Care Home: Oakfield House

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What the care home does well Residents made the following comments about their experience of living at Oakfield House:- "...they`re lovely here..." "...they`re very kind..." "...Robin is always there if you need him..." "...they look after my clothes nicely..." "...help me when I need help..." "...always help me with my problems..." "...they don`t rush me, they take their time, they`re very nice girls..." "...I can stay in my room if I want..." "...they`re very kind with all my things going wrong...". The home treats people as individuals. The manager is aware of the relevant legislation relating to diversity and there were clear examples of responding to peoples` needs or wishes regarding religion and disability. Other diversity issues are reflected in policies. What has improved since the last inspection? There were no requirements from the previous inspection. What the care home could do better: There are no requirements from this inspection. Robin Field has identified the following things for improvement in the next twelve months:- To employ one more member of staff to cover sickness and holidays, to repaint the exterior of the home and to continue to keep up to date with changes in legislation as well as continuing to seek feedback from current residents. CARE HOMES FOR OLDER PEOPLE Oakfield House High Street Wingham Canterbury Kent CT3 1BU Lead Inspector Christine Lawrence Key Unannounced Inspection 12th December 2007 10:20 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 Oakfield House DS0000023509.V356383.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. Oakfield House DS0000023509.V356383.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakfield House Address High Street Wingham Canterbury Kent CT3 1BU 01227 721107 01227 721107 robin.field@btinternet.com 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) Mr Roger Clive Field Mrs Gloria Ann Field, Mr Robin Grant Field Mr Robin Grant Field Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Oakfield House DS0000023509.V356383.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Not more than 30 persons ages 65yrs and over Date of last inspection 27 September 2006 Brief Description of the Service: Oakfield House is an extended, large, detached property. It was originally the village schoolhouse and was later used as a print shop. The home is registered to provide residential care for 30 older people over the age of 65. Oakfield House is a family run business. Accommodation is set over two floors and there is a stair lift available for access to the first floor. The home comprises 24 single rooms and 3 rooms that can be used as doubles for a couple to share on request. All rooms have en-suite toilet and washbasin facilities. Each room has a television point and a call bell, and most have telephone points. The home is located on the main road from Canterbury to Sandwich, within the quiet village of Wingham and there is easy access to public transport. The home is within easy walking distance of the village church, shops, post office, and local public houses. The front of the building has tubs and baskets. To the side there is a patio area and a well-kept garden, and at the rear there is car parking available. Information about the home, including the last inspection report will be made available to prospective residents and their representatives by the manager. Information about the current fees (£377.12 - £495.00 per week) was provided by the manager on 12 December 2007. Oakfield House DS0000023509.V356383.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and started at 10.20 and finished at 16.40. The inspector looked at various records in the home and also used information sent to the Commission for Social Care Inspection (CSCI) by the manager through his completion of the Annual Quality Assurance Assessment (AQAA). Information from the previous inspection was also referred to. I spoke with several residents and some visitors to the home. A tour of parts of the building was undertaken and I observed medications being given out. Staff were observed interacting with residents and I spoke to staff on duty as well as the manager and one of the other owners. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Oakfield House DS0000023509.V356383.R01.S.doc Version 5.2 Page 6 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 Oakfield House DS0000023509.V356383.R01.S.doc Version 5.2 Page 7 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 (Standard 6 does not apply to Oakfield House) People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents can be confident that the home judges that it can meet their needs because it assesses their needs before they move in. EVIDENCE: The individual records of five residents were looked at during this inspection. They showed that assessments are carried out on the needs of prospective residents. The assessment is recorded and covers the topics noted in Standard 3 of the National Minimum Standards. The pre-admission assessment is used to compile an individual plan for each resident. The manager said that he only admits someone to Oakfield if he is sure that the home can meet their needs, both in the short term and the long term. The assessments are carried out by the manager and the head of care. The assessments are used to compile care plans. Oakfield House DS0000023509.V356383.R01.S.doc Version 5.2 Page 8 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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from having an individual plan of care which identifies how their health and care needs are to be met. They are protected by the home’s procedures for dealing with medication and they can be confident that they will be treated with respect. EVIDENCE: Each resident has an individual plan of care. There is sufficient detail in the plans to ensure that health and care needs are identified. Staff spoken to said that there was enough information and detail in the plans to make sure that they can help and support the residents appropriately. Staff also said that the residents likes and dislikes in relation to their daily routines and preferences are known and responded to. One resident said, “…they look after me very well…” and another said that the staff were “…very good…”. The plans seen were up to date and any changes to residents’ needs are noted. A monthly summary is written which gives an overview of what is happening and the daily records were informative. Records showed that other health care professionals Oakfield House DS0000023509.V356383.R01.S.doc Version 5.2 Page 9 (including chiropodists, dentists and outpatient appointments) are involved as required. A visiting relative said that her mother’s general practitioner was called on her behalf when she needed attention. There were examples of the home supporting residents to see specialist healthcare professionals. Medication is appropriately stored and administered. The inspector observed medications being given out and looked at the medication administration records. Residents will be assessed to see if it would be appropriate for them to manage their own medication and some examples of this were noted from care plans seen. Robin Field has a copy of the new guidelines regarding medication (The Royal Pharmaceutical Society’s The Handling of Medicines in Social Care) and he intends to review his procedures to ensure they are compliant. A room is available for hairdressing and for chiropody and can be used by community nurses when treating a resident who does not wish to go to their room. Residents spoken to said that staff were polite and respectful. One resident said “…they are polite always…” and another said “…they don’t rush me…”. Staff knocked at bedroom doors and called residents by the name they preferred, which would be noted in their individual record. Oakfield House DS0000023509.V356383.R01.S.doc Version 5.2 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their preferences will be responded to and that they will be enabled to maintain contact with friends and family. Residents will be encouraged to make choices and they will benefit from healthy, wellpresented food at a time and place to suit them. EVIDENCE: Each resident has information as part of their care plan which includes individual preferences for daily routines. Residents told the inspector (through the written surveys as well as in conversation) that they could choose to take part in activities and entertainments or not, as they wished. One said “…I enjoy everything and try to do as much as possible…”. Activities include bingo sessions, reminiscence sessions, board games and craft sessions. There is a poster for the whole month and also a weekly notice about what is happening regarding activities. Visiting relatives said that they were made welcome when they visited the home and that they could meet with their relative/friend in private. The Oakfield House DS0000023509.V356383.R01.S.doc Version 5.2 Page 11 manager told the inspector that there is no restriction on visiting times and this was confirmed. The home does not get involved with the financial affairs of any resident. The rooms seen had residents’ own personal possessions. Observations of, and conversations with residents clearly reflected that people make choices about their routines and preferences. The manager is aware of his responsibilities under the Data Protection Act (1998) in terms of residents’ access to their personal records. There is a reminder to staff about confidentiality of information. The inspector observed lunchtime. The food looked and smelt good. Staff were helpful and assisted residents where necessary. A menu was on display in the home. The manager confirmed that special diets could be provided. The dining room provides a pleasant environment and most people take their meals there and many residents enjoyed sitting and chatting with a cup of tea/coffee after the meal had finished. Oakfield House DS0000023509.V356383.R01.S.doc Version 5.2 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Complaints would be handled objectively and in keeping with the home’s appropriate procedures and residents/their representatives can be confident that any concerns will be listened to, taken seriously and responded to. Staff are aware of adult protection issues and there are systems in place which create an atmosphere for protecting residents from abuse. EVIDENCE: There have been no complaints at the home in the past 12 months. Information about how to make a complaint is contained in the service user guide and this includes information about how to contact the Commission for Social Care Inspection. Relatives spoken to said they knew what the procedure was but they had never needed it. One resident said, “…never have to complain, they know if anything needs fixing…” and another said “…I know who to talk to if I have any problems…”. Robin Field said that it was important to sort things out at an early stage so they don’t become complaints. Staff have attended adult protection awareness training. Staff spoken to confirmed that they are aware of their responsibilities to keep residents safe and protected. There are appropriate policies and procedures in place, including disclosure of abuse and bad practice, which are up to date. Oakfield House DS0000023509.V356383.R01.S.doc Version 5.2 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a safe, well-maintained home which is homely, clean, comfortable, pleasant and hygienic. EVIDENCE: A tour of most parts of the building was undertaken and the home is clearly well maintained. The garden is accessible to residents, allowing them to enjoy sunshine and fresh air when they wish. Some improvements have been made to the patio area. The décor and furnishings make the place feel comfortable and look pleasant. There are different lounge areas, including a light and spacious conservatory area. There are a variety of different chairs. New carpets have been fitted on the upper landing, stairs and the lobby. The stairlift has been replaced with a more modern version and some double gazed windows have been replaced at the front of the building. Oakfield House DS0000023509.V356383.R01.S.doc Version 5.2 Page 14 The laundry room and routines for cleaning the house mean that it is maintained in a fresh and hygienic way. One resident who completed a survey ticked ‘Always’ in response to the question ‘Is the home fresh and clean?’ Oakfield House DS0000023509.V356383.R01.S.doc Version 5.2 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by sufficient staff who are competent and trained. Residents are supported and protected by the home’s recruitment procedures. EVIDENCE: A rota is kept which indicates who is on duty and in what capacity. The rota shows that staffing levels differ according to the time of day ie residents’ needs. There are two waking night staff. There are sufficient domestic staff employed. Records were seen for five members of staff and they showed that the recruitment procedure within the home includes and application form, an interview (plus a second interview involving residents), job descriptions, written terms and conditions of employment, the request for two references and criminal record bureau checks. Five care staff have a national vocational qualification (NVQ) Level 3 and two people are working towards this achievement, and people have NVQ Level 2, with one person working towards this. Staff confirmed they have opportunities for training. The individual records showed that induction training is provided and has been modified over time to reflect the Common Induction Standards specified by Skills for Care, the sector national training organisation. Oakfield House DS0000023509.V356383.R01.S.doc Version 5.2 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from the home being managed by someone who is competent, experienced and knowledgeable. Residents’ financial interests are safeguarded and their views are sought. Staff and residents have their health and safety promoted and protected. EVIDENCE: Robin Field, the manager, has attained appropriate management and care national vocational awards and he is also a NVQ assessor. He is experienced and knowledgeable and keeps up to date with current thoughts about care for older people through the home’s membership of the Care Homes Association. Policies and procedures are reviewed and updated if required every year by the manager. He also said that if there was a change in legislation that affected a Oakfield House DS0000023509.V356383.R01.S.doc Version 5.2 Page 17 policy it would be changed immediately. There is access to the internet within the home which can be used for maintaining knowledge about specific areas of care. There are clear lines of accountability within the home. Surveys are being undertaken regularly to ensure that residents’ views are known and responded to. The management value face to face discussions with residents and their representatives to make sure people are satisfied with the care at Oakfield House. Staff spoken to described Robin Field and the head of care as ‘approachable’. There are staff meetings but the last one was some time ago. The home is not involved in managing the financial affairs of any of the residents but will undertake to hold small amounts of cash for residents, with their agreement and those of their relatives if appropriate. When this happens receipts and records are kept. A spot check on maintenance and service contracts (gas safety, electrical installation and hoists) showed that they were appropriate and up to date. The written information provided by the manager through completion of the AQAA, confirmed this. Training courses and instruction relating to aspects of health and safety are undertaken within a rolling programme and at the time of induction training. Unfortunately, a training course for manual handling had to be cancelled because of the training provider but Robin Field is to reschedule this with a new provider. There is a range of policies and procedures relating to health and safety. Fire safety checks are carried out and accidents and other incidents are recorded and reported either under RIDDOR or Regulation 37 of The Care Homes Regulations. Oakfield House DS0000023509.V356383.R01.S.doc Version 5.2 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Oakfield House DS0000023509.V356383.R01.S.doc Version 5.2 Page 19 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Oakfield House DS0000023509.V356383.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Maidstone Local 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 Oakfield House DS0000023509.V356383.R01.S.doc Version 5.2 Page 21 - 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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