Care Home: Oak Mount Rest Home

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 The home provides a home-from-home atmosphere that is welcoming, friendly and cheerful. A positive outcome for the residents is the high number of regular visitors who call in every day, or very frequently. The style of leadership coming from the manager to the staff team makes for an environment where people can express themselves, be heard and understood. The residents have said, `I endorse this place 100%.` and `I can`t speak too highly of them.` One said, `I thought I was coming to a dump, and I found I`d landed in heaven`. Comments from the residents about the meals and also the in-house activities are very positive. `I have a very small appetite but the meals are very good`. `I am very happy with the food. I think it`s of a very high standard`. `They go out of their way to get a meal you like`. `Everything is very, very good. The food is good. They are very understanding if there`s something you don`t like`.`They have entertainment and exercises. There is usually something going on`. `My mother loves all the activities, especially the music, singing and `extend` sessions`. What has improved since the last inspection? The home has completed an internal quality assurance assessment by collecting views from the people who live in the home and their visitors, and received very positive feedback. As required in the last inspection report the manager has reviewed in detail the medication procedures and the changes have strengthened the whole process from prescription to discharge. A system of computerised records has been introduced to facilitate updates of the care plans as care needs change, and potentially all the records the home keeps. A number of rooms have been redecorated and provided with new furniture. New chairs have made movement in the dining room easier. An additional shared toilet has been provided, a new en-suite and a redesigned wet room. Air hand dryers have been provided in two of the shared bathrooms. CARE HOMES FOR OLDER PEOPLE Oak Mount Rest Home 2 Narrow Lane Poulner Ringwood Hampshire BH24 3EN Lead Inspector Joy Bingham Unannounced Inspection 25/06/08 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Oak Mount Rest Home DS0000011855.V365460.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 Mount Rest Home DS0000011855.V365460.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oak Mount Rest Home Address 2 Narrow Lane Poulner Ringwood Hampshire BH24 3EN 01425 479492 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) domfoot@hotmail.com Mr M J Foot Mrs H A Foot Linda Bath Care Home 21 Category(ies) of Dementia (21), Dementia - over 65 years of age registration, with number (21), Mental disorder, excluding learning of places disability or dementia (21), Mental Disorder, excluding learning disability or dementia - over 65 years of age (21), Old age, not falling within any other category (21) Oak Mount Rest Home DS0000011855.V365460.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in categories MD and DE must be at least 60 years of age. 16th August 2007 Date of last inspection Brief Description of the Service: Oakmount Rest Home provides accommodation and care for 21 residents in the categories Old Age, Old Age with dementia and Old Age with mental disorder. People in the categories Dementia and Mental Disorder may not be admitted under the age of 60 years. The service has a registered manager who is in day-to-day control of the home. Mr. M. and Mrs. H. Foot own the service with a second home in Southampton. The property is a large family home that has been extended to provide accommodation on two floors. All bedrooms are single and 7 have en suite facilities. There are two bedrooms currently shared by two couples with the second bedroom allocated as a sitting area. Shared areas comprise a dining room, large lounge and conservatory. Upstairs rooms are reached by a stair lift. The ground floor does not have level access to all areas, as there are a number of single steps to communal areas and some bedrooms. Because of this the home is unable to offer accommodation to residents who need to use a wheelchair. The home is situated at the end of a quiet residential road, close to local shops, amenities and public transport. The current fees range between £430- £450 per week and are inclusive of all meals, non-alcoholic beverages, laundry, home run entertainment and activities. The providers gave this information during the inspection process. Oak Mount Rest Home DS0000011855.V365460.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 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, family members, stakeholders and staff. An unannounced visit to the home was carried out on 25 June, lasting a total of 7 hours 15 minutes. During this time we were able to have a partial tour of the premises, including five ground floor bedrooms and a number on the first floor, the lounge and large conservatory, kitchen, dining room, laundry, bathrooms and toilets. We had private discussions with the manager and two staff, six visitors, including a district nurse 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 provides a home-from-home atmosphere that is welcoming, friendly and cheerful. A positive outcome for the residents is the high number of regular visitors who call in every day, or very frequently. The style of leadership coming from the manager to the staff team makes for an environment where people can express themselves, be heard and understood. The residents have said, ‘I endorse this place 100 .’ and ‘I can’t speak too highly of them.’ One said, ‘I thought I was coming to a dump, and I found I’d landed in heaven’. Comments from the residents about the meals and also the in-house activities are very positive. ‘I have a very small appetite but the meals are very good’. ‘I am very happy with the food. I think it’s of a very high standard’. ‘They go out of their way to get a meal you like’. ‘Everything is very, very good. The food is good. They are very understanding if there’s something you don’t like’. Oak Mount Rest Home DS0000011855.V365460.R01.S.doc Version 5.2 Page 6 ‘They have entertainment and exercises. There is usually something going on’. ‘My mother loves all the activities, especially the music, singing and ‘extend’ sessions’. What has improved since the last inspection? What they could do better: There is no outstanding action from the last report. The service user guide must be updated to include all the information required by law and be kept available for the residents and for public access. Although activities are maintained inside the home people would benefit from an occasional trip out. A minibus is parked outside the home but it does not seem to have any usage. The large grounds are not all accessible to the residents. Some have commented on the steep slope at the front of the house. The residents have expressed that they would like more time with the staff. Maintenance of records and the systems in place are reasonable, but continual attention to detail for complete compliance in all areas could be improved e.g. greater definition in care plans, regular updating of the staff training matrix, completion of the behaviour chart. Some matters concerning risk assessments, provision of a wash hand basin, and electrical wiring certificate have been left with the providers. Please contact the provider for advice of actions taken in response to this Oak Mount Rest Home DS0000011855.V365460.R01.S.doc Version 5.2 Page 7 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 Mount Rest Home DS0000011855.V365460.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 Mount Rest Home DS0000011855.V365460.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): 3, 5 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. In most cases service users’ needs are adequately identified through the process of pre-admission assessments to ensure the home can meet their needs. Service users are provided with limited information that welcomes them to the home but the service user guide falls short of the full range of legally required information that should be provided. EVIDENCE: The home informed us that all potential residents are given a brochure and a very large percentage of potential residents visit the home prior to admission, usually for at least a couple of hours including a lunch. We were told this gives the potential resident a good opportunity to see the home, get a feel for the atmosphere, as quite often it will have been family members who had initially viewed the home and the visiting time enables the home to acquire a more Oak Mount Rest Home DS0000011855.V365460.R01.S.doc Version 5.2 Page 10 rounded view of the clients’ needs. Every resident is then given one month’s trial residence. We asked what information the home gave out to potential residents. A copy of the brochure was supplied by the manager and a copy of the service user guide, which is the information required by law, was also requested. The brochure contains some information that is up-to-date and some that is no longer relevant. e.g Hampshire County Council is no longer the registration authority for residential care, and although the owners are present on a day to day basis there is a registered manager who is not referred to. The legal requirement is for the home to have available a service user guide meeting the information requirements of the legislation. The homes’s guide does not at present include: • A summary of the statement of purpose • The standard form of contract • The most recent inspection report • A summary of the complaints procedure • The address and telephone number of the Commission for Social care Inspection (CSCI). A copy of the service user guide is not currently readily available to each service user. Four residents returned survey forms and in relation to the pre admission assessment they said: • I had visited before moving in. I knew it had a friendly caring atmosphere • I visited the home and loved the friendly atmosphere • My mother had a day visit and enjoyed herself The home uses a pre-admission assessment form in order to assess and document the care that a client will need, taking in all aspects, including social needs. We were told that the written assessment is used to construct the plan of care that is agreed with the resident and/or their families. During the inspection four assessments were selected for people who had been admitted in recent months. Two had been admitted from their own home and two from another care service. In most cases the registered manager had conducted the assessment. In one case a representative of the owners had completed an assessment during the manager’s annual leave, and this placement had not proved to be successful. We looked at the information that had been available at the time, discussed the need for the resident’s change of care service and agreed that some clues had been missed during the assessment process that the resident required a more secure and specialist home. This was unfortunate as the behaviour was having some impact on some of the residents and making extra demands of the staff team. Oak Mount Rest Home DS0000011855.V365460.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): 7 8 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal support is offered in a way that promotes the residents’ privacy, dignity and independence. The systems for the administration of medication are good, with clear arrangements in place to ensure the residents’ medication needs are met. EVIDENCE: On arrival we saw that the majority of residents were either in the lounge or in process of arriving there. They were cheerful and smiling, although complaining of the draught from too many open windows. In appearance the residents were well presented, with cared for hands, hair and clothing. They were treated kindly and politely by the staff, with good humoured banter going in both directions. We noted conversation happening between the residents and not just with the staff. It was evident during the day that people who chose to stay in their rooms and come down for meals were enabled to do so, and those who chose to stay in Oak Mount Rest Home DS0000011855.V365460.R01.S.doc Version 5.2 Page 12 their rooms all day through frailty could also choose to. One resident whose bedroom was located directly off the main dining room said she like to have her door wide open during the day. We saw that a resident was supported to their own room when a health care professional visited to see them. Care plans for four residents were inspected. A new process has been established since the last inspection using computerised forms and the information from the earlier style of written records has been translated into the current care plans. The IT forms also provide a quick visual reference scale in each section of care to indicate to staff whether the resident is low, medium or high risk. They were found to be comprehensive in most areas, covering overall health, mobility, transfers, bathing, continence, appetite, the senses, oral health and medication, emotional and mental health, religion and language, hobbies and interests. The recent care plans have not been countersigned by the service users but the manager said that full discussion with the resident and/or their families is the next step in the process. They are updated electronically each month, and we were told they can be adjusted whenever a resident’s need changes. We discussed with the manager and the owner some aspects of the care plans that require still greater definition, e.g. ‘assistance with dressing’, could mean a variety of things such as help with stockings, assistance with buttons, or total support with every item of clothing. The manager acknowledged that aspects of these care plans need to be clearer in order to provide a working file for regular staff reference. Individual risk assessments should be completed on rooms where there are no window restrictors and those people where records indicate they are prone to falling. We were told in the AQAA (the annual quality assurance assessment) that the home has started to use an ABC chart (antecedent behaviour consequence chart) when special recording is needed for managing difficult behaviour. However, we were surprised to note that this had not been set up for the resident who was posing some challenges for the staff team and whose behaviour was having an impact on other residents. The home informed us through their AQAA that they have good relationships with other agencies (doctors, district nurses, occupational health therapists and community psychiatric nurses etc.) and they know the correct times to access their support. There was evidence in the files of medical, dental, and opticians’ visits. During the inspection one lady who was feeling poorly was asked if she would like to see her doctor and she replied she would. The doctor was present within the hour. A visiting professional said, ’it’s one of the better homes in our patch. No problems are encountered here’. Residents said: • If you don’t feel well they’ll always get a doctor. • At night staff look in every two hours. They keep an eye on me if I can’t sleep. Oak Mount Rest Home DS0000011855.V365460.R01.S.doc Version 5.2 Page 13 Although I would like to be independent I know I need more and more help. • The carers are always available when needed. From the written survey returns there was 100 satisfaction with both the care they receive and also the means of accessing medical support services. The home records the residents’ lives in a cardex system that is confidential for client access. We were told that all the staff team has a great rapport with the residents, enabling them to communicate any personal or delicate problems. The manager explained the process of drug administration from ordering through to return. The drug trolley and drug cupboard was inspected. An audit trail of most medicines was possible from the point when medicine is accepted by the home. Two doses of antibiotics had not been recorded in and this was brought to the manager’s attention. There was at least one example of a resident who self-administered her own eye drops. Eye ointment for two other people was kept in the food refrigerator. We advised the manager that any medication that requires refrigerating should be kept in a separate, sealed and labelled container. The home’s AQAA states that the previous improvements identified in the last inspection report and a further matter involving a review have strengthened the overall administration of medication. Improvements include: • Prescriptions are now checked and signed after leaving the surgery, and before going to the pharmacy. • There are photos of each individual resident on all the medication blisters and on every administration sheet. • Homely remedies have been updated and received medical certification. • Administration sheets now only contain medications that are currently in use. • A drugs returns book, supplied by the chemist is in use which allows records of returned medication to be kept in the care home and at the pharmacy, and allows records to be kept of who the medication was originally prescribed to. • The home has produced an in-house procedure, for the handling of anticoagulant drugs (e.g. warfarin) keeping up with current legislation. • Oak Mount Rest Home DS0000011855.V365460.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. Social activities and meals are both well managed and provide daily variation and interest for people living in the home. EVIDENCE: We observed that most of the residents came to the dining room for coffee and lunch and the mid-afternoon tea. Information about the lunch was put up on a notice board in the dining room. Lunch was served at 12:30 midday. The residents confirmed they had enjoyed the meal. One meal was saved for a resident who had gone out during the day with a family member. We saw that pureed meals were done in portions so they still looked inviting and had some colour. About the meals the residents said: • I have a very small appetite but the meals are very good. • I am very happy with the food. I think it’s of a very high standard. • They go out of their way t get a meal you like. • Everything is very, very good. The food is good. They are very understanding if there’s something you don’t like. Oak Mount Rest Home DS0000011855.V365460.R01.S.doc Version 5.2 Page 15 Comments from the residents about the daily activities include: • Once a week we have an art class and I enjoy that. • The manager uses her own car and takes me shopping, about once a month. • We have a communion service once a month. Everyone joins in. • It would be nice to go out but I need a wheelchair. • The home never seems to use the minibus. • They have entertainment and exercises. There is usually something going on. • My mother loves all the activities, especially the music, singing and ‘extend’ sessions. The large number of people visiting the home throughout the day was significant. We spoke privately with six of them and they told us they are always made welcome and provided with hospitality. One lady visiting a relative has a meal twice a week with their family member ’at no extra cost’. Another sibling who was visiting their parents who are both resident said how much she appreciated the fact that the home treats them both as individuals. We were told that ‘communicating things is easy’, and ‘being able to bring in their own belongings personalised everything so well’. Another said their friend has been resident for 18 months, and ‘its the happiest I have ever known them. It’s not like a home here. It’s a family’. Others said: • I endorse this place 100 . • I can’t speak too highly of them. The manager said that a list of the week’s activities are usually placed on the notice board in the dining room, but it had not been done this week. These include arts and crafts, chair-aerobics, entertainers, visiting clergy, a pantomime at Christmas, and on every day that an outside company/individual is not coming in then staff organise activities, including a sing-along, crosswords, hangman, quizzes and games. During the afternoon some exercises were taking place and a beanbag dartboard game that involved a good number of the residents. The availability of the large conservatory off the lounge provided an alternative venue for people who did not wish to join in. The owner said that a WII board has been purchased and will shortly be fitted up in the lounge when the bracket arrives. This will be providing residents with a variety of fun sport games that will help with stimulation and some armchair exercises. Oak Mount Rest Home DS0000011855.V365460.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 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are supported by a satisfactory complaints procedure. The residents feel listened to and their views matter. EVIDENCE: The residents’ survey informed us that if they were not happy about anything in the home they knew who they could talk to. Only 50 said they knew how to make a complaint. However, the home has a complaints procedure that is left available in the entrance hall. It also has a copy of the Hampshire County Council abuse policy and procedure, as well as the home’s own procedure including whistle-blowing. Three of the staff were spoken with in private. They expressed appropriate attitudes towards the support and protection of the residents and were aware of the policy of whistle blowing on poor and abusive practice. However, the home’s training records indicate that just over half of the staff have not received formal training in understanding and detecting abuse and the appropriate procedures to follow and this will be followed up by the home. Visitors told us that: • You wont find anything better. It’s very cheerful. I’ve never needed to complain-I’d soon find out how to if I needed to.’ Residents said that: Oak Mount Rest Home DS0000011855.V365460.R01.S.doc Version 5.2 Page 17 • • If you have any problems they try to understand and do what they can. They generally do help. I am very happy. I have no complaints. The complaints log included two complaints that had been processed and brought to conclusion within the timescales. There was one complaint/safeguarding matter that had been followed through but had not been notified to the CSCI under Regulation 37. The home was aware the CSCI had been notified by another route. Oak Mount Rest Home DS0000011855.V365460.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. The overall quality of the environment and its furnishings and fittings are good and provide the residents with a comfortable, homely and safe place to live. EVIDENCE: The home is located in its own large grounds up a narrow single file tarmac drive. There is parking for approximately six cars. The rest home is a converted private house that ahs undergone some extension and therefore presents as a family home. It is in a reasonable state of maintenance and the style of decoration and furnishing is in keeping. The grounds are kept tidy. There are some colourful shrubs and climbers and outdoor seating on the lawn. The ground at the front of the property is sloping and some of the paving stones are uneven and might present a hazard to an elderly person walking without assistance. One resident said, ‘the garden is a bit of a problem. You need someone with you.’ Oak Mount Rest Home DS0000011855.V365460.R01.S.doc Version 5.2 Page 19 The home’s AQAA informed us that they have made some improvements since the last inspection and these include: 1. Hand driers fitted in two of the communal toilets, as well as the staff toilet, as well as a paper towel dispenser in another shared toilet. 2. Soap dispensers are placed in all toilets. 3. Dining room chairs have been replaced with brand new chairs that have ski feet, for easier sliding. 4. The Health and Safety policy now covers outside contractors. 5. The home has an extra communal toilet and an extra en-suite toilet. 6. Lino has been replaced in one of the bedrooms, to reduce unpleasant odour. 7. A number of bedrooms have been redecorated including new furniture. We toured the home and found it to be clean and largely odour free apart from two rooms that we brought to the attention of the manager. The home accommodates two couples. The bedrooms are shared and their second room then makes a private living area for them. We made a number of points to the owner and the manager that we had noted during the walk around and they agreed to attend to the following: • Some window frames are in need of repainting. • The absence of a window lock on Room12 is a hazard and should be risk assessed. We discussed the more appropriate aspect allowed by a window catch rather than restrictive bars, if action is required following the risk assessment. • A shared toilet ion the first floor lacks a wash hand basin. • Light pull cords in some locations are very grubby • Room 11 lacks a door lock. The residents expressed satisfaction with their rooms. One said, ‘I thought I was coming to a dump, and then I realised I’d landed in heaven’. Another said, ‘I do like my room. I don’t want to change anything.’ One resident has a step down into her room from the main corridor and when she was asked about it she said she had never had any trouble with the step. Information from the AQAA indicated that the home may not have had its electrical circuitry checked for some time. Despite a search the owner could not locate a certificate and readily agreed to process a building service check of the electric installation. We looked at the fire service report and the environmental health officer’s report that contained 5 requirements. The owner said that all but one of the latter’s requirements had been completed. Access to the laundry is from outside the home. It has a commercial washing Oak Mount Rest Home DS0000011855.V365460.R01.S.doc Version 5.2 Page 20 machine with specified programming ability to meet disinfection standards, and a tumble dryer. The laundry floor is impermeable and the walls are readily cleanable. The home has an electric sluice facility on the first floor. Oak Mount Rest Home DS0000011855.V365460.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. The residents are supported and protected by a team of staff who offer a good standard of care consistently. EVIDENCE: We observed the staff interaction with the residents throughout the day. They were attentive and respectful, and there was a degree of happy banter between the staff and the residents as they moved between the rooms. The location of the manager’s work station, just off the dining room, gives her a central point for her to engage/interrupt/steer as necessary and she was observed to do that during the day. The manager informed us that the normal staff roster is to provide two carers, and the manager and the cook each day. Shift patterns follow an 8am to 2 pm and 2pm to 10pm. Two night staff are awake from 8pm to 8am. The staff duty roster was available for inspection and was up-to-date. The residents’ survey confirmed they always receive the care they need, and the staff always listen and act on what they say. Particular comments about the staff support include: • All the staff are most attentive and always willing to do anything to help. • The carers are always available when needed. Oak Mount Rest Home DS0000011855.V365460.R01.S.doc Version 5.2 Page 22 • • • The staff are very helpful and kind I would give them 8 out of 10- more if they had a little more timethey’re too busy to spend time. They’re so busy but if you call them, immediately they’re there! Four of the staff, including the manager, were spoken with in private and they confirmed their confidence in their role and satisfaction with the support they receive working at the home. We noted that the majority we spoke with had been working at the home for a number of years. They told us that training was available and they had benefited from attending relevant courses. They all expressed sound values about care and were aware of the potential of abuse in this setting and what to do if it was ever experienced or witnessed. One of the staff had just started work at the home and she told us about the style of induction which she said she had found supportive and helpful. The manager forwarded a summary copy of the training details for each member of staff shortly after the inspection, as agreed. We were told it is being put into a computerised training matrix so that the home can easily monitor who has completed relevant training and highlight when training dates are overdue. It was agreed completion of this task is a matter of priority. Recruitment records were sampled. Those inspected were found to be up-todate containing references, application forms, Criminal Records checks and Protection of vulnerable adults checks, identity checks and where necessary current working permits. Induction records were available and supervision records were maintained. We noted that there is some diversity in the team, with at least one member of staff who is foreign. This had been an issue for one of the residents but the owner detailed for us the support he had given the staff member and the action he had taken followed up with a letter to the resident concerned. The AQAA informed us that of the 14 staff members 5 have a national vocational qualification equivalent to level 2 or above, and three are working towards that. Oak Mount Rest Home DS0000011855.V365460.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): 31 33 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 good home management and leadership to staff, ensuring that the residents receive a consistent quality care service. EVIDENCE: The AQAA informed us that the owners have great confidence in the manager who has been running the home since it was registered in their names. She has worked for 23 years in care and recently won the Hampshire Care Associations’ Care Manager of the Year award. We were told that she is of good character, trustworthy and her personality sets the tone and atmosphere for the whole home, from residents through to staff. The two proprietors, with over sixty years experience between them, are also involved in the day-to-day Oak Mount Rest Home DS0000011855.V365460.R01.S.doc Version 5.2 Page 24 running of the home. The AQAA states that allowing for constraints within Health and Safety, the home is run as the residents’ wish, always promoting individual choice. It also states that 2005 was the last time that the policies and procedures were reviewed. We discussed this and discovered this was the date that major changes had been forwarded by the Care Association. We discussed with the manager the training that she has received and in particular the specialist training in mental health and dementia care. She obtained the NVQ level 4 and Registered Manager’s award in 2006 and attended the Alzheimer’s 4-day course in dementia in 2007. She expressed an open and co-operative attitude, and demonstrated throughout the day that she has a ‘hands on’ approach. We were told her joviality is a significantly buoyant element for the people who live at Oakmount and is a contributor to the happy atmosphere for family and friends who visit. The owners, who live locally, are the registered providers and they either work at the home each day, supporting the team by cooking the main meal, or on this occasion cleaning as the domestic assistant was on holiday, or visiting. As the owners keep a significant presence at Oakmount we were told that most of the overall management of the premises, building requirements, development of the business is taken off the manager. Between them there was an understanding of their respective roles, and there was mutual respect and affirmation expressed. The home has conducted its internal quality assurance review in April 2008 involving the residents, their families and friends and said they will shortly be extending this wider to the stakeholders. A copy was available in the entrance hall. A high rating of 91 was concluded, with positive comments about the family atmosphere and friendliness of the home. Attitudes towards the staff were very positive. Two negative comments related to staff levels, and one about the steep nature of the garden. We discussed the recording and safe keeping of monies held for the residents. The provider explained that he does not process personal allowances but will hold amounts of cash if requested for residents. The owner had purchased but not yet fitted a storage facility with numerous compartments to facilitate separate storage of money for individual residents, as requested at the last inspection. The accident book was inspected. We noted a significant number of falls in a short period of time and recommended that the manager conduct a review and complete an overall risk assessment for the home in relation to this. We also recommended that she monitor and countersign every entry made by the staff to demonstrate that she has taken any remedial action to ensure, where possible, a similar accident/incident is not repeated. Oak Mount Rest Home DS0000011855.V365460.R01.S.doc Version 5.2 Page 25 During the day we brought a number of matters to the attention of the providers and manager and left them to attend to them, including risk assessments for window locks and people prone to falling, lack of a wash hand basin in a first floor toilet, electrical wiring certificate, a poor odour in a couple of bedrooms and no door lock on bedroom 11. No requirements have been made on this occasion. Oak Mount Rest Home DS0000011855.V365460.R01.S.doc Version 5.2 Page 26 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 1 x 2 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 4 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 3 3 3 X 3 X 3 2 Oak Mount Rest Home DS0000011855.V365460.R01.S.doc Version 5.2 Page 27 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 OP1 Regulation 5 (1) & (2) Requirement An up-to-date service user guide must be established and maintained and kept available for reference to enable the residents and potential service users to fully understand what the home provides. Timescale for action 01/10/08 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 Oak Mount Rest Home DS0000011855.V365460.R01.S.doc Version 5.2 Page 28 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 Oak Mount Rest Home DS0000011855.V365460.R01.S.doc Version 5.2 Page 29 - 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. 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