Care Home: Oakdene

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 service does well to provide a service that is centred around the individual needs and wishes of the residents. This takes into account their individual beliefs, abilities and mental capacity. To ensure the service is able to meet the needs of prospective residents it undertakes a thorough assessment, which involves the resident, family members and others, such as healthcare professionals where applicable. Each resident has a personal plan which describes the care they need, this includes the assistance they may need with their personal, physical, mental health and social care needs. Clear records are kept and the needs of residents are regularly reviewed. Where and when necessary the staff will call upon healthcare professionals such as GP`s, district nurse and community psychiatric nurses to assist in maintaining good health for the resident. Residents are encouraged and supported to engage in a wide range of in house and external activities. The home supports residents to maintain contact with family and friends and assists them to integrate into their local community and maintain essential life skills. Meal times are a favoured time of the day by residents, the majority who tell us the meals are very good. Special diets are catered for. Residents are cared for in a homely, friendly and relaxed environment by staff who are well trained, stay working in the home a long time, understand their different needs and recruited in a way that protects them. The environment is decorated and furnished to a high standard. It is kept clean and free from odours by dedicated ancillary staff who take pride in their work. Residents are encouraged and supported to be involved in the decoration and furnishing of their rooms and a landscape garden offers a pleasant environment in the warmer months. The home is regularly maintained and all areas of health and safety, such as fire safety is regularly checked. The registered manager is experienced in running and managing registered care homes. The manager is aware of the importance of meeting the National Minimum Standards for Older People, the Care Homes Regulations and ensuring the care given to the residents is good. The registered manager ensures the way the home is run is led by the needs and wishes of the residents. This is done by speaking with them daily and asking them to complete annual questionnaires. The registered manager also recognises the views of relatives, staff and other visitors play an important part in ensuring the home is run well. Comments received from residents, relatives and staff told us that Oakdene is a good place to live and work. "Oakdene is a very friendly family orientated home. It is very well furnished and a well kept home. Staff are friendly and helpful to each other". "Marvellous home with staff who do a wonderful job". "We would recommend Oakdene to any family considering putting their relative or friend into care". "My relative feels lucky to have found Oakdene". What has improved since the last inspection? Following the last visit to the home it was issued with four requirements, three of which were related to the administration of medication and one in respect of record keeping. A recommendation was also issued in respect of auditing all records relating to residents. This inspection provided evidence that all requirements and the recommendation have been met. This demonstrates the service recognises where there are areas in need of improvement to ensure residents recieve a good service. The home continues to improve the environment encouraging residents to be involved in making choices in how the home and their individual rooms should look. The home continues to develop its internal and external activities programme. This is to meet the changing age range of residents, who along with relatives and staff talk positively about the activities provided. The home demonstrates that it continues to support residents to maintain their independence. In some instances the service supports residents to redevelop skills and confidences they may have lost through various illnesses. What the care home could do better: No requirements or recommendations have been issued following this inspection visit. Key inspection report Care homes for older people Name: Address: Oakdene 197 London Road Waterlooville Hampshire PO7 7RN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Christine Walsh     Date: 2 6 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 37 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 37 Information about the care home Name of care home: Address: Oakdene 197 London Road Waterlooville Hampshire PO7 7RN 02392640055 02392640055 gillsteve.bryden@virgin.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs G Bryden care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is:19 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Dementia - DE Mental Disorder, excluding learning disability or dementia - MD Date of last inspection Brief description of the care home The home is a large Edwardian building set on the main road between Waterlooville and Cowplain. It is registered to provide a service for up to nineteen older people, some of whom may have dementia or mental health problems. The home has eleven single rooms and four shared rooms. Four of the rooms have enCare Homes for Older People Page 4 of 37 2 8 1 1 2 0 0 8 19 19 0 Over 65 0 0 19 Brief description of the care home suite facilities. There are two lounges, a large dining room and a conservatory overlooking the gardens. The gardens are very well maintained and designed so that residents can access them safely. Care Homes for Older People Page 5 of 37 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This site visit formed part of the key inspection process and was carried out over one day by Mrs C Walsh, regulatory inspector, the registered manager and administrator assisted the inspector with the inspection visit. The manager completed an Annual Quality Assurance Assessment (AQAA) document, which was returned to the Care Quality Commission (CQC) prior to the visit to the service. The AQAA informed us that the service ensures the race, gender, identity, sexual orientation, age, religion and the beliefs of the residents are promoted and incorporated into what they do. This includes supporting residents to attend church or Care Homes for Older People Page 6 of 37 receive communion in the home. The information obtained to inform this report was based on viewing the records of the people who use and work for the service, of which four residents records were looked at in depth. The day-to-day management of the home was observed, and discussions with residents, staff and visitors took place. We looked at comments received in Have Your Say comment cards, some of which have been incorporated into this report and assisted in us in our decision making and overall rating of the home. The people who use this service are referred to as residents and referred to as such throughout the body of the report. Care Homes for Older People Page 7 of 37 What the care home does well: The service does well to provide a service that is centred around the individual needs and wishes of the residents. This takes into account their individual beliefs, abilities and mental capacity. To ensure the service is able to meet the needs of prospective residents it undertakes a thorough assessment, which involves the resident, family members and others, such as healthcare professionals where applicable. Each resident has a personal plan which describes the care they need, this includes the assistance they may need with their personal, physical, mental health and social care needs. Clear records are kept and the needs of residents are regularly reviewed. Where and when necessary the staff will call upon healthcare professionals such as GPs, district nurse and community psychiatric nurses to assist in maintaining good health for the resident. Residents are encouraged and supported to engage in a wide range of in house and external activities. The home supports residents to maintain contact with family and friends and assists them to integrate into their local community and maintain essential life skills. Meal times are a favoured time of the day by residents, the majority who tell us the meals are very good. Special diets are catered for. Residents are cared for in a homely, friendly and relaxed environment by staff who are well trained, stay working in the home a long time, understand their different needs and recruited in a way that protects them. The environment is decorated and furnished to a high standard. It is kept clean and free from odours by dedicated ancillary staff who take pride in their work. Residents are encouraged and supported to be involved in the decoration and furnishing of their rooms and a landscape garden offers a pleasant environment in the warmer months. The home is regularly maintained and all areas of health and safety, such as fire safety is regularly checked. The registered manager is experienced in running and managing registered care homes. The manager is aware of the importance of meeting the National Minimum Standards for Older People, the Care Homes Regulations and ensuring the care given to the residents is good. The registered manager ensures the way the home is run is led by the needs and wishes of the residents. This is done by speaking with them daily and asking them to complete annual questionnaires. The registered manager also recognises the views of relatives, staff and other visitors play an important part in ensuring the home is run well. Comments received from residents, relatives and staff told us that Oakdene is a good place to live and work. Oakdene is a very friendly family orientated home. It is very well furnished and a well kept home. Staff are friendly and helpful to each other. Care Homes for Older People Page 8 of 37 Marvellous home with staff who do a wonderful job. We would recommend Oakdene to any family considering putting their relative or friend into care. My relative feels lucky to have found Oakdene. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 37 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 37 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures the people who wish to move into the home have their needs assessed prior to admission to make sure they can meet their needs. The home does not provide intermediate care, but offers a service on a short term basis. Evidence: The AQAA (Annual Quality Assurance Assessment) told us that the home does well to carry detailed pre admission assessments, support perspective residents to visit the home as many times as they wish before making a decision to move in. The AQAA also told us Oakdene provides detailed information about the home and offers a very happy and relaxed atmosphere. This was tested by viewing the assessment documents of four residents, speaking with a small number of residents, a visiting family member and the registered manager. Care Homes for Older People Page 11 of 37 Evidence: The registered manager told us she or her head of care will meet and obtain relevant information about the prospective resident. This is obtained where possible from the prospective resident, family members and others involved in their care prior to offering a place in the home. This is known as the assessment process and provides the home with information that will tell them if they are able to meet the prospective residents needs. Have Your Say comment cards received from residents, relatives and health care professionals told us the home does well to always meet the needs of the residents and provide an environment where they feel safe and well cared for. Assessment documents were viewed for four residents two of which had recently moved in, the assessment information is comprehensive and asks for information about the persons health, strengths and needs and other information relating the residents wellbeing, social interests, likes and dislikes and cultural and religious beliefs. This demonstrates the home considers the diverse needs of residents. The registered manager informed us that on occasions and on exceptional circumstances they will take emergency admissions. On these occasions very little information is gained prior to admission. The registered manager went onto tell us on these occasions a member of staff will closely monitor and support the resident to familiarise themselves with the home and gain information about them where possible. Information in two personal plans seen at the time of the visit told us that the emergency admissions had been successful. A resident said. The staff have been great, they have made me feel very welcome and supported me to get better. There was evidence in personal care plans that information obtained through the assessment process is reflected in the day-to-day care of the residents. Plans are regularly reviewed and provide evidence residents who are admitted using emergency procedures are settling and beginning to thrive, an example of this is weight gain and improved awareness. The home is not registered to provide intermediate care, but it does offer respite care Care Homes for Older People Page 12 of 37 Evidence: where residents are welcome to stay for short breaks, be it to support main carers or to support the resident to get back to good health following an illness. Care Homes for Older People Page 13 of 37 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in the home have there personal care needs met as described in their personal plans. The people who live in the home have access to health care professionals to ensure their health care needs are met. The home has taken steps to ensure the health care needs of the people who live in the home are maintained by adopting safe medication administration procedures. The people who use the home tell us they feel they are treated with respect and their right to privacy upheld. Evidence: The AQAA told us that the home does well to have comprehensive care plans, which respect the residents at all times. The AQAA tells us they have risk assessments in place to ensure the home is giving appropriate care and the residents rights to privacy and dignity is maintained. The AQAA went onto tell us they also do well to Care Homes for Older People Page 14 of 37 Evidence: have good links with health care professionals. The home acknowledges where it could do better and told us they will continually enhance staff knowledge to ensure good communication and to boost their confidence in the area of record keeping. The above was tested by viewing the personal plans, daily notes and medication records of four residents. We spoke with residents, visiting relatives, staff, the registered manager and head of care. We also observed the day-to-day practice in the home. Each resident has a personal plan of their own which provides information on their daily personal, physical and mental health care needs, social support and areas of where the residents maybe at risk. Care plans provide detail on how the resident requires assistance allowing for consistency of care. The registered manager told us following the last inspection visit they have completely reviewed all personal plans and improved the layout, providing a system that is easier to follow. This includes an index which takes the reader straight to the area of the personal plan wished to be seen. Residents and relatives who were spoken with at the time of the visit were very complimentary of the care and support the staff and manager provides. Seven Have Your Say comment cards were received from residents, six of the seven told us they always and the other resident told us they usually receive the care and support they need. I am well looked after From the limited time xxx has been in the home we can give nothing but praise. They are friendly, approachable and willing to do anything to make xxx adaptation to nursing care easier. They have a very caring attitude towards the residents and are friendly and helpful in their care. There is a high standard of care and the staff are very patient. There is a homely atmosphere. Some of the residents have a life history in their personal file providing staff with background knowledge about the person, their occupation, their family, their likes and dislikes and their social hobbies and interests. The registered manager told us residents, relatives and friends will assist in providing information for personal plans and life histories. Care Homes for Older People Page 15 of 37 Evidence: Care plans are linked to risk assessment and provide detail of the risk and action required by staff to minimise the risks. The information was written in plain English and easy to follow. Each resident is registered with a GP and information in residents personal plans tells us that a record is kept of the residents personal health care needs and the support they require to get better. In addition residents have access to other health care professionals such as dentists, opticians, chiropodists and community health care teams such as district nurses and psychiatrists. The registered manager told us the home has very good relationships with health care professionals, in particular the community mental health practitioner who visits regularly. Comments received from health care professionals told us residents social and health care needs are always met by staff who are experienced, skilled and respectful. The home is quick to respond to changing healthcare needs and act appropriately to ensure the resident receives the correct care. A GP told us Oakdene is a very well run home. A relative told us. I am informed immediately if a doctor is to be called to attend to my xxx At the time of the visit the head of care was observed making arrangements for a GP to attend the home as the rapid changing health needs of a resident was causing concern. The home has systems in place for the administration of medication. The home uses a monitored dossett system which is supplied by a local pharmacy. A large number of medications that can not be placed in a blister pack are stored within a secure trolley and topical creams and lotions are stored separately. Medications are received, stored and disposed of using systems as stipulated in the Royal Pharmaceutical Guidelines. Following the last inspection visit three requirements were issued in respect of safe handling of medications. These included ensuring only medications prescribed for the named resident are given, ensuring medication administration records (MAR) are Care Homes for Older People Page 16 of 37 Evidence: accurate and medications given as required have a care plan in place to support staff to know when to give the medication. The registered manager provided us with evidence to demonstrate the requirements have been met. The registered manager provided documentation to evidence that a full review of the administration, storage, stock and medication records have been assessed by an external company specialising in the administration of medications in care and nursing homes. The same company provided staff with training. Staff told us the training was comprehensive and provided them with the confidence to administer medications correctly. The home has invested in new lockable storage, which includes a new medication trolley and individual lockable medicine cabinets in residents bedrooms. These cabinets are used to store individual topical creams and lotions. The registered manager told us she regularly audits medication administration records and two staff always check and sign that medications have been given correctly. This was seen at the time of the visit. Following the last visit to the service concerns were raised regarding the use of certain wording that described some residents behaviours, which was felt to be disrespectful. Evidence in the same residents files seen during this inspection visit told us this area of recording has improved. The registered manager told us she has met with staff and regularly audits residents personal plans to ensure accurate and appropriate recording is made. On the day of the visit staff were observed speaking with residents in a respectful manner and addressing them by their preferred name. Staff spoken with at the time of the visit described what steps they take when supporting residents with sensitive areas of their personal care. They also verbally demonstrated they have an awareness and understanding of the principles of care. A relative told us. My xxx is always treated with respect and they uphold the dignity of the individuals in their care as an important aspect of their responsibilities A resident told us. Care Homes for Older People Page 17 of 37 Evidence: I am well looked after and all members of staff are very kind. Care Homes for Older People Page 18 of 37 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures the service supports the people who use the service to participate and engage in activities of their choice, maintain contact with family and friends and provide them with meals that meet their dietary needs and preferences. Evidence: The AQAA told us the home has a comprehensive internal and external activities programme, some of which is planned and some impromptu. It told us residents are involved in making decisions about their daily lives, visitors are encouraged to visit at all times and menus are nutritious and varied. This was tested through observation on the day of the visit, viewing menu and activity plans, viewing surveys received from residents, staff and family members. It was also tested by speaking with residents, staff and visitors. The residents personal files provide information on the residents social interests, hobbies and likes and dislikes. A personal history is in place for residents, where it has been possible to obtain one. The personal history provides staff with information about residents occupation and family history. Photographs of residents in their hay-day are displayed in the entrance hall and provide a source of stimulation and Care Homes for Older People Page 19 of 37 Evidence: opportunities for residents to reminisce. An electronic photo frame also situated in the main entrance provides a sequence of pictures of residents taking part in various stimulating activities such as visiting garden centres and having parties. The home provides a weekly news letter in a format that is accessible for the majority of residents, it provides information on activities, special events and information about staff. A resident told us that they felt the information helpful to know what is going on day-to- day. Observations on the day of the visit provided evidence that staff spend time with the residents engaging in general conversation, having a laugh and joke and providing reassurance for residents who have queries and concerns. The home provides a number of planned activities through out the year which are both seasonal and at the request of the residents such as visiting the theatre, Christmas and Summer parties. Board games, reminiscence therapy and watching old musicals and comedy films is a regular occurrence. At the time of the visit a resident was observed engaged in completing a jigsaw puzzle and told us how they regularly visit the shops and especially likes choosing and buying their own clothes. The majority of surveys received from residents, relatives and staff told us they were very happy with the range of activities. It is a happy home, we go out a lot and do a lot in the home. I enjoy the games at the home and Im well looked after. They take me out a lot and buy me things. The home provides daily activities for the stimulation of the residents. The home is well organised with plenty of activities arranged during the afternoon. The home provides evidence that it encourages and promotes residents independence, supporting residents to regain confidence to access the community alone and use public transport. A relative told us. The home provides appropriate care for my mother, her particular needs are Care Homes for Older People Page 20 of 37 Evidence: addressed and she has been able to keep some independence despite her problems. Residents spoken with at the time of the visit told us they enjoyed the activities provided for them and were looking forward to the Christmas celebrations, which will include a trip to the theatre. They also told us staff are very supportive but encouraged them to do as much for themselves as possible. Visitors to the home were observed to be made welcome and staff were able to provide an update on the wellbeing and care of their next of kin. A visitor told us they visit regularly and are always made to feel welcome. The visitor told us they had no concerns about the home and wellbeing of their relative. A visitors book provided evidence that the home receives regular visitors to the home at all times of the day Other information told us the home makes arrangements for residents to maintain contact with family and friends from arranging visits to the family home to writing letters. Residents are supported to make choices and decisions about how they would like to spend their day, what they would like to eat, drink and activities they would like to take part in. Personal plans seen at the time of the visit told us the wishes and preferences of residents are recorded. This provides staff with specific information which ensures continuity of care and individual routines are maintained. A relaxed and friendly atmosphere seen at the time of the visit and discussions had with residents and staff provided evidence that the home centres its care and support around the decisions, choices and wishes made by residents. The registered manager informed us all staff have received training in the Mental Capacity Act and Deprivation of Liberty and was able to demonstrate that the home will use the Act to protect residents whose capacity has been affected by their illness. The home continues to provide regular fluids, snacks and wholesome meals. Residents and relatives are complimentary of the meals provided. I really look forward to mealtimes, the food is very good here. Mum always appears to enjoy her meals. The member of staff responsible for the cooking informed us that the home uses fresh produce and is provided with information regarding the residents specific likes, dislikes Care Homes for Older People Page 21 of 37 Evidence: and dietary needs. This included preparing/baking sugar free desserts and puddings. The home has two dining rooms, which allows the home to support residents who require support to eat and those who are independent, separately. Residents who require support, receive their meals in manageable consistencies to assist with the mechanics of eating and swallowing. As part of the pre assessment process the home assesses residents nutritional intake, likes and dislikes and takes a record of their weight. A record of weights seen at the time of the visit provided evidence that the home has supported residents to gain and sustain an appropriate weight for their age, height and activity level. The registered manager told us where there are concerns regarding a residents weight they will call on the appropriate healthcare professional for advise. Evidence told us where there are concerns additional nutrients are prescribed by the GP. Some residents have their own fridge in their rooms and are supported to purchase their own groceries if they wish. This demonstrates the home is supporting residents to maintain their independence. Care Homes for Older People Page 22 of 37 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures that the people who use the service are listened and concerns raised by them are acted upon. The home takes steps to ensure the people who use the service are safeguarded from the potential risk of abuse. Evidence: The AQAA told us the home does well to have a comprehensive and accessible complaints procedure and has open dialogue with all people who have a stake in the wellbeing of the residents. The AQAA told us staff are aware of the legal rights of residents and receive regular updates on issues relating to abuse and protection. This was tested by viewing the complaints procedures and logbook, testing if the home had procedures for safeguarding the residents, speaking with the residents, staff and relatives. The complaints procedure details how the people who use the service can make a complaint and what action must be taken to resolve a complaint. The registered manager told us she speaks daily with residents and any visiting relatives, encouraging open dialogue and minimising any concerns escalating into complaints. All Have Your Say comment cards received from residents, relatives and healthcare Care Homes for Older People Page 23 of 37 Evidence: professionals tell us they have no reasons to make a complaint or have any concerns about the care provided at Oakdene. Residents and relatives told us they are very happy with the care, the friendly, homely atmosphere, food, cleanliness of the home and the activities provided at Oakdene. They were especially complimentary of the kindness and dedication of staff, some who have worked in the home for many years. The home cares for all their needs very well All members of staff are very kind. I would like to say thank you for treating me well. A resident spoken with at the time of the visit told us she knows how to make a complaint but has never felt the need to do so. The majority of the residents who live at Oakdene have varying degrees of dementia, the home has taken steps to ensure staff receive training and develop a good understanding of the physical, sensory and cognitive needs of people who have dementia and how this could impinge their ability to make or raise concerns. In addition to receiving training in dementia staff have all recieved training in the Mental Capacity Act and Deprivation of Liberty. A member of staff spoken with at the time of the visit told us receiving this training had provided her with a good insight into the rights of the people they support in the home and how they could be easily and unknowingly be denied. Documentation seen at the time of the visit told us where it is considered a resident is unable to make a decision about their health and welfare and could potentially place themselves at risk, a a mental health capacity assessment has taken place. The registered manager told us the information has been shared with appropriate health and social care professionals. The AQAA informed us the home has received one complaint in the last twelve months. The complaints log book was viewed and the recorded information told us the home had responded to the complaint appropriately and as per the homes complaints procedure. The staff are provided with safeguarding of vulnerable adults training, which provides them with the knowledge to identify various types of abuse and how to report these. The staff spoken with at the time of visit confirmed that they had received training Care Homes for Older People Page 24 of 37 Evidence: and were aware of their roles and responsibilities in maintaining the residents health and wellbeing and reporting incidents of concern. Care Homes for Older People Page 25 of 37 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures the people who use the service live in a welcoming, comfortable and clean environment. Evidence: The AQAA told us the environment they provide is safe and well maintained, light and airy and both indoor and outdoor facilities are comfortable. The AQAA went onto tell us all individual and communal areas are regularly decorated and refurbished, which residents are involved in where possible. It also told us the home is clean and free from odours and housekeeping staff take pride in their work whilst adhering to health and safety standards. This was tested by touring the home, speaking with residents about their personal rooms and the homes environment, speaking with care staff and visitors. A tour of the home provided us with evidence that the home takes pride in its facilities, including the refurbishment of several areas of the home. A number of residents bedrooms have recently been redecorated and furnished using quality furniture and furnishings. A resident showed off their bedroom which had been recently decorated and refurbished with new bedlinen and curtains. The resident told us she had been Care Homes for Older People Page 26 of 37 Evidence: involved in choosing the decoration and soft furnishings. A relative also showed us their next of kins bedroom and spoke of the time and dedication the manager and staff had taken to make their relative comfortable and feel at home. When planning changes to the environment the registered manager told us they consider the individual residents sensory, cognitive and physical needs. This demonstrates the home is aware of the importance of promoting and maintaining residents independence. The home has sufficient numbers of toilet and bathing facilities to meet the number and needs of residents. Where required these facilities are equipped with moving and handling equipment such as hoists and handrails. The home is a two-story building with a stair lift to the first floor. The home has a large lounge, separate conservatory and dining room. All areas of the home are tastefully decorated and furnished. The garden is landscaped, surrounded by a variety of trees and shrubs and levelled patio areas, which residents can access during the warmer months of the year. Large windows allow a good view into the garden and alterations to the front of the home have provided better access to the car park. A resident told us in a Have Your Say comment card that they particularly like spending time in the garden as this is their favourite area of the home. Bedrooms seen were homely, furnished with personal items and in some case furniture brought from their previous home. The rooms were individualised and reflected the persons hobbies interests and personality. The residents with whom were spoken with appeared pleased with their rooms and the cleanliness of the home. This was supported by comments received from residents and relatives in Have Your Say comment cards. The home is always, clean and odour free, unlike some other care homes I have visited I like the look of it (the home), it is clean and tidy and also well decorated. I have a single room with an outside view, which is what I requested. Residents who are deemed able are provided with a key to their bedroom if they wish. The home has staff appointed to clean the home who are responsible for maintaining a Care Homes for Older People Page 27 of 37 Evidence: good standard of hygiene throughout the home. The home was noted to be clean and free from offensive odours. The registered manager told us cleaning staff receive training relevant to their roles and responsibilities including health and safety, The Control of Substances Hazardous to Health (COSHH) and infection control. The AQAA and comment cards received from staff told us they have received training in infection control. Equipment such as protective clothing is provided for staff to assist in minimising the risk of cross infection. Notices and antibacterial hand gels discreetly displayed around the home notified staff of good hygiene standards. Care Homes for Older People Page 28 of 37 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures the people who use the service are supported by adequate numbers of appropriately recruited staff, who receive training that meets the needs of the people they support. Evidence: The AQAA told us that they have an enthusiastic and trained care team to care for the residents. The AQAA told us the home has a robust recruitment process and a detailed induction programme, giving residents and their relatives confidence in what they do. This was tested by observing care practices on the day of the visit, seeking the views of residents and visitors, speaking with staff, viewing staff recruitment and training files and Have Your Say comment cards. The service provides a relaxed, unrushed and welcoming home. Many comments similar to the above have been received from residents and relatives and was witnessed on the day of the visit. Whilst ensuring residents have their needs met in the way in which they prefer, staff were observed spending time interacting with residents, offering reassurance where needed and engaging in everyday conversation and jokey banter. staff were observed to be happy in their work. Care Homes for Older People Page 29 of 37 Evidence: The duty rota confirmed that there are sufficient numbers of staff on duty including ancillary staff to meet the current needs of the residents and running of the home. Call bells were answered promptly and a prompt response by staff was observed when the changing physical needs of a resident was cause for concern. Two members of staff who were spoken with at the time of the visit confirmed that they have a good understanding of the individual needs of the residents and the importance of providing their care in the way in which the residents prefer. Examples of this were provided by the staff who were able to recall the daily routines of residents whose personal plans had been looked at. This demonstrates that staff refer to residents personal plans and the communication between staff ensures residents receive continuity of care. A member of staff said. The home in my opinion caters brilliantly for the needs of all the residents and their relatives. The home is very well run and anything it should need is supplied without delay. I feel the training given is exemplary and I feel supported and safe carrying out my role at Oakdene. The AQAA told us twelve staff have a National Vocational Qualification (NVQ) level two or above, this is more than fifty percent of the staff and meets the current National Minimum Standards. The AQAA also told us all staff are registered on the Skills for Care data base. This demonstrates the home is ensuring it has a skilled workforce to meet the needs of the residents. Staff told us in Have Your Say comment cards that they always feel they have enough support, experience and knowledge to meet the different needs of the people who live at the home. They also told us they feel they receive training relevant to their role, training that helps them to understand and meet residents different needs, keeps them up to date with the new ways of working and are provided with a enough knowledge about health care and medication. A member of staff said. I enjoy working here and the training is comprehensive Another said. The manager keeps us up to date with all new legislation in respect of the running of Care Homes for Older People Page 30 of 37 Evidence: the home. The induction and training records for two members of staff were seen and confirmed that staff are provided with mandatory training such as moving and handling, fire safety, emergency first aid, food hygiene and infection control. In addition to these courses staff must receive, the home provides training on medication administration, the Mental Capacity Act, dementia, basic care skills and the role of the carer. The recruitment records of two staff were viewed to establish if the home undertakes a robust recruitment procedure. Recruitment records indicated that appropriate checks are carried out on staff prior to them starting in the home, including two references, criminal record bureau (CRBs) and protection of vulnerable adult (PoVA) checks. A member of staff was met with as part of the tracking process and confirmed that they had completed an application, attended an interview and were fully inducted with support whilst getting to know and work with the residents. Evidence of these documents were found on the staff personal records. A resident told us. Staff stay years and the owner is very careful who she employs. A relative said. The strong point at Oakdene is the staff, some of who have worked in the home for years. A member of staff said. I have worked at Oakdene for over twenty years and I still enjoy my work. Each day is different as are the staff and residents, but as a whole we all gel together well and work well. There is always a happy atmosphere at Oakdene. Care Homes for Older People Page 31 of 37 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run by a registered manager who ensures the home is run in the best interest of the people who use it and ensures they are safeguarded from potential risk of harm from their environment. Evidence: The AQAA told us the home is run by Gill Bryden who is experienced and well qualified. The AQAA told us the home is run in the best interest of the residents, which is very relaxed but quietly efficient with an open and positive atmosphere. The AQAA also told us comprehensive quality assurance procedures are in place to ensure the home is run in the best interests of the residents. This was tested by spending time with the registered manager, administrator and observing practice and running of the home. We observed interactions between staff, residents and relatives. We viewed health and safety documents including fire safety records, quality monitoring records including regulation 26 reports and spoke with residents, staff and visitors. Care Homes for Older People Page 32 of 37 Evidence: The registered manager Gill Bryden told us about her experiences of running registered care homes, her professional qualifications and the relationships she has built with residents, staff, relatives and other professionals, such as GPs and social workers. All of which she told us makes Oakdene well known within the local community and a home where people wish to come and spend their later years. The registered manager was observed engaging and spending time with residents, supporting them to make decisions and informed choices. She was observed giving clear direction and support to care staff. This was done using a friendly and open approach. Staff, residents and visitors were complimentary of the manager and her management team, speaking of their kindness, thoughtfulness and support when the need arises. A relative said. The continuity and stability of staff is a reflection of good management and of the strong ethos of the home. The home demonstrates through its quality monitoring systems that it takes seriously its responsibility to ensure the views of residents, staff and relatives are heard. We saw evidence of regulation 26 visits taking place monthly. (A regulation 26 visit is undertaken by someone who is not involved in the day-to-day running of the home. It involves looking at all areas of care and administration practices and includes seeking the views of residents, staff, relatives and any visiting health care professionals). Following the visit a report is completed, identifying areas of good practice and areas that may need improving upon. In addition to seeking the views of residents and others the home carries out a number of other internal audits. This is done to ensure all aspect of care practices, health and safety, environment and administration meet required standards. These include weekly medication audits, falls screening, house keeping, catering and maintenance checks. The systems in place were observed to be monitored regularly by the administrator and registered manager. The administrator told us the service provides support to residents with their personal finances, evidence told us that this is usually done through a solicitor acting on behalf of a resident and where the resident has been assessed has not having capacity to manage their own financial affairs. Care Homes for Older People Page 33 of 37 Evidence: The home provides evidence that they support residents to maintain and develop the skills to be independent with their personal monies, taking them shopping for personal items and advising them on day-to-day expenditure. Records viewed at the time of the visit told us the home keeps a clear audit trail of individuals personal expenditure. Records told us there are safe systems in place for fire safety. Staff receive regular training and regular checks are made on fire safety equipment. Corrosive substances hazardous to health (COSHH) are securely locked away, there are notices discreetly displayed around the home reminding people of good hygiene practices and all serviceable utilities such as gas and electrical appliances are regularly checked to ensure they are in goods working order. Care Homes for Older People Page 34 of 37 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 35 of 37 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 36 of 37 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 37 of 37 - 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!