Care Home: Oaklands North Care Home

What the care home does well There has been obvious improvement at the care home in the last eight weeks, with all of the statutory requirements made at the last key inspection having been actioned and met. The medication systems have been overhauled, with clear progress, which means that people living at the home are safer, and risks have been reduced. Several areas have been redecorated, and much of the flooring and lighting have been replaced. In addition new bedroom furniture has been ordered, and the lingering malodour has been removed. What the care home could do better: No statutory requirements were made as a result of this random inspection, altrhough five good practice recommendations were made, relating to introducing a person centred care planning system, medicines prescribed as `when required` should be supported by a care plan, Staff should record the use of medicines prescribed `when required` in line with current professional guidance, a risk assessment should be carried out for storing skin creams in people`s bedrooms, and detailed records of the use of skin care products should be made by the staff member responsible for carrying out the task. Random inspection report Care homes for older people Name: Address: Oaklands North Care Home North Road Whaley Thorns Langwith Derbyshire NG20 9BN zero star poor service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Rob Cooper Date: 3 1 0 8 2 0 1 0 Information about the care home Name of care home: Address: Oaklands North Care Home North Road Whaley Thorns Langwith Derbyshire NG20 9BN 01623744412 01623748759 oaklands@schealthcare.co.uk www.schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Southern Cross Care Homes No 2 Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 40 Number of places (if applicable): Under 65 Over 65 0 0 dementia mental disorder, excluding learning disability or dementia Conditions of registration: 20 20 Southern Cross Care Homes No.2 Limited 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 categories: Mental disorder - Code MD, MD over the age of 55 years and over. Dementia - Code DE 60 years and over. Mental disorder - Code MD, age 55 years and over. Dementia - Code DE, age 60 years and over. The maximum number of service users who can be accommodated is 40. Date of last inspection Care Homes for Older People 2 3 1 0 2 0 0 9 Page 2 of 8 Brief description of the care home Oaklands North Care Home is a purpose built forty bedded care home set on the outskirts of the village of Whaley Thorns. People who live at the care home are situated on two floors, each with its own lounge and dining areas. The care home is registered to provide nursing care for people with dementia (twenty places) and mental disorder (twenty places.) The ground floor is dedicated to caring for people with mental health needs and the first floor people with dementia. The home is within walking distance of the few local shops and GP surgery. The range of fees charged at the home are £364.07 to £819.84 per week with extra charges made for Chiropody, toiletries and newspapers. This information is taken from documents in the home during this key inspection visit, on 13th July 2010. Care Homes for Older People Page 3 of 8 What we found: This random inspection was to follow up and check progress with statutory requirements made at the last key inspection on 13th July 2010. As there were a number of medication issues highlighted at that key inspection, a pharmacy inspector was present at this random inspection to check the medication practice and procedures. Both the Service User Guide and the Statement Of Purpose seen, they had been updated since the key inspection, and both carried the necessary and required information. A pharmacist inspector spent more than five hours looking at the medication administration record charts (MARs) and at the medicines ordering, receipt, storage and disposal arrangements in the home. The outcome is as follows. People living in the home can expect to be given their prescribed medicines correctly. We found that the medicines management systems in the home have changed so that they now mostly follow good practice guidance. Some further improvements in practice and record keeping are recommended. We examined all recent MARs for accuracy and completeness and found no significant administration gaps, nor did we find any evidence that people had run out of their medicines during the last month. All essential information is copied onto the new MARs each month and hand written entries and amendments are now checked for accuracy. Some MAR entries for medicines prescribed when required were unclear as staff didnt always record the usual omission codes consistently. Not all care plans for people who were prescribed such medicines were sufficently clear or detailed to ensure staff would use these medicines safely and consistently. Advice should be sought from the appropriate healthcare professional so that such care plans can be updated regularly. We found inadequate records for the use of prescribed skin care products. We were told these products were usually applied by care staff but that records of their use were not routinely made. It is difficult to know whether people are receiving the intended benefit of such treatments, particularly for those items prescribed as directed but without any further instructions being provided by the prescriber. Most medicines are stored securely and are only accessible to trained staff so there is now a greatly reduced risk of any loss of medicines from the home. However, we were told some skin care products were kept in peoples bedrooms. It is important to make sure these products are always kept safely and are not used by anyone not authorised to do so. The temperatures of the medicines storage ares are checked regularly so staff know medicines are being kept at the temperatures recommended by the manufacturer. Regualr checks are now made to ensure sufficient medicines are always available to give when needed. Additional checks of quantities of medicines remaining made during this visit identified no discrepancies or losses. Four peoples care plans were seen, these had be rewritten since the last key inspection, and were more focussed. One person had a care plan for a specific health condition, that had not been in place at the last key inspection. The care planning system still relies on the activities of daily living which is not a person centred system, and as such the care plans while better than they were, are still missing the essential personal touch for each individual. Care Homes for Older People Page 4 of 8 A partial tour of the building showed that all of the light fittings have been replaced, with modern round fittings, the kitchen has been redecorated , and the cracked tiling replaced. New carpets and flooring were being fitted during the inspection, with a laminate flooring in the reception area and corridors downstairs. Since the last key inspection the people living at Oaklands North have changed position, in that the people with dementia now live upstairs, and the people with mental health needs are downstairs. The home was much busier than previously, with obvious sign of activitiy, where before people were often out of sight in their bedrooms. Staff training records were seen, and there has been a push to put staff through their mandatory training in the last eight weeks, staff training records and supporting documentary evidence demonstrated this. The new manager has addressed many of the management issues identified in previous reports, and there is an obvious drive among the staff who were spoken with to improve and move forward, as evidenced by better working arrangements, and better outcomes for people who live at the care home. What the care home does well: 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 2. Care Homes for Older People Page 5 of 8 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 6 of 8 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, 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 Consideration should be given to a more person centred care planning system, that does not try to make the person fit into care categories. Staff should record the use of medicines prescribed when required consistently in line with current professional guidance. A risk assessment should be carried out for storing skin creams in peoples bedrooms. Detailed records of the use of skin care products should be made by the staff member responsible for carrying out the task. The use of medicines prescribed when required should be supported by an up to date robust care plan. 2 9 3 4 9 9 5 9 Care Homes for Older People Page 7 of 8 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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