Care Home: Oaklea Nursing Home

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What the care home does well Oaklea Nursing Home provides residents with a warm, pleasant and friendly environment. Resident`s needs are generally well met by staff who have the appropriate level of knowledge and are well trained. 88% of care staff have achieved an NVQ level 2 in Care with a number of other staff working towards achieving the qualification. Residents spoken to during the inspection and surveys completed by resident and relatives said, "I am totally satisfied with all of the care and service that is provided" "The home provides good meals and good care" "Staff are always pleasant and helpful" What has improved since the last inspection? Since last inspection resident`s plans of care have been developed to ensure that they are specific to the resident and reflect current treatment. This will help to ensure that the resident gets the help that they need and receive care/treatment prescribed. Many bedrooms in the home environment have benefited from new carpets and bedroom furniture. The sluice on the first floor of the home has been refurbished. Since last inspection the Manager has commenced her own monthly health and safety audits. One area of the audit looks at medication systems and observing medication practice to ensure safe procedures are followed. What the care home could do better: Risk assessments for those residents that require bed rails to ensure safety need to be developed. The decision to use bed rails must be discussed with a multidisciplinary team and include where possible residents and their representatives. Recruitment procedures need to be strengthened by obtaining a reference from the previous employer for any newly appointed staff member. Staff files need to be updated to include proof of identity of the staff member. The homes adult protection procedure needs to be updated to reflect change in contact details for the adult protection teams. CARE HOMES FOR OLDER PEOPLE Oaklea Nursing Home 2 - 4 Eastbourne Road Linthorpe Middlesbrough TS5 6QW Lead Inspector Katherine Acheson Key Unannounced Inspection 3rd December 2007 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 Oaklea Nursing Home DS0000000194.V355425.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. Oaklea Nursing Home DS0000000194.V355425.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oaklea Nursing Home Address 2 - 4 Eastbourne Road Linthorpe Middlesbrough TS5 6QW 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) 01642 819667 F/P 01642 819667 Oaklea Nursing Home Ltd Mrs Elaine Bloomer Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20), Physical disability (20) of places Oaklea Nursing Home DS0000000194.V355425.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 categories: Old age, not falling within any other category - Code OP 2. Physical disability - Code PD The maximum number of service users who can be accommodated is: 20 27th February 2007 Date of last inspection Brief Description of the Service: Oaklea Nursing Home is registered to provide personal and nursing care to twenty residents aged sixty-five and above. The home is situated on Eastbourne Road, Middlesbrough, and is close to Linthorpe Village and other local amenities. The home has been converted from two houses and provides accommodation in the form of fourteen single bedrooms and three double bedrooms. All bedrooms meet with size requirements of National Minimum Standards, however, do not have ensuite facilities. There are two lounge areas and a separate dining room. The home is set in its own grounds and has a large patio/garden area to the front of the property. The cost of care at the time of the inspection visit ranged from £355 to £494 per week depending on the category of care. Oaklea Nursing Home DS0000000194.V355425.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was carried out by two Inspectors on 3rd December 2007 and lasted for five hours. The reason for the inspection was to see how good a job the home does in meeting the National Minimum Standards set by the government for Care Homes. Four residents and two Care Assistants were spoken to during the visit. Lengthy discussions also took place with the Manager. Numerous records including care plans, menus, complaints and staff recruitment and training records were examined. The Inspector walked around the home. Before the inspection ten surveys for residents and ten surveys for relatives were sent to the home for the Manager to distribute accordingly. Surveys requested feedback on the service and staff provided. One resident and six relative surveys were returned to the Commission for Social Care Inspection. Comments received can be read within the report. The Manager had completed an Annual Quality Assurance Assessment (AQAA) before to the inspection. The AQAA is the Registered Persons own selfassessment of the service and care that is provided. Information contained within the AQAA is reflected within the report and is also used to support the judgements. The findings from the inspection were that the home provides a good service with most of the National Minimum Standards being met. The details of any issues identified at this inspection requiring action are to be found at the back of this report. What the service does well: Oaklea Nursing Home provides residents with a warm, pleasant and friendly environment. Resident’s needs are generally well met by staff who have the appropriate level of knowledge and are well trained. 88 of care staff have achieved an NVQ level 2 in Care with a number of other staff working towards achieving the qualification. Residents spoken to during the inspection and surveys completed by resident and relatives said, Oaklea Nursing Home DS0000000194.V355425.R01.S.doc Version 5.2 Page 6 “I am totally satisfied with all of the care and service that is provided” “The home provides good meals and good care” “Staff are always pleasant and helpful” What has improved since the last inspection? 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. Oaklea Nursing Home DS0000000194.V355425.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 Oaklea Nursing Home DS0000000194.V355425.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): Standards assessed 3 and 6 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Assessments of prospective residents are carried out to ensure that the home can meet their needs. EVIDENCE: Before going into Oaklea Nursing Home, residents are assessed by a Social Worker or health care professional. A copy of this assessment is forwarded to the management of the home so that a judgement can be made to see if needs can be met. The Manager said that staff at the home do not routinely carry out their own pre-admission assessment of a prospective resident before admission unless the resident is self-funding or has complex care needs. The Manager advised that an assessment of the resident is done soon after admission with a plan of care being developed there after. Oaklea Nursing Home DS0000000194.V355425.R01.S.doc Version 5.2 Page 9 Surveys, received by the Commission for Social Care Inspection, and residents who spoke with us confirmed residents had enough information about the home before they moved in. The home does not provide intermediate care and as such standard 6 does not apply. Oaklea Nursing Home DS0000000194.V355425.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): Standards assessed 7, 8, 9 and 10 People who use 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. The home provides a good standard of care, residents living at the home are happy. Procedures are in place to ensure good management of medication to ensure safety of residents. EVIDENCE: Two plans of care were looked at during this visit both of which contained detailed information about the resident and the help they needed. Likes, dislikes and personal preferences were recorded. Care plans showed clear evidence of choice. Care plans were evaluated on a monthly basis. Resident’s files included healthcare visits and appointments. The records showed the regularity of visits for treatment from: doctors and district nurses, opticians, dentists and other healthcare specialists. Oaklea Nursing Home DS0000000194.V355425.R01.S.doc Version 5.2 Page 11 One file sampled during the inspection was that of a resident that required bed rails attaching to their bed to help to maintain safety. Although a risk assessment was in place in respect of this, it was insufficiently detailed and did not contain evidence to confirm that a multidisciplinary team including the resident and family had been involved in deciding if bed rails were the most appropriate safety measure. A discussion took place with the Manager in respect of this. Residents spoken to confirmed that their dignity and privacy was respected. During the inspection staff were observed to knock on residents doors before going in. Staff spoken to during the inspection were knowledgeable about the people they were caring for. Residents spoken to during the inspection and comment cards received stated, “I’m happy here the staff are good to me. Night and day they check on you” “All the blokes we get on well, it’s good for me” “Staff spend time chatting to me” “The home provides a good standard of care and treats residents well. All staff are approachable and friendly” A discussion with one resident at the home identified some dissatisfaction. Following discussion with the Manager, it was identified that this resident was in need of a review of their care. The Manager said that she would organise this as soon as possible with the Social Worker. During the inspection arrangements for receiving, storing, administering, recording and disposing of resident’s medication were observed and examined. The home has a medication policy, however this was not looked at during the visit. The Manager said that nurses administer medication to residents. Medication systems were looked at during the visit, the ordering, storage and returning of unused medication was good and records were well written. Since last inspection the Manager has introduced her own auditing of medication systems, which includes observing nurses to ensure that safe procedures and practice are followed. Oaklea Nursing Home DS0000000194.V355425.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): Standards assessed 12, 13, 14 and 15 People who use 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. Appropriate and enjoyable activities do take place at the home and residents are able to exercise choice and control. Visitors are encouraged and made to feel welcome at anytime. Food provided is enjoyed by residents and provides residents with a wholesome balanced diet. EVIDENCE: Care staff plan, arrange and take part in resident activities when time permits. Activities taking place include bingo, sing-a-long and dominoes. The Manager said that since the last inspection in February this year the home has hosted a summer fete, clothes party, afternoon tea and BBQ. Family are encouraged to join in activities planned by the home. The home was busy making plans for Christmas, one of which is to go to the Local theatre to see a pantomime. The home supports residents to practice their religion, a representative from the Roman Catholic Church visits on a regular basis to give some residents communion. A representative from the local Church of England Church also visits regularly. The Manager said that at present there are no residents Oaklea Nursing Home DS0000000194.V355425.R01.S.doc Version 5.2 Page 13 expressing a wish to visit church, however if they did then this could be arranged. Of questionnaires received one person said that they would like more activities and another said that the home could improve by taking residents out a little more. Visits from relatives and friends are welcome at any time. Residents interviewed spoke of flexibility in routine and freedom of choice. Food provided by the home is enjoyed by residents. There is a four-week menu plan in which residents are offered choice. The dining room is pleasant. The lunchtime of residents was observed. Mealtime was relaxing with residents enjoying the food provided. The lunchtime menu on the day of the inspection was liver, potatoes, sprouts and mixed vegetables. One resident spoken to said, “Food is usually home made and a good standard” another said, “The food is good but on Saturday night I fancied a kebab and staff at the home arranged for it to be delivered to me” Oaklea Nursing Home DS0000000194.V355425.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): Standards assessed People who use 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 relatives are able to express their concerns. Staff are aware of procedures to follow if abuse is suspected which helps to protect residents. EVIDENCE: The home has a complaint procedure, which informs residents/relatives of their right to complain to any commissioning authorities such as the Primary Care Trust or Social Services. The home keeps a record of complaints. There have not been any complaints made to the home in the last twelve months. Residents, relatives and comment cards received stated that they were able to approach the staff to raise any concern that they may have. One comment card received stated, “In six years we have had few complaints and they were minor things and soon sorted”. The home has an adult protection policy that details action that staff should take if abuse is suspected. This procedure needs to be updated to reflect change in contact details for the adult protection teams. The Manager said that staff receive adult protection training on induction and then on a regular Oaklea Nursing Home DS0000000194.V355425.R01.S.doc Version 5.2 Page 15 basis thereafter. Staff spoken to during the inspection were able to inform of procedures to follow if abuse is suspected. Oaklea Nursing Home DS0000000194.V355425.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): Standards assessed 19, 21, 26 People who use 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. The standard of the environment within this home is good providing the people who live there with and attractive, homely and comfortable place to live. EVIDENCE: Oaklea Nursing Home provides a comfortable homely environment for residents. The home has been converted from two houses and provides accommodation in the form of fourteen single bedrooms and three double bedrooms. All bedrooms meet with size requirements of National Minimum Standards, however, do not have ensuite facilities. The Inspector walked around the home with the Manager. Since last inspection a number of bedroom carpets have been replaced. Many bedrooms have benefited from new wardrobes, drawers and lockable bedside cabinets. Oaklea Nursing Home DS0000000194.V355425.R01.S.doc Version 5.2 Page 17 Bedrooms visited were personalised with many residents having brought items of furniture and ornaments from home. There are two lounge areas and a separate dining room on the ground floor of the home. In general communal areas are well maintained with appropriate furnishings throughout On the day of the inspection the home was found to be clean and odour free. The home is set in its own grounds and has a large patio/garden area to the front of the property. The Manager said that there are plans for a conservatory to be built in the near future; this is to be used as a quiet area for residents and relatives to enjoy. Since last inspection the sluice on the first floor of the home has been refurbished. Laundry facilities are in place and staff are aware of procedures to follow to prevent the spread of infection. Oaklea Nursing Home DS0000000194.V355425.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): Standards assessed 27, 28, 29 and 30 People who use 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. Staff at the home are experienced to meet the needs of residents. In general good recruitment procedures are followed, however, applying for a reference from the staff members last employer will further enhance this. EVIDENCE: At the time of the inspection there were seventeen residents living at the home. The homes duty rota showed that there were four care assistants on duty on a morning three on an afternoon and evening, and one care assistant on duty at night. There is one trained nurse on during the day and night. The Manager of the home, who is also nurse, works full time. For two days most weeks she is supernumerary and as such works in addition to the staff numbers above. The Manager said that 88 of care staff working at the home have achieved a minimum qualification of NVQ level 2 in Care with other staff working towards achieving the qualification. Oaklea Nursing Home DS0000000194.V355425.R01.S.doc Version 5.2 Page 19 Two staff files were looked at during the inspection both of which contained a certificate confirming that they had undertaken an induction programme. The Manager said that this induction meets with the required standards as set by Skills for Care. Appropriate Criminal Record Bureau Checks are carried out on staff before they start working at the home. Both staff files looked at during the visit contained two references, however not from the last employer. The Manager said that she had attempted to get references from the last employer, however they had failed to respond. One of the files looked at contained proof of identity, however the other did not. A discussion took place with the Manager in respect of obtaining references and ensuring that the required information was kept on file for staff. Certificates were available on staff files looked at to confirm that they had received recent training in fire, Parkinson’s disease and moving and handling. One comment card received stated, “As far as I am aware all staff are trained and most of them have the most important skill which cannot be taught with training and that is a caring nature, and a good attitude with residents and visitors” Staff spoken to during the visit were knowledgeable about the people that they were caring for. Oaklea Nursing Home DS0000000194.V355425.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): Standards assessed 31, 33, 35 and 38 People who use 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. Quality assurance systems are in place to ensure that the home is run in the best interest of residents. In general the home is well run with the health and safety of residents being promoted. EVIDENCE: The Manager is a Registered Nurse who has achieved a management qualification. The Manager has many years of experience of working with older people in a care home environment. The Manager advised that she has attended lots of training during the last twelve months. Training mentioned included moving and handling, fire Parkinson’s disease update, ear syringing and fire warden training. Oaklea Nursing Home DS0000000194.V355425.R01.S.doc Version 5.2 Page 21 The Manager said that quality assurance and quality monitoring practices are in place. Surveys are sent out to residents on a yearly basis to see if they are happy with the home and care that is provided. The results are published and displayed in the entrance to the home. The Manager said that surveys are sent out to residents and relatives in their Christmas cards so that they are sure to read them. The home looks after small amounts of money belonging to some residents. Appropriate records of transactions are kept. A sample of health and safety records were examined and were found to be in order. Records were examined to confirm that the Gas boilers and fire extinguishers had been serviced within the last year. Water temperatures in resident’s bathrooms are taken on a weekly basis to ensure that they are within normal limits. The Manager said that regular checks of the fire alarm system are also carried out and that this sometimes includes a practice on evacuation. Oaklea Nursing Home DS0000000194.V355425.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 2 3 X 3 X X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Oaklea Nursing Home DS0000000194.V355425.R01.S.doc Version 5.2 Page 23 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. 1. Standard OP29 Regulation 19 Requirement The Registered Person must ensure where possible that references for new staff are obtained from their previous employer Timescale for action 03/12/07 2. OP7 13 3. OP18 13 4. OP29 19 The Registered Person must 30/01/08 consult with a multidisciplinary team and develop a detailed risk assessment for those residents who it is felt that bed rails should be in place to promote safety The Registered Person must 03/12/08 update the homes adult protection policy/procedure to reflect change in contact details for the adult protection teams The Registered Person must 30/01/08 ensure proof of identity is on all staff files RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Oaklea Nursing Home DS0000000194.V355425.R01.S.doc Version 5.2 Page 24 No. Refer to Standard Good Practice Recommendations Oaklea Nursing Home DS0000000194.V355425.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Oaklea Nursing Home DS0000000194.V355425.R01.S.doc Version 5.2 Page 26 - 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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