Care Home: Oaklands Care Home

What the care home does well Admission to the home is personal and well managed. Prospective residents and their families are treated as individuals and with dignity and respect for the life changing decisions they need to make. Staff respond to individual needs for information, reassurance and support. The delivery of recreational activities is tailored to meet the residents` individual needs and choices. People who use the service are assisted to use and visit local facilities. Appetising and nourishing meals with varied menus are served in the dining room. Records required by regulation for the protection of service users and for the efficient running of the business are maintained, stored securely, up to date and accurate. What has improved since the last inspection? Staffing numbers and skill mix have been changed to ensure a better balance of the service`s own staff to resident need. Staff training is well organised and the options open to staff ensure that they develop on a professional level as well as receiving mandatory updates. Staff supervision has improved with individual support available. Care planning has improved as the management has changed the format to make it more person centred, clear, and readable and so residents (if able) and their families can understand the information better and be involved in the care process. Care plans now contain a risk assessment element. The manager is good at involving people in all aspects of the service. Management have a good day-to-day rapport with residents to ascertain their satisfaction and well being that is also backed up by a formal quality assurance process. There has been considerable improvement in the facilities, furnishings and grounds to make Oaklands a more dignified place to live. What the care home could do better: This service has more strengths than areas for improvement. There are no significant areas for improvement needed relating to the health and safety of people using the service or issues of management. We are confident that the management will address any areas for improvement identified by the service itself e.g. re-locating the laundry. The service now has measures in place to recognise its own weaknesses as they emerge and manage them well. CARE HOMES FOR OLDER PEOPLE Oaklands Care Home Weston Lane Oswestry Shropshire SY11 2BQ Lead Inspector Pat Scott Unannounced Inspection 25th September 2008 10:00 25/09/08 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 Oaklands Care Home DS0000068187.V372326.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. Oaklands Care Home DS0000068187.V372326.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oaklands Care Home Address Weston Lane Oswestry Shropshire SY11 2BQ 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) 01691 652543 Sure Care (UK) Ltd Mrs Judith Richards Care Home 18 Category(ies) of Dementia - over 65 years of age (18) registration, with number of places Oaklands Care Home DS0000068187.V372326.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th September 2007 Brief Description of the Service: Oakland’s is a service that provides personal care to meet the needs of eighteen elderly people with dementia. The home is situated in a quiet residential area within easy reach of the centre of Oswestry with gardens at the rear for use by service users. The home is owned by Sure Care (UK) Ltd. The accommodation is an adapted large family house with a mixture of single and double rooms on three floors. Access to the first and second floor for those who cannot use the stairs is provided by a stair lift. The front door is kept locked in order to prevent people leaving the home unsupervised. Fees range from £364 to £464 and are reviewed on an annual basis. Information about the service is contained in the statement of purpose and service user guide. Inspection reports are available from the home. Oaklands Care Home DS0000068187.V372326.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 *TWO star good service. This means the people who use this service experience good quality outcomes. We, the commission, used a range of evidence to make judgements about this service. This includes: information from the manager in the annual quality assurance assessment (AQAA), staff records kept in the home, medication audits, discussion with the manager, tour of the premises, previous inspection reports, quality assurance processes, Fire Authority reports, Environmental Health Office reports, observation of care experienced by people using the service. What the service does well: What has improved since the last inspection? Staffing numbers and skill mix have been changed to ensure a better balance of the service’s own staff to resident need. Staff training is well organised and the options open to staff ensure that they develop on a professional level as well as receiving mandatory updates. Staff supervision has improved with individual support available. Care planning has improved as the management has changed the format to make it more person centred, clear, and readable and so residents (if able) Oaklands Care Home DS0000068187.V372326.R01.S.doc Version 5.2 Page 6 and their families can understand the information better and be involved in the care process. Care plans now contain a risk assessment element. The manager is good at involving people in all aspects of the service. Management have a good day-to-day rapport with residents to ascertain their satisfaction and well being that is also backed up by a formal quality assurance process. There has been considerable improvement in the facilities, furnishings and grounds to make Oaklands a more dignified place to live. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Oaklands Care Home DS0000068187.V372326.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 Oaklands Care Home DS0000068187.V372326.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): Key Standard 3. 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be confident that the care home can support them. This is because there is a complete assessment of their needs that they, or people close to them, have been involved in. People will be able to feel that they can live the life they choose in the home. This is because the assessment is now more person centred and shows an understanding and respect for their diversity. EVIDENCE: Admission assessments of three people needing dementia care were read. They show that the service is taking into account the individual physical care needs of a resident in a person centred way. Detailed information is written about the person’s personal/social history. Oaklands Care Home DS0000068187.V372326.R01.S.doc Version 5.2 Page 9 The manager is in the process of updating the service’s statement of purpose. This document delivers a more reader friendly message about the service the home aims to provide. Oaklands admits people with dementia and provides staff with training and guidance to enable them to be responsive to individual needs. This dementia service is now more established with staff having gradually built their expertise in this area of care. The provider has invested in good training resources for staff to build on current knowledge and best practice. Oaklands Care Home DS0000068187.V372326.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): Key Standards 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s care needs and risk assessments are set out in their individual plans of care which ensures that care needs have been addressed and will be met. The manager understands the need to comply with safe medication systems and staff practice ensures that the home’s procedures are complied with and that residents’ health matters are safely addressed. The actions of staff and their approach to care ensures that people are treated with respect and their right to privacy is upheld. EVIDENCE: The new care documentation was examined in detail for 3 residents. All have care plans derived from the initial assessments. Each plan has a recorded monthly review of the elements of care. They provide clear detail as to how care is to be delivered by staff in a way that the person prefers. Staff spoken Oaklands Care Home DS0000068187.V372326.R01.S.doc Version 5.2 Page 11 with state that the care plans provide them with a clear picture of the person’s needs and progress. Keyworkers are also involved in care planning. Weights are routinely recorded and referrals made to the speech and language therapist as necessary. The service does not yet conduct nutritional risk assessments. Daily records monitor the progress of individuals which provide clear indications of how a person has spent their day. The plans demonstrate contact with healthcare professionals such as the community psychiatric nurse or general practitioner. Service users all appeared well groomed with their hair, nails and clothes looking clean. The manager has arranged for one resident to have a specially adapted wheelchair to enable him to leave his bedroom and increase his interaction with the other residents. The service accepts responsibility for administering medication to residents and has improved practice in this area. The service has suitable storage facilities for prescribed drugs and for homely remedies with the exception controlled medication. The manager stated that they have yet to purchase the correct cabinet and gave assurance that this will be addressed. Written records for receipt, administration and disposal of medication are in place. The service audits the medication system on a monthly basis for compliance and errors. Oaklands Care Home DS0000068187.V372326.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): Key Standards 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff support people to keep in touch with family, friends and representatives so that they have appropriate relationships. The food in the home is of good quality so that the dietary needs of people are met. EVIDENCE: Menus seen are nutritionally balanced and food and drinks are readily available. There is choice and staff state they use picture cards to aid memory re preferences when choosing a meal from the menu. People who prefer to rise early are able to have their breakfast at a time suitable to them. The service conducts surveys on the hospitality service in the home and this is also discussed at resident meetings. People were seen to enjoy their meal and to interact well during their lunch. The provision of activities has improved and events are displayed in the home. Residents can participate in more trips out and are involved in the planning of Oaklands Care Home DS0000068187.V372326.R01.S.doc Version 5.2 Page 13 events. Activity sheets are recorded in the care plans which the manager has identified could be more descriptive. Advocacy arrangements are in place for a resident who needs assistance to interact socially. Residents look content and relaxed. Families are at ease when they visit. Staff have a good interaction with the people they look after. Oaklands Care Home DS0000068187.V372326.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): Key Standards 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure that is up to date and accessible so that anyone associated with the service can complain or make suggestions for improvement. EVIDENCE: Complaints made to the manager have been promptly dealt with and a satisfactory outcome reached. There is a good level of accessibility to the management at this home which ensures that concerns can be dealt with very quickly. The manager has opened new communication channels such as resident meetings, day to day contact and care plan reviews. Numerous written booklets are available in the hall to provide advice about the services of external agencies such as Shropshire County Council, Age Concern etc. Adult protection is covered after recruitment and discussed at supervision. Staff training records seen show that staff are provided with regular updates in adult protection. The manager is clear when an incident needs referral through the safeguarding process. Recent referrals have been dealt with thoroughly with full records kept. Oaklands Care Home DS0000068187.V372326.R01.S.doc Version 5.2 Page 15 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): Key Standards 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personalisation of the home has improved, through service user choice, so that people feel they live in a comfortable, clean home with modern furnishings and facilities which suit their individual needs and preferences EVIDENCE: The home is comfortable and clean. Furnishings and fittings are generally well presented. Vacant rooms are not always redecorated before a new resident is admitted. The provider should consider refreshing rooms according to any new resident’s preference. Assisted bathing facilities have improved. The home has a large well presented garden and a secure large courtyard area. Oaklands Care Home DS0000068187.V372326.R01.S.doc Version 5.2 Page 16 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): Key Standards 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff get access to training, supervision and support they need from the manager so that people receive planned care. Staff in the home are trained and recognise the importance of care planning so that peoples’ changing needs are identified and acted upon. EVIDENCE: Staff rotas are in place but without full names/qualifications recorded. Staff files show that there are NVQ qualified and experienced staff employed to provide care to people at the home. Care staff without NVQ qualification have received all mandatory training and complete the common induction standards. The staff have better managerial support to develop their experience in the service they are delivering. Staff spoken with are positive about the change in management and that residents are getting out more. They feel they have a good manager who listens to their concerns. Staff are also aware of the procedures that affect their roles such as complaints and adult protection. Oaklands Care Home DS0000068187.V372326.R01.S.doc Version 5.2 Page 17 Care plans show that there is understanding of the individual way of delivering care and support which is supported by training. Three staff personnel files were selected for inspection. All the necessary identity checks have been carried out. Oaklands Care Home DS0000068187.V372326.R01.S.doc Version 5.2 Page 18 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): Key Standards 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home is based on openness and respect. The service has quality assurance surveys in place so that people are assured that the overall conduct of the home is taking into account their views. People’s opinions are more central to how the home develops and reviews its practice, and the service is developing appropriate ways of making sure they get things right. So, people have confidence in the care home because it is run and managed well. EVIDENCE: Oaklands Care Home DS0000068187.V372326.R01.S.doc Version 5.2 Page 19 The service sent us their annual quality assurance assessment (AQAA) when we asked for it. It was clear and gave us all the information we asked for. The manager’s practice is resident focussed and their involvement is encouraged. This is evidenced by the commitment to conducting surveys and resident meetings. The manager and her staff have attended training events and updates to complement their roles within the home. Staff files seen record all training activity. Through discussions with the manager, she demonstrates that she is confident in her ability to lead and develop a staff team whilst being fully aware of the individual needs of the people living at Oaklands. The home has a system for managing residents’ own money. Accurate records are kept and audited. Equality and diversity for service users is promoted throughout the home within the assessments, care plans and activities. Equality for staff is promoted through the opportunities for training at all levels. Quality assurance takes place throughout the service in both a formal and informal manner. Meetings, surveys, audits, day to day contact all provide records to show that resident satisfaction is at the heart of the service. The manager and her senior carers implement plans for improvement The provider produces a monthly report to the manager to demonstrate that the overall conduct of the service is being managed well. It covers areas such as; interviewing residents, relatives, staff, catering, complaints, health and safety. The home keeps records to show that the health and safety of service users is promoted and protected. The service conducts stringent fire drills and has regular alarm tests and is reviewing its fire risk assessment. Oaklands Care Home DS0000068187.V372326.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Oaklands Care Home DS0000068187.V372326.R01.S.doc Version 5.2 Page 21 No Are there any outstanding requirements from the last inspection? 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 2 3 4 Refer to Standard OP9 OP8 OP19 OP27 Good Practice Recommendations Install a controlled drugs cabinet. To introduce nutritional risk assessments To re-decorate bedrooms when vacant taking into account any new admission’s preference. To display full names/qualifications/role on the staff rota. Oaklands Care Home DS0000068187.V372326.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Oaklands Care Home DS0000068187.V372326.R01.S.doc Version 5.2 Page 23 - 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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