Care Home: Oaklands

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• St Vincents
• The Cotswold Home
• Winton House
• Rush Court
• Hillyfield Rest Home
• The Maypole Nursing Centre
• The Briars

What the care home does well The service is managed by a experienced manager who leads an enthusiastic team . The Responsible Individual (RI)is present in the home at least three times a week to monitor the quality of the service. There is a low staff turnover which means that residents needs are met by staff who have formed friendships and have a good understanding of residents needs. The premises are clean and comfortable and residents feel safe at the service. Residents are consulted on the running of the home and are central to how the service operates. Residents and relatives are confident that any concerns they have will be addressed promptly and they are kept informed of any changes to the way the service operates. What has improved since the last inspection? Since the last inspection redecorating had been carried out at various points around the service. More work has been carried out in respect of care plan documentation and nutritional screening for residents to ensure they receive a nutritional meals. More training is being provided for staff to ensure they continue to develop their skills in line with changing care needs of residents. What the care home could do better: While a lot of work has been carried out with care plans ,records pertaining to residents mental heath needs need a little more information to be recorded. This will enable staff to be able to monitor more clearly any changes in this area so they can support residents more appropriately as their needs change. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Oaklands Lower Common Road West Wellow Romsey Hampshire SO51 6BT     The quality rating for this care home is:   three star excellent 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: Kathryn Emmons     Date: 0 8 0 4 2 0 0 9 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. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. 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 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Oaklands Lower Common Road West Wellow Romsey Hampshire SO51 6BT 01794322005 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : admin@oaklandscarehome.co.uk Delicourt Limited care home 45 Number of places (if applicable): Under 65 Over 65 0 0 45 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 45 45 0 The maximum number of service users to be accommodated is 45 The registered person may provide the following category of service only: Care home only(PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category : Dementia (DE) Mental disorder, excluding learning disability or dementia(MD) Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home This residential home is registered to provide personal care and accommodation to 45 residents who are over 65 years in age and are in the category of Old Age. They may also have dementia or mental health problems. The home is privately owned by Delicourt Limited. This organisation owns a number of Care Homes for Older People Page 4 of 26 Brief description of the care home residential and nursing homes in the county. Mr Robert Tyson is the registered manager. Accommodation is provided in a large house that has been extensively extended to provide thirty five single and five shared bedrooms located on the ground and first floors, thirty of which have en suite facilities. Two passenger lifts enable residents to access both floors. Communal space is provided in four lounges, a chapel/quiet room and a large dining room. The home has a large patio area and garden to the rear of the property with car parking space at the front and is situated in a quiet residential road in a rural area between Romsey and Salisbury. The home is close to local shops, amenities and public transport. The Mr Tyson confirmed the fees for the home range from #415 to #450 per week. Care Homes for Older People Page 5 of 26 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: three star excellent 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 visit to the service was undertaken by one inspector who spent six hours at the home. The care received by three residents was looked at in detail. This is a method called case tracking. This included looking at their personal records, a range of general records and staff details. This forms part of a key inspection and focused on the standards in the key areas that most effect the quality of life for the residents. Information already held such as a service history and the providers self -audit which is called an AQAA (Annual Quality Assessment Audit) were used to plan the visit. During the visit the inspector spoke to the responsible individual , manager , four staff and two relatives. We observed residents interactions with staff. We also sent comment cards for staff and residents and health care professionals to complete and we considered the comments these contained when writing the report. Care Homes for Older People Page 6 of 26 The current weekly fees for the service start from #415 pounds to #450 per week. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 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 9 of 26 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. Residents are assessed before admission so they can be confident that the service is aware of their individual needs and can meet these. Current information is available in a format which enables residents to be clear on the services available. A contract protects residents right to receive a service which had been legally agreed. Evidence: We spoke to two relatives about the admission process of their relatives. We were told that a visit had been carried out at the prospective residents home and a detailed assessment was carried out. A trial visit was recommended and any questions the prospective residents and their families had were answered by the manager. A brochure was provided which includes information regarding what services are offered at the home. Staff were aware of the brochure and were able to tell us why it was important the residents were made aware of the services available. The manager said that each prospective resident was assessed and then the assessment was discussed Care Homes for Older People Page 10 of 26 Evidence: between himself and the deputy manager to ensure that the prospective residents needs could be met at the service and that the prospective resident would fit in with other residents. This means that the manager understands that the service is the residents home and consideration needs to be given to them when considering to admit a new resident. Prospective residents are given verbal confirmation that they can live at the service .Currently this is not followed up with written confirmation. The manager confirmed that following this visit the practice will now be to provide written confirmation of a placement. We saw contracts were in place and these had been signed by the resident or their supporter and the manager. This means that residents rights are upheld and they can be confident in expecting to receive a service the home has legally agreed to provide. Care Homes for Older People Page 11 of 26 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. Residents live in a service where their care needs are known. More information regarding levels of support will enable residents to continue to receive the correct level of support they need. Medication arrangements are clear and keep residents safe. A good rapport existed between health care professionals and the service so residents can be confident they will receive the services they need. Dignity and respect for residents is acknowledged and positive examples of these were seen. Evidence: We casetraked three residents and this included looking at their care plans. We could see that these covered all aspects of their care including emotional support and recreational choices.While the care plans have been developed since the last inspection visit ,more detail is still needed to ensure care staff are clear on how much support they need to provide to residents. Without this information residents may not receive enough support or may be assisted more than is necessary so they do not remain as independent as they would chose to be. Relatives we spoke with said they had seen care plans and had signed these . Staff said the care plans were fairly new and that Care Homes for Older People Page 12 of 26 Evidence: they worked with the deputy manager in writing care plans and reviewing them. Residents we spoke with were not always aware of their care plans but three said staff came and spoke to them and would always ask them if they needed any help.The deputy manager was aware that all care plans needed to be agreed by either the resident if they were able to agree to them or the supporter of the resident. This means that residents are clear that they have decided how to have their care delivered and it is not task driven by the care staff. Medication records had been completed correctly and staff confirmed they had received training in administering medications. We received comment cards from health care professionals who visited the service and they said the home provided An excellent service and that medication issues are very good. We saw evidence in care plans to show that people who needed to see the doctor were referred promptly. Opticians and dentists visit the service when needed and we saw from three sets of daily notes that residents had recently seen the chiropodist. We saw many interactions while at the service and staff were seen to have a very good rapport with all of the residents. Some of the residents were needing assistance with sitting in the lounge after lunch and we saw this task was carried out with politeness and respect. Relatives we spoke to said they often listened to interactions between staff and other residents and found staff to always speak to the resident in a lovely way always kind and patient. Care Homes for Older People Page 13 of 26 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. Residents rights are upheld an they are able to make decisions regarding how they spend their time. Catering preferences are met and residents are involved in choices regrarding mealtimes. Religious and cultural needs are understood and met. Evidence: During the visit we saw that residents were engaged in various activities. These included watching television, reading books and magazines and talking with staff. We saw photographs of a dance afternoon from the previous weekend and a couple of relatives told us that when they visited the service there always seemed to be some activity taking place. The manager spoke about a recent fete ,we saw a display board informing of visitors from the local church and a trip to the theater. A volunteer visits the home for one day a week and holds quizzes and group discussions with residents. We could see that there were entries in the daily notes to show some residents had attended activities but this needs to be in a little more detail so it can be clear what activities were offered to residents. All comment cards except one which were all completed by residents, stated there were sufficient activities taking place. We saw that records showed each residents religious and cultural needs. We saw that one resident was a Jehovah Witness and that during Christian celebrations part of the Care Homes for Older People Page 14 of 26 Evidence: home was not decorated in Christmas or Easter decorations so that the resident had somewhere where they could uphold their religious beliefs. We saw that residents were given choice over all aspects of their care and where choice was restricted it was clear why this was in place. An example of this was that an application had been made to DOLS. (Deprivation Of Liberty Safeguards) for one resident who had been restricted in leaving the service without support. The correct process had been followed so a decision to limit this residents choice was lawful and in their best interests. All of the comment cards we received stated that food was always of a good standard. We saw a nutritional system has been put in place which enables staff to check that residents have received the right amount of vegetables and protein and other nutrients which are needed for well health. We saw a record of varied food provided ,including alternatives. Meals are taken in either the dinning room or a tray service is available. Residents can choose when they take their lunch and there is an earlier sitting for those residents who need more assistance to take their meals. This means they can still remain as independent as possible and their dignity is maintained as they are assisted in a discreet manner. Care Homes for Older People Page 15 of 26 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. Residents and their supporters can be confident that any concerns they raise will be investigated and taken seriously. Safeguarding adults polices and staff knowledge protect residents. Ensuring that more safeguarding training is provided following what is covered in induction,will ensure all staff are up to date with current safeguarding practices. Evidence: We looked at staff training files and could see that training had been carried out with regard to safeguarding adults training. The service had a copy of the Hampshire County Council joint working procedure and we were told the services own procedure was in place and regularly updated. We spoke to staff and gave them several scenarios in respect of safeguarding adult issues. Staff answered these appropriately and had a clear understanding of what constituted abuse and what action to take if they thought care practices were not appropriate. We also discussed with the manager the need to ensure that refresher training took place for all staff within suggested timescales.The manager confirmed safeguarding training was due to take place in the next couple of months. A complaint file is in place and the AQAA informed us that no concerns or complaints had been raised in the previous year. Relatives we spoke with said the manager was always available for them to speak to and if they had any concerns they were certain the staff would take them seriously. Staff we spoke with understood that any issue a Care Homes for Older People Page 16 of 26 Evidence: resident or supporter raised needed to be taken seriously, reported and investigated. The manager said he felt concerns were minimal as he and the care team worked hard at addressing any issues as soon as they were mentioned. A couple of residents we spoke with said they felt at ease and safe and looked after at the service. Care Homes for Older People Page 17 of 26 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. Residents live in clean and comfortable surroundings. Infection control systems work well and systems for servicing aids and adaptations and service equipment ensure the home is safe for the residents and staff. Evidence: we undertook a tour of the premises during our visit. We spoke to two residents in their bedrooms and both indicated they were satisfied with the decor in their rooms. All areas of the home were clean, tidy and smelt fresh and were well decorated.The AQAA informed us that since the last inspection several areas of the service have been redecorated and new carpet had been fitted in a couple of areas. Bathrooms we viewed were clean and safe to use and residents had access to toilets nearby all of the lounge areas.One comment card indicated that a resident felt it was sometimes difficult to access the garden. We did not find this during our visit. There are several lounge areas where residents can sit in small grpups and some of these lounges do not have televisions so residents can sit in quiet. There is a large dining room which was spacious and residents who used wheelchairs were able to access the dining room with ease. We saw domestic staff on duty and the use of chemical cleaning agents was carried out safely with staff never leaving their trolleys unattended. This means that those residents who journey around the home and are not aware of the risks associated with Care Homes for Older People Page 18 of 26 Evidence: cleaning chemicals have risk minimised to them. We saw that staff wear a uniform and also wore gloves and aprons when delivery care and serving food. We saw from staff training records that staff had received training in infection control. We saw from the AQAA that equipment such as the fire safety system, hoists and bath aids were regularly serviced. This means that residents and staff can be confident that they are living and working in a service which the manager ensures is safe. Care Homes for Older People Page 19 of 26 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. Residents can be confident that they are in safe hands. Staff are recruited safely and receive induction and training which ensures they have the skills to provide the support residents require. Ongoing training in areas such as dementia care will ensure residents ever changing needs will continue to be met. Evidence: All of the comment cards we received back indicated that staff always were available for residents to talk to and call bells were responded to promptly. We looked at the duty rota and saw that staffing levlels remained constant each day. Staff we spoke with said that sometimes the morning was busy and the staff were trying to find ways to meet resident requests for assistance when they called for support. Resident said that sometimes they waited a short time for assistance but felt there were enough staff on duty. One relative said You never have to go looking for a member of staff, they are always near by. Relatives we spoke with said they had a good rapport with all of the staff. Residents we spoke with made comments about staff such as They are smashing and All very good and caring. The interactions we saw between residents and staff were very good. All of the staff understood the best way to communicate with residents and the interactions were valuing of the resident. We looked at the recruitment records for three staff . We could see that all paper work was in place and checks had been carried out such as references, criminal record bureau (CRBs)checks Care Homes for Older People Page 20 of 26 Evidence: and these had all been obtained before an offer of employment had been made. This means that residents can be confident that the right people are supporting them. We saw that training takes place and this included health and safety, basic food hygiene , moving and handling and first aid. we saw that most of the care staff had received NVQs (National Vocational Qualifications) in care and some of these were level three as well as level 2. The service admits people who may have a dementia type condition. We saw that there was some training in place for dementia awareness and the manager is looking at providing more as residents conditions change and staff need to have more skills to deal with changing behaviours of residents. Care Homes for Older People Page 21 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a service which is managed by an enthusiastic and competent manager. Quality assurance systems ensure the service continues to evolve and improve the quality of life for residents at the service. Health and safety arrangements keep people at the service safe. Evidence: The service is manged by Mr Robert Tyson who has been the registered manager for the service for sixteen years. Mr Tyson is supported by a deputy manager, care staff and hotel services staff such as domestic and catering staff. Comment cards we received back from staff and residents all stated that Mr Tyson was a very competent and experienced manager . Comments from staff and residents and relatives on our visit included, he is very good, lovely, always happy to talk to you, always stops to say hello and listen to you, you can approach him about anything he will always try and help. Staff all receive supervision sessions from either the manager or the deputy manager. Care Homes for Older People Page 22 of 26 Evidence: Several systems have been tried out to ensure that all areas which need to be covered in supervision are recorded in a clear and easy way. Staff confirmed that staff meetings take place every couple of weeks and resident meetings take place regularly with Mr Tyson trying to speak to all of the residents each day he is working. The Responsible Iindividual(RI) visits the service at least three times a week and monthly, produces a report regarding the conduct of the service. These are stored at the service and discussed with the manager. The manager also receives supervision from the RI but currently a record is not maintained of the supervision. We met with the responsible individual during our visit. The RI confirmed that supervision notes would be maintained and that he was planning to include more information in the monthly visit report. The visits form part of the services ongoing quality assurance system. This includes sending out questionnaires to residents and relatives and other stakeholders such as Doctors and care managers. Feedback is recorded and the findings are available for residents to see and also form part of the ongoing business plan. The manager and RI both show enthusiasm for moving the service forward and improving the quality of life for the residents who live at the service and a positive working environment for the staff. We have received notifications when necessary for any incident or accidents that have occurred in the service. We saw a record in the day notes recording that a resident had an accident and we found the record for this in the accident book. We saw that a fire risk assessment was in place and that health and safety training is provided to all staff. This means that systems for keeping people safe at the service are in place. Care Homes for Older People Page 23 of 26 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 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) 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. 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