information contained in the care plans; relatives and service users response to CSCI pre inspection questionnaire and discussion with care workers supported this. We reviewed up to date accidents records, audits of falls, which was enclosed in the personal files of the service user and also contained on a spreadsheet, which is sent to head office on a monthly basis. We were told that as a result of auditing these falls, two members of staff are now allocated to work together and this is having a good result. We also noted that records of personal care given or refused with documented evidence of reason for refusal were available for review. All service users are registered with a local General Practitioner (GP) of their choice and visits are recorded, with access to specialist healthcare professionals through their GP practice as required. Service users are offered a six weekly access to chiropody service, six monthly dental or as required services and six monthly community optician service. We were told that no service user on the day of the visit was being cared for in bed and this was supported during the tour of the premises. Care staff identified as capable to administer medication are requested to leave a sample of their signature, which is dated in the medication trolley. All service users have a recent photograph included in their medication record to reduce the risk of mistakes happening during medication administration. No service users were assessed as capable to self medicate. Medication records were checked and found to be correct as documented on the Medication Administration Record (MAR) sheet. There was no one on Controlled medication on the day of the visit. We observed the medication cupboard left open and medicines left on the floor for a long period of time whilst the carer completed the medication administration. A requirement was issued on this standard. Three relatives, and one service user responded to the CSCI questionnaires and all stated they were mainly happy with the care given to the service users. Relatives wrote the staff are always polite to them and they were free to visit any part of the home their relative/client was using. All three relatives referred to the recent change around of staff at the home. One relative wrote, “I am quite concerned about recent staff changes at the home whereby staff were sent to other homes at very short notice. I think this is very upsetting for the residents”. We observed that care workers did not wear name badges to enable visitors and service users with memory impairment to be sure of Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 13 whom they are speaking with. A recommendation of good practice was made on this standard. We observed service users being treated in a friendly but respectful manner by care workers. It was noted that care workers communicated amongst themselves and with the manager and with the service users in English. However, it was also noted that their English was not standard and elderly people might not be able to understand them. This aspect was also raised by relatives in the CSCI questionnaire “ I think residents sometimes have difficulty in understanding staff- perhaps their English is not clear and possibly they don’t speak clearly enough”. In discussion with the manager we were told this is being addressed, as it was mainly a cultural thing where the overseas carers show respect to the elderly by not speaking loudly to them. In discussion with a number of service users we were told that they are treated with respect and dignity, and that they are able to make their own choice. A sample of comments made by service users is included; They told us “I am very happy here. Everything is so nice”. “I have my own room; I can have as much privacy as I want”. “We have good staff here; they are kind to me. I choose my own clothing every day”. “Any issues I have I speak to the manager and it is sorted.” One relative wrote “My relative is very frail now and needs constant help and guidance when she wants to get up or go to bed and when she goes to the bathroom or dining room. I feel fairly confident she receives this help but she does have the occasional fall.” Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 14 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. Service users are involved in meaningful daytime activities of their own choice and according to their individual interests and capabilities. Care workers are sensitive to the needs of those service users who find it difficult to eat and give assistance with feeding. They are aware of the importance of feeding at the pace of the service user; thereby respecting the service user’s dignity and making them feel comfortable, safe and unhurried. EVIDENCE: The home employs a care worker who also undertakes the role of Activities coordinator. We were told that since the last inspection the home has made adjustments to the activities provided for the service users. This was mainly through discussions with service users at the residents meeting. Service users were asked what type of activities they would like and their wishes are then transferred on to the plan. We noticed that there were no craft included and was told the service users did not want any and this came over loud and clear at the residents’ meetings. Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 15 The carer/activities co-ordinator has contacted Alzheimer’s Society and Age Concern for help and direction in providing suitable activities for people with Dementia. We noted that a record of daily activities for each service user was kept in an Activities folder. On the day of the inspection we noted that some service users were participating in “Ball games with music” whilst others were taken in their wheelchairs for a stroll around the grounds. One service user told us he enjoys a game of dominoes and regularly beat one of the male care worker who plays with him. A list of activities was available for review, and the manager told us “that although all service users were encouraged to participate in activities, and whilst we encourage participation we respect the decision of any resident who expresses a wish not to take advantage of any activities on offer”. One relative commented “I think it is very difficult to keep elderly people motivated and happy but I would like to see more activities taking place and more music played of the type to suit the age of the residents, and also more thought required as to the TV programmes showing. I think Nature and wildlife programmes, dance, documentary if the subject is interesting, ceremonial, i.e. Trooping the Colour, Remembrance Day should be considered. Cartoons should not be shown”. The inspector did not observe any visitors to the home during the visit, but on checking the visitors book there was a good record of visitors that day to the home. In discussion with service users they told us they have visitors and they can visit whenever they have the time and this was supported in discussion with care workers and the manager. We were told by the manager that she had contacted the local C/E church and asked the Vicar to arrange services or visit to the home, and was turned down as the Vicar said he had no capacity to fit the home in. We were also told that one service user relative promised to investigate Church service for the home from another source. Only one service user expressed a wish to attend Church service and when asked she decided not to attend, even though a member of staff was able to accompany her. In discussion with service users they confirmed what the manager told us. They told us they were not really bothered about not having religious services at the home or to go out to church. Catering facilities are managed and carried out by the homes’ Cook. On the day of the visit one carer who has had training in safe handling of food and food hygiene prepared the meal. She told us she has been with the company for many years, but has only recently moved to this home. She was able to discuss the dietary needs and preferences of the service users. On the day of the visit the service users were served their mid-day meals from the previously agreed main menu, which included a note at the bottom advising service users of their right to choose something different if they did not want the set meal. The inspector did not sample the meals, but the service users all Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 16 said the food is good, the texture just right and the amount was what they ordered. It was observed that the dining room was pleasantly decorated, and that staff interactions with service users were friendly but professional. For those service users who needed help with feeding we observed the care worker sitting beside the service user whilst performing this task. On one occasion we noticed a care worker standing to help a service user with her meal, and in discussion with the care worker we were told that she stands to protect her face as the service user unknowingly lashes out without warning. This statement was supported by the manager who told us they have risk assessed this service user and decided this was the best way to help her and keep staff safe. Service users were served sherry or fruit juices with their main meal, and in discussion with some service users they told us they look forward to their glass of sherry at lunchtime. We noticed that the menu card was very busy and could cause people with poor or diminishing eyesight difficulties in reading it. Also the diagrams on the menu were not appropriately placed. Following full discussion with the manager it was recommended that the menu card be redesigned to make it clearer and easier for service users to read. Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints policy and procedure and training in place that evidenced that service users and relatives concerns are listened to and acted upon. Robust Safeguarding adults’ policies are in place to protect the service users from abuse. EVIDENCE: CSCI received no complaints against the home since the last inspection. No complaints were logged at the home, and the manager informed us that she is in touch with service users on a daily basis and issues raised are dealt with immediately; this prevents any need for service users to complain. Service users spoken to said they have no need to complain, as they are able to discuss everything with the manager. Information contained in the relatives’ questionnaire indicated they knew how to complain and to whom they would complain if the need arises. Comments such as, “I would speak to the manager or the owner” “I would contact social services” “Generally I have no specific complaints” were included in their responses. The home has a complaints procedure and policy, which is fully adhered to. The care workers were aware of the homes’ policy and procedure on Safeguarding Adults and felt secure in the knowledge that if they had to use Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 18 the whistle blowing procedure the manager/ Owner of the company would support them. The home has received a number of complimentary letters and cards from relatives of service users, commenting in a positive way about the care their relatives’ received at the home. A random sample of care workers training record demonstrated that care workers are being trained to undertake the duties of meeting the service users assessed needs, thereby protecting them from abuse. Planned programme of update on Safeguarding Adults are in progress. Posted around the home (dining room, sitting room and office) are written instructions, and flowchart instructions with telephone numbers for staff, service users and visitors to the home on how to contact the Surrey Safeguarding Team. Social Services cards with telephone numbers for various areas are also available. Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally clean and tidy but there are areas in the home where hygiene issues which could result in cross infection needs to be addressed. Hygiene equipment is available but this is not always fully utilised EVIDENCE: The manager told us that staff encourages the service users to view the home as their own home. We observed that the home presents as comfortable with some aids to meet the service users’ needs. We observed that service users appeared happy in the company of the carers and with each other. This was supported by comments made by one relative who wrote, “ I like the fact that all residents are encouraged to sit in the lounge together and are not left in their bedrooms. The atmosphere in the home is usually good and happy”. Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 20 We observed that service users bedrooms were clean and odour free and that their personal belongings were stored safely, all clothing folded or hung on hangers. Service users were able to personalise their bedroom and the manager told us service users are consulted about the décor of their bedrooms when it needs redecorating. The home has attractive gardens, which are well maintained and there is good access to the gardens from various parts of the home. Some service users told the inspectors that they try to go out daily weather permitting to enjoy the gardens and this was observed to be true. The inspector noted that adverse weather would not stop service users enjoying the garden, as the windows are low enough to allow service users to view the gardens from their armchairs. In discussion with the carer who was working as the cook regarding the state of the kitchen, we were told that no time was allocated for deep cleaning. A requirement was made to have the cooker hood cleaned. We observed dry foods, which were opened such as flour, pastry mix; tea bags being stored in an open cupboard that was quite dusty. In discussion with the carer/cook, we were told no time is allocated to her for cleaning, as she has to work the afternoons out on the floor doing care work. In discussion with the manager she did not uphold this statement. A requirement was issued to provide a cupboard with doors in which to keep open dry foods, and a recommendation of good practice was made to ensure the person working as cook in the kitchen does not work on the floor with service users, as there is the possibility that this action could increase the risk of cross infection in the home. Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 21 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. Staff in the home are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the changing needs of the service users. EVIDENCE: The staff rota demonstrated the number and grade of staff on duty to provide care and attention to service users for any twenty-four period was suitable to meet the assessed care needs of the service users. The home has a programme of planned training in place and all members of staff have an individual training record. A number of care workers have attained the National Vocation Qualification at Level 2 (NVQ L2). Care workers are encouraged and enabled to undertake developmental training as well as the mandatory training. . One newly appointed staff was in the process of undertaking the Skills for Care Common Induction programme. Care workers files reviewed indicated that care workers are Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checked prior to commencing employment, and they are in receipt of terms and conditions of employment, as evidenced in their randomly selected files, which contained the information required under care Homes Regulations 2001 Schedule 2. Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 22 The manager told us that supervision records were up to date and this was verified during random sampling of care workers files. Documented evidence indicated that the home ensures that care workers receives the mandatory training with yearly updates planned as necessary to maintain their competency to fulfil their duties. This was evidenced through discussion with the manager and care workers and from review of planned training records. Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 23 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has the experience to run the home and works to continuously improve services and provide an increased quality of life for the service users. There is a strong ethos of being transparent and open in all areas of running the home EVIDENCE: The manager of the home has been in post since May 2007. She informed us she took her completed manager’s application to the Wimbledon office and was instructed to take it to Southampton or Oxford. At the time of the visit the application was not sent in. We advised her to use the London office Finlaison House, as she was so wary of travelling to Oxford or Southampton. She is currently undertaking the Registered managers Award with a local Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 24 College. She told us she has had ten years experience working with the elderly. We were told that improved quality audits were in place to monitor staff, relatives and service users concerns and views. Minutes of staff and service users meeting were available. We were also told that all requirements made at the last key and random inspections were actioned and this has resulted in improvements in care to service users. We were told that the service users are not all capable to be fully involved in the running of the home, but their relatives are encouraged to be as involved as their time allows them to be The home does not become involved in service user’s finances. The relatives/court of protection manages all their finance. Only small amount of spending money is kept for some service users and good records are kept with receipts for any expenditure. Review of documented records demonstrated that health and safety checks are routinely carried out at the home. All equipment examined on the day was properly maintained. Records indicated that fire drills, fire alarm, and water temperature were regularly checked. Random sample of care workers’ training files demonstrated that up to date and relevant training were carried out by care workers to protect service users’ health, welfare and safety. In discussion with care workers they discussed their understanding and implementation of appropriate procedures to safeguard service users. Furthermore they spoke about their understanding of promoting safe working practices based on their health and safety training. Throughout the service there is a highly evolved understanding of the equality and diversity needs of the individual service users (all staff had very recently completed the course). Care workers are confident in delivering high quality outcomes for service users in the areas of age, sexuality, gender, disability and belief. Although the care workers are knowledgeable about issues relating to race and equality and diversity amongst the staff group, they are not able at the moment to put this knowledge into practice, with service users, as the current service users are all Caucasians. Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 25 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 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 17 X 18 3 2 X X X X X X 2 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 Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 26 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 OP19 Regulation 16 (g) Requirement The registered provider must ensure that all areas of the kitchen is kept in a clean condition, particular attention is drawn to the cooker hood The registered provider must ensure that suitable storage with doors is provided for open dry foods. The registered provider must review their practice of safekeeping of medication especially during administration of medicines. Timescale for action 05/02/08 2 OP26 23 (k) (1) 22/02/08 3 OP9 13(2) 05/02/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP27 Good Practice Recommendations Employ domestic staff in sufficient numbers to ensure staff working in the kitchen does not work with service users. Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Oxford Office 4630 Kingsgate Oxford Business Park South Cowley Oxford OX4 2SU 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 Oak House DS0000049203.V358012.R01.S.doc Version 5.2 Page 28 - 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!