Care Home: Oakland Grange

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What the care home does well People living at the home that returned our surveys, were interviewed or spoken to more informally were found to be happy living at the home and with the quality of care and support they received on a daily basis. People were observed to have good relations with the staff team and the managers, and spoke highly of the staff in general. Residents choose the food they eat and are offered alternatives if the main menu options were not to their liking. On the day of our visit we joined people for lunch and we observed people enjoying their main meal. There was evidence of regular activities arranged. As far as possible these were planned and provided on the basis of each individual`s assessed needs and wishes. It was evident that people were being supported to lead the lifestyles they chose, and that support also took account of the abilities and skills of the person concerned. Staff members were found to engage well with residents, and there was a range of skills and experience in the team. Staff are supported in their training and development, and the staff are trained and qualified, or training toward the national vocational qualification level as set out by Government benchmarks. In addition to this the manager and deputy have recently trained and qualified to NVQ level 4 in care with the Registered Managers Award. The manager makes sure documentation provides information needed by staff members relevant to any specialist needs of service users and also provides staff with opportunities to attend more specialist courses. We were advised that any visitors are always made to feel welcome, and could visit at any reasonable time. There is a clear statement in respect of visitors available at the home. Two visitors interviewed said they could visit their loved ones / friends when they wished and were always made welcome. A number of residents said they received visitors at any reasonable time and in private if they wished. Visitors said they were aware of how to make any concerns known to the home, and that they felt confident that the registered manager would deal with any issues as they arose. Oakland Grange`s AQAA states - We have regualr meetings with service users to discuss any matters they are concerned about. Share any views they have that will improve our service. The manager`s door is always open so service users and/or family members can talk freely to management at any time. Oakland Grange is well presented and the physical environment provides a valuing home for the people who live there. What has improved since the last inspection? Oakland Grange`s AQAA states - We have employed an activities organiser, and fitted a second juccuzi bath. We are planning to provide more group activities and to restart the bingo sessions. As part of the general up keep and refurbishment programme we plan to continue to replace more windows. We have added equality and diversity to our staff induction programme, and we plan to provide more staff training in this area and on nutrition.We were planning on developing the home further, but have been refused planning permission recently due to the location of the home being in a conversation area. What the care home could do better: Outcomes in quality of life experienced by people living at Oakland Grange could be measured more accurately by the home by adopting more person centred planning systems, and by developing daily recording to include specific details of outcomes for/with people. The home could make use of valuable information and resources available on the internet including our professional website, if the home had access to a computer linked to the internet for web access. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Oakland Grange 10-12 Merton Road Southsea Hampshire PO5 2AG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Richard Slimm     Date: 0 3 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Oakland Grange 10-12 Merton Road Southsea Hampshire PO5 2AG 02392820141 02392820141 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Angela Kish Type of registration: Number of places registered: Crescent Care Limited care home 43 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 physical disability Additional conditions: Four named service users betweem 55 and 65 years of age in the categories LD and MD may be accommodated No more than six service users in the categories MD(E) and DE(E) may be accommodated at any one time No more than two service users in the category PD(E) may be accommodated at any one time Date of last inspection 0 0 0 0 Over 65 6 6 43 2 Care Homes for Older People Page 4 of 30 Brief description of the care home Oakland Grange is a large, period, detached residence situated in a quiet residential area of Portsmouth. The home is maintained to a good standard providing a valuing environment to residents. The home is registered with the Commission for Social Care Inspection (CSCI) to accommodate up to 43 older people, including up to six with an age related mental health problem and two service users with a physical disability. Accommodation is organised over a number of floors with access available to frail persons via the provision of a shaft lift. It is one of a number of registered care homes that the owner has an interest in. The home is centrally placed and is close to the shopping area in Southsea where there is a wide range of shops situated. The local bus stop, where buses run regularly into Portsmouths main shopping centre is nearby as is the main seafront at Southsea. Care Homes for Older People Page 5 of 30 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 inspection was an unannounced Key Inspection of the home, a Key Inspection being part of the CSCI inspection programme, which measures the service against the key National Minimum Standards, and outcomes for people using the service as part of a process known as Inspecting for Better Lives (IBL). This report incorporates information gained from people using the service and/or their advocates / relatives, staff, including managers and comments from external stakeholders who completed professional comment cards. Care Homes for Older People Page 6 of 30 We were also provided with the services annual quality assurance assessment (AQAA) completed by the manager and other relevant information gained by the inspector via such processes as observations, interviews, inspection of documents and records and case tracking, during a site visit to the home. The visit to the home was undertaken by one inspector and lasted 5 hours. What the care home does well: What has improved since the last inspection? Oakland Granges AQAA states - We have employed an activities organiser, and fitted a second juccuzi bath. We are planning to provide more group activities and to restart the bingo sessions. As part of the general up keep and refurbishment programme we plan to continue to replace more windows. We have added equality and diversity to our staff induction programme, and we plan to provide more staff training in this area and on nutrition. Care Homes for Older People Page 8 of 30 We were planning on developing the home further, but have been refused planning permission recently due to the location of the home being in a conversation area. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 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 30 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. Assessments are carried out by suitably qualified and experienced staff with all prospective residents prior to admission, in order to ensure that peoples needs can be met at the home. Oakland Grange does not provide intermediate care services. Evidence: Oakland Grange sent us their AQAA, and this tells us - All service users are assessed before admission to ensure we can provide the appropriate care. People are encouraged to visit the home before they make a decision to move in at Oakland Grange. People can come for a day visit as well if they wish. We case tracked 3 people living at the home. We found assessments on each case record we viewed. We interviewed those three people plus another 8 people, each Care Homes for Older People Page 11 of 30 Evidence: confirmed they had been given contracts, had received sufficient information about moving into Oakland Grange, and were happy with the quality of care and support they received. We received 20 responses to surveys sent out to service users. All confirmed they had been provided with contracts, pre-admission information and assessments, as well as indicating they were happy with the service they received at Oakland Grange. Assessment materials seen covered all relevant functional areas of daily living, key information; key contacts / social / family networks; likes/dislikes; activity based risk assessments and this information was then used to inform a plan of care and support. People said their needs were known and met on a daily basis. Staff interviewed confirmed that they used the assessment and care planning information, and this guided them in their dealing with residents. The manager promotes the use of assessment and care planning, and is usually the person who carries out the initial assessment. Both the manager and deputy manager have NVQ level 4 in care and the Registered managers Award. Assessment formats were a little dated and predominantly task oriented, and could be updated with more person centred formats that take more account of wishes, feelings, views, aspirations etc as well as needs. Care Homes for Older People Page 12 of 30 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. Peoples health, personal and social care needs are set out in an individual plan of care and support. More person centred planning could be developed to reflect increased detail about wishes and aspirations as well as needs. People make decisions about their lives with support when needed. People where appropriate and able are responsible for their own medication, are support where ever needed, and are protected by the home practices and procedures for dealing with medications. People feel they are treated with dignity and respect and their rights to privacy upheld and promoted. Evidence: Oakland Grange sent us their AQAA, and this tells us - All service users have a detailed up to date care plan. Staff record daily about each service user. If a service user Care Homes for Older People Page 13 of 30 Evidence: wishes to self medicate a risk assessment is completed and monitored. All staff are trained in medicine management. All staff are either NVQ trained or working towards their NVQ qualifications. Service users privacy and dignity is always respected and promoted. We have a good working relationship with GPs and district nurses. We case tracked 3 people living at the home. We found care plans in place for each person, that had been informed by assessments as above. We interviewed those three people plus another 8 people, all of whom said they were aware of their plans of care. We received 20 responses to surveys sent out to service users, and people said they were happy with the quality of care and support they received at Oakland Grange. We interviewed two staff members, and observed staff using the care planning and recording systems at the home. As identified above assessment and care planning systems at the home are quite dated now, and tended to be fairly task based. We discussed the need to develop more person centred approaches, as current systems did not appear to be capturing all of the good work being done with people at the home, especially in the areas of empowerment, aspirations, choice and control. Daily notes could also record more detail about outcomes for people, especially in such areas as activities, visits, entertainments attended, choices made and outings, so as managers can obtain an accurate measurement of quality of life experiences and outcomes of service users. This information can then feed into monthly monitoring and on into annual reviews of care and support, and bring more resident experiences into service development. Plans of care seen by us identified peoples health and psychological needs, and the actions needed to support people in these areas. There was one case where a resident who told us he wanted to have greater control and autonomy over his affairs. With this residents permission we fed this back to managers who agreed to arrange a review with this person and their power of attorney, to explore ways forward. People told us they had access to health care services such as GPs on request. External health professionals who responded to our surveys told us they felt confident the needs of their patients were met at Oakland grange. We observed practices in respect of the administration of medication. People were found to be happy with the arrangements in place to support them. We did question the giving of eye drops at the meal table, while the resident concerned was still eating. We found that medication is only given at the point of recording administration in line with the homes procedures and best practice. The home has recently updated the medication systems at the home and these were found to be well organised and promoting best practice. Oakland Grange adopts a monitored dosage system for the safe storage, administration, recording and disposal of drugs and medications. Staff Care Homes for Older People Page 14 of 30 Evidence: interviewed confirmed they receive training before being expected to administer medications. All bedrooms at Oakland Grange are single occupancy. People said their privacy and dignity is respected by staff. A local doctor told us they felt confident that the home promotes and protects patient autonomy. Other visiting professionals told us they could always see their patients in private as each person has their own room. Staff interviewed were found to have an understanding of the core values for residents, and demonstrated an awareness of how they promoted and protected peoples privacy, dignity and respect. Residents told us the staff always treated them well, and were very kind and considerate. Care Homes for Older People Page 15 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People lead the lifestyle they wish, that matched their skills and their expectations. Social, cultural, religious and recreational needs and interests are met. People are encouraged and supported to maintain contact with family and friends in the wider community as they wish. People are encouraged and supported to exercise choice and control over their lives. Were the home discovers anyone who is not happy with arrangements management are happy to attempt to find resident led solutions and ways forward. People receive a wholesome, appealing, balanced diet in pleasing surroundings at times convenient to them. Evidence: The home provides a variety of opportunities for people to enjoy stimulating activities. People told us about the regular things that happen at the home that they looked forward to such as the bingo and quizzes. One survey response said - I love to join in quizzes. Thirteen of the service user surveys told us there are always activities they Care Homes for Older People Page 16 of 30 Evidence: can join in with at Oakland Grange, two responses said there were never any activities, two said there were activities sometimes, one said usually, but added a rider that this was through choice and visual impairment, and two did not comment. There was not a great amount detailed information in assessment or care plans about each persons particular, individual interests, or wishes in the areas of activities, entertainments or preferred frequency of outings, but as mentioned above as plans develop more person centred approaches this information will increase in detail and will be able to inform ongoing developments in this area at Oakland Grange, and should enable a more accurate measurement of outcomes for people. Oakland Granges AQAA states - Service Users have varied activities most days. The activities co-coordinator arranges and fulfills service users requirements. We arrange for a Communion service every four weeks, and arrange for visits by Priests on request. (This was confirmed by people we spoke to as well.) Families and friends can have a meal at Oakland Grange on request. Our next major event will be the Christmas party. We saw a notice board that showed the activities that were/had happened recently. There was some information about social needs/interests in care records. There is a specific staff member with responsibility to ensure activities take place regularly at Oakland Grange. We interviewed two people visiting residents during our site visit. They confirmed that they were always made welcome by the home, and could pop in to see their friend/relative whenever they wished. Residents interviewed told us they had visitors at any convenient time and that their visitors are always made welcome. Oakland Grange has a visiting policy that is available, clear and places residents at the centre of the homes arrangements for visiting. Oakland Grange provides only single room accommodation so people can always see their visitors in private if they wish. One relative told us in a survey response - After a couple of years worrying about my mother, I can now sleep at night, thanks to the wonderful Oakland Grange. My Mother looks better than she has done for several years. There is always laughter at the home, a good sign. Most people interviewed were found to be entirely happy with the arrangements made at Oakland Grange for their help and support. One person did say they would like to have greater autonomy and control over their personal/financial affairs. With this persons permission we mentioned this to the manager who was totally happy to arrange a review of current arrangements with the resident and their power of attorney to see how things could be arranged differently in order to better meet the Care Homes for Older People Page 17 of 30 Evidence: needs and wishes of the resident concerned. The home has regular meetings with service users, and people are consulted about the running of their home. This is currently facilitated via resident meetings, and occasional questionnaires for service users and other stakeholders, as well as less formal feedback in respect of the development of menus. As care planning becomes more person centred it will be possible to provide even more valuable information about peoples wishes, preferences and aspirations in respect of how the home is run and developed in the future. People told us the food at Oakland Grange is good. We were able to join people at lunch time and found the meal to be well resented, appetizing and enjoyed by everyone we spoke to. More dependent people were provided with discreet support and where needed aids and adaptations were provided with the view to promote and sustain independence in this area of daily living. The cook told us she always had the resources needed to ensure people were provided with a good diet, as well as with choices about what they eat. Survey feedback also told us people were happy with this aspect of the service provision at Oakland Grange. Care Homes for Older People Page 18 of 30 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. People who live at the home, and their relatives / advocates are confident that any concerns of complaints will be listened to, taken seriously and acted upon. People are protected from abuse. Evidence: Oakland Granges AQAA states - We have a clear complaints policy. Records are kept of any complaints and of the outcome. Management adopt an open door policy so residents, friends, relatives or other stakeholders can speak to someone at any time. All staff are trained in safeguarding and are aware of the signs of abuse. This is incorporated in staff induction, supervision and training. We received 20 resident responses to our survey. People told us that they knew who to speak to if they had any concerns. People interviewed said they would speak to the manager or any staff member if anything was worrying them. Two visitors said to us that they felt the manager would deal with any issue before it became problematic. There had been no complaints at the home in the last year. The complaints procedure is displayed prominantly in the home. The home ensures the complaints procedure is part of the homes contract and is made available to every one. Care Homes for Older People Page 19 of 30 Evidence: The home has clear safeguarding adult policies and procedures and these link to the local authority protocols. The home are aware of what to do in the event of identifying any safeguarding issues and refer accordingly to the relevant agencies. Staff interviewed had received safeguarding training and were able to demonstrate an awareness of what constituted abuse of vulnerable persons. People told us they felt safe living at the home. We confirmed that staff recruitment and selection took account of safeguarding, and all relevant checks were being undertaken at the home on any new staff, and updated for existing staff as needed. Care Homes for Older People Page 20 of 30 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. People live in a safe well maintained environment. The home is clean, pleasant and hygienic. Evidence: Oakland Granges AQAA states - The home is kept free from smells. The home is kept in good decorative order. Service users rooms are refurbished regularly, as are lounges, dining areas and other communal areas of the home. Over the past 12 months the middle floor bathroom has been refurbished, and an additional Jacuzzi bath fitted. Both communal lounges have been redecorated and had new curtains. One lounge has been provided with a new plasma TV. A number of bedrooms have benefited from redecoration and the provision of new furnishings. We toured the building. There were four domestic staff on the rota. One was unwell, so three people were keeping the home clean and tidy. Managers tend to put a domestic on each floor so as to ensure the environment is kept clean and free from any odours. The home was well presented, providing a valuing environment to people living there. There was ongoing redecoration to some corridors at the time of our visit. There were no odours or offensive smells evident during our visit. People also told us in surveys Care Homes for Older People Page 21 of 30 Evidence: that the home is always well maintained, cleaned to a good standard and fresh. People we spoke to said the home is always clean. One person told us Oakland Grange is the best home around. Care Homes for Older People Page 22 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know their needs will be met by the number and skill mix of the staff team. People feel they are in safe hands at all times. The safety of people using the service is promoted by the homes recruitment policies and practices. The staff team are trained and are competent to do their jobs. Evidence: Oakland Grange sent us their AQAA, and this tells us - We have a low turnover of staff that helps us provide good continuity of care and support. All staff undertake training to national vocational qualification levels, as well as being provided with other core and more specialist training. All staff either have or are enrolled on NVQ courses, our senior staff are now doing NVQ level 3 and the managers both have NVQ 4 with the registered managers award. We never need to use agency staff to cover, and our staffing levels exceed minimum standards. We checked three staff files and each had personal details including all necessary checks including CRB (safeguarding) checks, references, photocopy of their Care Homes for Older People Page 23 of 30 Evidence: Identification, application forms with their work and educational history. We were told new staff shadow a senior member of staff until we feel they are competent to do tasks unassisted. Staff are all issued with a Contract of Employment. Staff turnover and staff sickness is low. Induction covered areas identified in the Skills for Care Common Induction / occupational standards. All care staff are interviewed. Staff get regular supervision sessions and appraisals. The home hold regular staff meetings and keep minutes of the meetings. Staff are supervised at least 6 times a year. Staff said they felt confident in the way the home is managed and run. Residents said there are always staff available, and little delay when they had to call for assistance. People spoke highly of the staff team and the manager saying that nothing is too much trouble for them. they are all very good. The staff are very patient and kind. We received 10 responses to staff surveys, comments from staff included - We provide well balanced meals, and a warm and friendly atmosphere between residents and staff. - The home is always clean and tidy. I think we provide great care for service users and they make the staff feel welcome and comfortable at work. I always feel appreciated. Staff spoken to were able to demonstrate an awareness of the core values for residents in such areas as privacy, dignity, respect, choice and independence. The home applies a robust staff selection and recruitment procedure both promotes diversity and equal opportunities. The process also ensures all appropriate safeguarding checks are carried out in order to protect any vulnerable adults accommodated. Staff interviewed confirmed the recruitment process they were subject to matched the records we saw. Care Homes for Older People Page 24 of 30 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. People live in a home that is run and managed by a person who is fit to be in charge, of good character and able to discharge his/her responsibilities fully. The home is run in the best interests of the people who live there. Peoples financial interests are safeguarded. The health, safety and welfare of people and staff are promoted and protected. Evidence: The AQAA sent to us by Oakland Grange tells us, - Staff are trained in all aspects required. Individual supervision for staff is done every two months. Regular staff meetings are held. Regular resident meetings are held. The home is kept in excellent decorative order, and all appliances are checked to maintain safety. We have good relationships with service user, visitors and professionals. Care Homes for Older People Page 25 of 30 Evidence: Both the registered and deputy manager have recently undertaken a course of study and have obtained the NVQ level 4 with the Registered Managers Ward. Both managers have also had many years experience of working in the care and support of older persons. Surveys indicated that managers are available and approachable, and would deal with difficulties or concerns quickly. Two visitors to the home also said they felt confident the home was well managed. This was also evident in feedback from other stakeholders external to the home who responded to our surveys. A professional advocate acting on behalf of residents said she felt Oakland Grange was a well run, caring home. A local GP said he felt management and staff were excellent. We spoke to ten residents who they said they felt the managers were very good, and would deal with any issues as they arose. Staff feedback included comments such as - I am very happy with the way the home is run, I have no concerns. - We work well as a team, and the home has a warm and happy atmosphere. - The management always make a point of ensuring the needs of residents are met. - I would say that clients are given good services. - I am very happy with the way the home is run. There was evidence that people were being consulted about the way their home was run. The managers hold regular resident meetings, and also carry out questionnaires on residents and other stakeholders to seek the views of people about how the home is doing. As identified above as systems for care planning become more person centred this will provide even more quality, resident based information that will be able to be used to inform the homes ongoing development. Feedback in surveys indicated that people felt they were listened to, consulted and involved. Residents we spoke to said they were happy with the way their home was run. The home supports some residents with their personal allowances. We checked three peoples accounts. All transactions are fully and transparently recorded. We found one account balanced, two other accounts had more money in than recorded, as residents had received services, that had been recorded but not yet paid for. We noted that the discrepancies were in the residents favour. People we spoke to said they were happy with the arrangements for their personal Care Homes for Older People Page 26 of 30 Evidence: affairs, and could always access money when needed. One person identified above felt he would like more autonomy, and the managers are going to look into this with the resident concerned and their advocate. There are systems in place to ensure the premises are maintained, and that hazards/risks are minimised. All checks and services take place in line with health and safety guidance and/or manufacturers recommendations. People said they felt safe living at the home. Staff confirmed that action is taken to promote safe practices in such areas as manual handling and moving, first aid, food hygiene and health and safety, including infection control. We saw hoists to aid staff and people with mobility problems. There are assisted, therapeutic baths at the home. The AQAA tells us all necessary servicing and checks are carried out to ensure the building is safe in all areas such as fire alarms, personal alarms, servicing aids and equipment such as those above and the shaft lift, boiler and central heating. The home applies COSHH, and promotes good infection control practices. The home has electrical wiring certification as well as regular test to electrical equipment in the home. Records and staff confirmed induction systems include health and safety input. Care Homes for Older People Page 27 of 30 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 28 of 30 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 1 7 It is recommended that the management look into developing more person centred systems of assessment, care planning, monitoring and review. Staff training will need to be included in these developments. Care Homes for Older People Page 29 of 30 Helpline: 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 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 © (2008) Commission for Social Care Inspection (CSCI). 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