Care Home: Oakland Nursing Home

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What the care home does well Oakland provides a safe, comfortable and homely environment for the people who live there. There is a good staff-training programme and all members of staff are encouraged to undertake training that will aid their professional development and help them meet the needs of the people living in the home. Good information is available to help prospective residents and their families decide if the home is suitable for their needs. People living in the home and their relatives spoke very highly about Oakland and praised the manager and staff for the way in which they were looked after. What has improved since the last inspection? What the care home could do better: Although the staff files contained all of the necessary information, they were poorly organised and in some cases contained information that should not havebeen there. The manager should review all of the files to make sure they are better organised. CARE HOMES FOR OLDER PEOPLE Oakland Nursing Home Whitepoint Road West Cliffe Whitby North Yorkshire YO21 3JR Lead Inspector Ray Burton Unannounced Inspection 12th June 2008 10:00 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 Oakland Nursing Home DS0000071192.V368612.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. Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakland Nursing Home Address Whitepoint Road West Cliffe Whitby North Yorkshire YO21 3JR 01947 602400 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) www.oaklandnursinghome.co.uk Oakland Care Ltd Mrs Pauline McNeil Stonehouse Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following category: Old Age, not falling within any other category, Code OP - maximum number of places 27 The maximum number of service users who can be accommodated is: 27 This was the first inspection since the home was bought by Oakland Care ltd. 2. Date of last inspection Brief Description of the Service: Oakland Nursing Home (formerly Westcliffe Nursing Home) provides general nursing care and accommodation for up to 27 older people. Oakland is a large detached building situated on the West Cliff in Whitby. The town centre and facilities are within easy reach of the home. There is a regular bus service that passes close by. Accommodation is provided in both single and double bedrooms over three floors. There is a passenger lift to all floors and level access to the front of the home. Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced inspection covering all of the key standards of the National Minimum Standards for Care Homes for Older People; it commenced on 12th June and was completed on 16th June 2008. During the inspection the inspector looked around the home, examined various records and spoke to people living in the home as well as to visitors, the owner of the home, the registered manager and members of staff The weekly fees range from £490 to £613 What the service does well: What has improved since the last inspection? What they could do better: Although the staff files contained all of the necessary information, they were poorly organised and in some cases contained information that should not have Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 6 been there. The manager should review all of the files to make sure they are better organised. 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. Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 7 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 Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 8 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): 1, 2, 3,4, 5. People who use this service experience good quality outcomes in this area. Prospective residents are given information prior to and after admission to enable them to make an informed decision about the suitability of the home and its ability to meet their needs. The homes assessment procedure ensured no one would be admitted unless his or her needs could be met. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: Prospective residents and their families were provided with sufficient information to enable them to make an informed choice about the suitability of the home. The Statement of Purpose and Service Users Guide were available in large print and also available on the homes website. The files belonging to three people living in the home were examined; each contained a copy of the homes own assessment which had been conducted by Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 9 a Registered Nurse from the home with the involvement of the prospective resident, next of kin and appropriate healthcare professionals. Where the referral had been made by the Social Services Department a care managers assessment had also been obtained. Prior to admission, prospective residents and their families were invited to visit to look around the home and to meet members of staff and the people already living there. The manager said if the prospective resident were unable to visit the home she, or a nurse from Oakland, would visit the person in his/her own home or in hospital so that a pre-admission assessment could be carried out to determine if the home would be able to meet the persons needs. Following admission there was a trial period during which time new residents were able to decide if they wished to continue to live at Oakland. The home does not offer intermediate care therefore standard 6 does not apply. Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 10 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, 10, 11. People who use this service experience good quality outcomes in this area. The homes care planning process ensured that residents’ needs were identified and met. Personal care was conducted in a sensitive manner that upheld the dignity and privacy of the people living in the home. Systems were in place to ensure the safe handling of medication. An appropriate policy was in place to deal with the dying and death of a resident. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: Care plans provide a comprehensive and detailed record of the individual’s health, personal and social needs. Assessments of physical and social needs had been conducted and risk assessments were in place. Reviews and audits were conducted monthly, or if necessary more frequently, and appropriate action taken to respond to any changes that might have taken place. Daily records showed health was closely monitored and healthcare needs addressed Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 11 by Oakland staff in conjunction with community based healthcare professionals such as the person’s own GP, chiropodists etc. Medicines were stored suitably and securely and administered, according to the homes policy and procedures, by Registered Nurses who had undertaken regular refresher training in the safe handling of medicines. It was observed during the inspection that people living in the home were treated with respect and addressed courteously and appropriately. Members of staff displayed insight into the difficulties associated with old age and spoke sensitively about how needs could be met and how they could help a resident to preserve his/her dignity and privacy, particularly when assisting with personal care. Oakland was looked on as a “home for life” with residents being able to remain there throughout their last days. Suitable policies and procedures were in place to deal with dying and death and staff had received training in palliative care. Relatives were encouraged and enabled to remain with their loved one during their last stages of life and an in-house bereavement leaflet was available. Surveys returned by relatives contained the following comments: “We have met with staff to explain our wishes should Dad deteriorate or need hospital attention. They were helpful, understanding and sympathetic.” “From what I have seen the staff team is motivated, positive and kind. They are clearly skilled at what they do and show a good amount of respect and dignity.” “My mother was admitted to the home a month ago from hospital. In that time she has improved 100 health wise due, I am certain, to the kindly and attentive staff who have encouraged her to get better, She is very happy here.” Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 12 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, 15. People who use this service experience good quality outcomes in this area. People living in the home were able to exercise choice and make decisions about their lives. Routines were flexible and able to accommodate individual preferences and expectations. Residents were supported to maintain links with family, friends and the local community. A healthy and balanced diet was provided. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: Oakland provides care in an informal, friendly and relaxed atmosphere. Routines appeared flexible with residents being able to make decisions about everyday things such as when to rise and retire to bed. Members of staff said people living in the home were encouraged to exercise choice and to make decisions about their own lives and to be as independent as possible, subject to their individual plan and risk assessments. Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 13 The home employed a part-time activities co-ordinator who, along with other staff, organised various regular in-house activities and events e.g: board games; sing-a-longs; quizzes etc. A member of staff said that whilst encouraging people to take part in organised activities it was important to recognise that not everyone wished, or was able, to participate in communal activities; and that for those people it was important they were “not forgotten” and staff found some time to spend on a one to one basis either just chatting or sitting quietly. One resident said: “ I prefer to stay in my own room, so it’s my choice not to join in.” Local clergy visited each week so that people living in the home could take part in an act of religious worship if they wished. Two visitors spoke to the inspector; both made very positive comments about the home and expressed satisfaction with the way in which their relative was being cared for: “I visit my mother very regularly and am always made to feel very welcome by the staff. It’s a wonderful home; the staff are excellent and are very good at informing me of my mothers progress. The food is good and there appears to be a very varied diet. I am not at all worried when I leave the home, I know my mother is being well cared for.” “I am extremely satisfied with the home; the food and the care is good.” Meals were generally served in the dining room at set times although there was flexibility to suit individual wishes, and meals could be served in people’s own rooms if they wished. There was a four-week rolling menu showing a varied and balanced diet was provided. Alternatives were always available should someone not wish to have the dish of the day. The home was able to cater for special dietary needs. Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. People who use this service experience good quality outcomes in this area. The home had appropriate policies and procedures in relation to the protection of vulnerable adults and for dealing with complaints. People living in the home and their relatives felt confident that appropriate and swift action would be taken to resolve any complaint or concern they might have. All staff had received training in adult protection. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: The homes complaints procedure was on display in the home and was also included in the information pack given to each new resident. The procedure showed how to make a complaint, to whom the complaint should be made, the timescale for dealing with the complaint and the course of action to be taken should the complainant not be satisfied with the way in which the matter had been handled. Records showed that no complaints had been received in the last twelve months. Returned questionnaires and conversation with the people living in the home indicated they knew how to make a complaint. Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 15 The following comments were made to the inspector by visiting relatives: “I have no complaints but if I am concerned about anything I will speak to Polly (the manager) and it is sorted.” “I have no complaints whatsoever but if I had I would speak to Polly, I have faith in her and know she would deal with it.” Policies and procedures were in place to ensure the safety and protection of the people living in the home and to respond to any suspicion or allegation of abuse. Members of staff had received training in “Safeguarding” and were able to demonstrate an understanding of what constituted abuse and what to do in the event of such an incident being brought to their attention. Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 16 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, 23, 24, 25, 26. People who use this service experience good quality outcomes in this area. Oakland provides a comfortable, homely and safe environment for the people living there. The home was clean and hygienic. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: A walk around the home revealed it to be clean and hygienic and free from offensive odours. The fabric of the building was well maintained and records showed equipment was regularly checked and serviced; décor throughout the house, however, was looking a little tired. The proprietor said he had recently commenced a rolling programme of work, which when completed would result in the complete refurbishment of all areas of the home. Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 17 Bedrooms were comfortably and appropriately furnished and had been individualised by the inclusion of small items of furniture and other personal effects such as pictures and photographs brought from the occupants home. Health & safety documentation was up-to-date. Records were kept showing fire safety equipment was regularly maintained and fire safety checks e.g. fire alarm test took place regularly. All members of staff received regular fire training. Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 18 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, 30. People who use this service experience good quality outcomes in this area. Members of staff were employed in sufficient numbers, and with appropriate skills and training, to meet the needs of the people living in the home. The home operated an appropriate recruitment procedure. EVIDENCE: On the days of the inspection there were sufficient members of staff on duty to meet the needs of the people living in the home. Examination of staffing rosters revealed the home was always appropriately staffed. All members of staff were encouraged to undertake training that would develop and update their professional skills and help them meet the needs of the people living in the home. Newly appointed staff received induction training, and all staff underwent mandatory training as well as further training specific to their role and to help them meet the identified needs of the people living in the home e.g: training in dementia, nutrition, palliative care, equality & diversity and diabetes. Of the 24 full and part time staff, seven were Registered General Nurses, eight care assistants were qualified to a minimum of NVQ level 2 in Care and four care assistants were currently working toward achieving NVQ level 2. The Deputy Manager had recently completed the NVQ level 4 in Management. Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 19 Conversation with the manager and examination of randomly selected personnel files showed the home operated a recruitment and staff selection procedure ensuring all necessary checks, including Criminal Records Bureau (CRB), were conducted and two suitable references received prior to commencement of employment; however some of the inspected files were poorly organised and in one instance contained information not relevant to the member of staff who was the subject of the file. The manager should review all personnel files to ensure they are all properly organised and contain only information pertinent to the subject. Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 20 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, 32, 33, 35, 36, 38. People who use this service experience good quality outcomes in this area. A well managed home with policies and procedures in place to protect the people living there and to ensure their health & safety. We have made this judgement using a range of evidence, including a visit to the service. EVIDENCE: The manager has the appropriate experience and qualifications to manage the home. Members of staff, people living in the home and visitors considered it to be well managed and expressed confidence in the registered manager who, they said, was approachable and supportive. Staff said they were happy in their work and felt their contribution towards the running of the home was appreciated. Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 21 All members of staff received formal supervision on at least six occasions per year. Appropriate policies and procedures covering all aspects of the management of the home were in place and regularly reviewed to reflect changing legislation and current good practice. Records, including care plans, were maintained in good order and were held securely and appropriately. The manager and staff were aware of their responsibilities under health & safety legislation. The building, furnishings and fittings were regularly checked and serviced to maintain a safe environment. A designated representative, usually a family member, dealt with the financial affairs of residents and only small amounts of cash were held by staff at the home. Any item of value held for safekeeping on behalf of a person living in the home was held securely and an appropriate record kept. Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 22 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 23 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. 1 Refer to Standard OP29 Good Practice Recommendations Each personnel file should be reviewed to ensure it contains only information relevant to the named member of staff. Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Oakland Nursing Home DS0000071192.V368612.R01.S.doc Version 5.2 Page 25 - 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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