Care Home: Oakleigh Care Centre

What the care home does well The relatives and carers who responded to the CSCI questionnaire, stated clearly that they were satisfied with the overall quality of care provided at the home, and that they were positively welcomed by staff into the home at any time. Questions concerning being kept involved in decision-making on behalf of their relative or friend, and whether the home provided appropriate care for their loved one were unanimously answered in the affirmative. The overwhelming majority also felt that staff were adequately trained and supported people well to live the life they choose. Four people indicated that they were unclear about the formal process of making a complaint, but all qualified this with comments relating to speaking to staff, and having confidence in the home. Feedback about how the home actually dealt with concerns or complaints was also positive. Relatives spoke of well-trained carers, and of their friendliness, and importantly, the relationship between staff and people living at the home was described as very friendly and warm. Staff were noted to be dedicated and hard working, another word used more than once being excellent. Staff members in their responses were generally very positive about the service provided at the home, with few negative comments concerning the delivery of care, but some less enthusiastic reports about the support gained from senior staff through focused one to one, formal supervision. All staff were very conversant with how to handle a concern or a complaint. Staff were generally positive about staff training - all stating that a wide opportunity for input was available. Regarding staffing levels, staff felt there were sometimes or usually sufficient staff available, none stating that there were never enough staff. Interestingly, all staff were in general accord with a positive feeling about life at Oakleigh, and are clearly a committed and interested group of employees. Further qualitative comments from the questionnaires are available throughout this report under appropriate sections. What has improved since the last inspection? Since the last inspection, some people using a service called Franklin House, situated in South Beddington, have moved in, with their staff and their registered manager to Oakleigh, as these two homes have amalgamated as part of the Sutton Council Adult Social Services strategic plan for improving services for people with dementia in the Borough. Care planning and recording is much improved, and the stabilisation of the staff team, through the coming together of the Franklin House and Oakleigh staff teams, has resulted in a greater sense of stability. The move towards a more focused person centred care planning approach also ensures that the person remains in the centre of the homes caring focus. Memory Boxes outside each residents door helps them locate their own room. The front garden has been renovated and is now a sensory garden set out with stimulation, pleasure, safety and interest in mind. The rear garden has also beenimproved to provide another pleasant sitting area. Internally, new curtains and flooring has improved the decor, alongside corridors being refurbished. Each floor has gained a room, through reorganisation, to provide a sensory and reminiscence area for use and this is another bolthole for peace and quiet outside those structured times. What the care home could do better: From the relative and carer survey, the home still clearly needs to ensure that the Boroughs complaints procedure is actively made available to all who use the service. The other focus recommended for attention is to ensure that the supervision process for staff on a one to one basis is supported to be effective. There was evidence of such sessions, but consistency is important - especially for the carer staff who work independently on units for the majority of their time. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Oakleigh Care Centre Oakleigh 89 Benhill Avenue Sutton Surrey SM1 4DJ     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: David Pennells     Date: 0 7 1 1 2 0 0 8 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 29 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Oakleigh Care Centre 89 Benhill Avenue Oakleigh Sutton Surrey SM1 4DJ 02087704919 02086422192 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): London Borough of Sutton Name of registered manager (if applicable) Ricky Anthony Mayne Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: Oakleigh Care Centre is registered for 35 places, 5 of which are used for respite care. Date of last inspection Brief description of the care home Oakleigh Care Centre provides residential care for up to 35 older people with a dementia (or similar condition) diagnosis; the home is owned and managed by the London Borough of Sutton Community Services Department. The home was built in 1972 to a design familiar in that period, and is now divided into six units with their own lounges, kitchens, dining rooms, toilets and bathrooms. Overall, the home has 29 single rooms and additionally 6 larger rooms (which were previously double rooms but are now in single occupancy). The service is divided into Units on each floor, five units providing for long-term care, whilst the Balmoral Unit provides respite care for up to five people. The premises is also host to a day centre, currently run by the Borough, but transferring to an independent provider in January Care Homes for Older People Page 4 of 29 care home 35 Over 65 35 0 Brief description of the care home 2009. The home also provides relative and carer support in addition to the residential and day care. People permanently using the service are encouraged to have items of their own furniture and personal possessions with them in their rooms. Lounges are small and cosy, and all have TV, sound system and other furnishings. Dining areas are quite intimate, with kitchenette food-preparation areas attached, allowing a domestic, homecooked approach to food provision. The home is kept clean and odour-free. Movement around the home is generally free, though staff members encourage people to relate to their local unit area where familiar faces of both service users and staff are present. Keypad security systems operate at all final exit doors and between floors on the staircases, to ensure the safety of the service users. On the ground floor, there is access to secure garden areas, which have recently been upgraded and make a very attractive space for peace and quiet when it may be needed. The home has its own transport, which is used for the benefit of all service users. Care Homes for Older People Page 5 of 29 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: This unannounced visit was conducted from lunchtime through to the early evening of an ordinary weekday. We spent some time reviewing documentation and evidence of maintenance and safety measures at the home, and also spent some time with the registered manager, Rick Mayne. The requirements and recommendations for the previous 2006 inspection report were also reviewed and checked off, this resulting in no requirements being carried forward into this report. Time was also spent with both staff and people using the service, on the different units within the home, as they went about their daytime and evening routines. People at the home were again noted to be generally content, and many in a positively cheerful, relaxed mood. There was, again, no sense of anxiety within the establishment, this Care Homes for Older People Page 6 of 29 indicating that people clearly felt safe, indeed, feedback from relatives suggested that the home had enabled some people to become more relaxed and content since they moved into Oakleigh. We are grateful to the manager, staff and people using the service for their positive welcome, hospitality and cooperation throughout the visit. Relatives and carers of those using the service were circulated with a questionnaire to elicit their current views on the service at the home, fourteen being returned to the Commission, this giving us a clear idea of opinions about the service actually provided at the home. Staff were also asked to respond to a survey, eight being returned to us. What the care home does well: What has improved since the last inspection? Since the last inspection, some people using a service called Franklin House, situated in South Beddington, have moved in, with their staff and their registered manager to Oakleigh, as these two homes have amalgamated as part of the Sutton Council Adult Social Services strategic plan for improving services for people with dementia in the Borough. Care planning and recording is much improved, and the stabilisation of the staff team, through the coming together of the Franklin House and Oakleigh staff teams, has resulted in a greater sense of stability. The move towards a more focused person centred care planning approach also ensures that the person remains in the centre of the homes caring focus. Memory Boxes outside each residents door helps them locate their own room. The front garden has been renovated and is now a sensory garden set out with stimulation, pleasure, safety and interest in mind. The rear garden has also been Care Homes for Older People Page 8 of 29 improved to provide another pleasant sitting area. Internally, new curtains and flooring has improved the decor, alongside corridors being refurbished. Each floor has gained a room, through reorganisation, to provide a sensory and reminiscence area for use and this is another bolthole for peace and quiet outside those structured times. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 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 10 of 29 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. People using the service can expect to be well informed about the service prior to admission, documentation and the admission process enabling any queries to be answered. Trial visits are encouraged to ensure compatibility with the environment, prior to permanency of the accommodation being confirmed. People using the service receive a care plan package provided in house - including respite care users - this is based on full assessment information obtained, or required by the home from other professionals, and results in a clear plan of care being devised. The Home does not provide intermediate care, therefore standard 6 does not apply in this inspection. Care Homes for Older People Page 11 of 29 Evidence: Access to the Borough social services database system allows a good accumulation of information concerning individuals referred to the home. This process is doubly vital with regard to service users coming to Oakleigh on a shared respite care basis, where information concerning a person on a short stay is important to immediately provide a supportive care approach. The home also ensures that it accesses up-to-date information from care management, refusing to accept out-of-date assessments. A more focused initial assessment of need on referral then leads to a person being assessed, with senior staff usually visiting a service user at home prior to admission. People interested in using the service are encouraged to personally visit the premises and to meet with staff. Documentation, which is clearly presented, and attractively produced, is available to guide people both in using the long-term service and the respite care service. In the past twelve months, seventeen new residents have been admitted to the home - this due to the closure of a sister service, Franklin House, and due to higher uptake following the refurbishment of the house. The respite care unit has accommodated eighty seven separate visits of people on respite care in the past twelve months. Standard 6 does not apply to Oakleigh, as the home does not provide an intermediate care service. Care Homes for Older People Page 12 of 29 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. People using the service can expect to have their needs clearly expressed in a plan of care and they can be confident that their wider health care needs will be recognised and met through the home providing regular access to medical, paramedical and psychiatric or psychological services, as appropriate. People using the service can expect to be assisted with their medication by staff trained to administer and monitor the medication. The home has a clear policy and procedures and training which ensures their protection in this regard. Service users can expect staff to relate to them and also to provide care in a dignified and respectful, but friendly manner. Evidence: Care notes are kept on the Unit in easily accessible formats, until such time as they move to the first level of archiving in the Residents Personal File. The current, active care plan is held alongside the day to day notes on the units. Day-to-day notes were Care Homes for Older People Page 13 of 29 Evidence: improving, moving away from being too physically orientated. A more rounded reporting of the achievements, satisfactions and social engagement enjoyed by service users now appears, alongside the more physical facts of the day. All assessments and care planning are now based on the person centred care principle. This approach places the service user at the centre of the planning focus, and ensures that all actions are undertaken with the person being as central as possible to decision-making. Care staff are currently receiving training in the Person centred approach. Clearly it is beneficial with people with dementia, that this can involve relatives and friends, as the whole person includes their history and personality, as well as the present circumstances. Reviews are held six monthly to maintain an ongoing view of the care plan, and relatives confirmed their involvement. The manager confirmed that 95 of people resident at the home had had a review undertaken by their care manager or social worker within the past twelve months. Handover records showed that staff pass on the necessary daily information, with any updates concerning a persons health and welfare recorded. Conversations with staff and relatives showed that an holistic approach to care is being fully adopted, with life history books and memory boxes near bedroom doors, and relevant pictures showing that their previous circumstances are being taken into account to make life fulfilling. The recording of information showed that risk assessments and regular reviews were evidently taking place. On top of the basic contact details for each persons personal network, the initial assessment, a separate personal portrait, the care plan, various risk assessments, including moving and handling assessments, and other charts and records were all found on file. GP and other medical services are provided, and contact with Community Psychiatric Services is available, through regular six weekly visits of the local Psychogeriatrician from Sutton Hospital accompanied by a Community Psychiatric Nurse, or on request. Medication was audited and assessed in one long stay unit at the home. This showed clearly the care taken in managing medication, from receipt, storage, administration to recording. The senior Boots pharmacist visits the home regularly and inspects processes and gives advice. Medication cupboards and medication fridges are regularly monitored for safe temperatures, and all audit trails were found to be completed satisfactorily. The fact that only five people have any medication at nighttimes indicates a positive approach to holistic care as the need to provide sedation of any chemical form is clearly not necessary. Care Homes for Older People Page 14 of 29 Care Homes for Older People Page 15 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can expect to enjoy a lifestyle which seeks to reflect their cultural / social background, through the provision of a varied and appropriate programme of social engagement both within and outside the home. People are encouraged to maintain contact with their relatives, friends and colleagues through the positive open house approach that the home has, this encouraging visitors to engage with the home and their loved ones. People can expect to receive a good level of nutritious and well presented food suited to their specific needs, and served in a pleasant and homely environment. Evidence: Activities are focussed on the individual units, ensuring that such engagement is not too threatening. Music, Sing-alongs, Ball games, Bingo, Quizzes, and Painting and Colouring are engaged in, as well as watching the TV. Each lounge area has leisure equipment provided in their sideboards for use. The newly refurbished enclosed garden provides for people to escape to the quiet and interest of the outside, whilst having their security and safety maintained. Care Homes for Older People Page 16 of 29 Evidence: Relatives reported their loved ones being engaged in activities - though some reported more than others, and it is clear that structured activity is not so focused at weekends. The manager informed us that an Activities Audit is being conducted to review this element in the home. Trips out into the local town centre shops and market are arranged, as well as meals out to restaurants and local cafes, and pub lunches are popular. Summer trips to the seaside and places of interest are also arranged. Five residents were accompanied by five staff members on a holiday trip to Butlins Holiday Camp. Evening or matinee trips to the local theatre are also undertaken and enjoyed. Outside entertainers are also invited into the home, these events often being shared with relatives and carers. Resident focus group meetings provide for receiving feedback about life at the home and Friends of the Elderly, an independent older peoples charity, conduct an annual survey of relatives for the home to ensure a quality service input. There is a monthly Christian Service organised by a congregation local to the home, and both Roman Catholic and Anglican priests visit to administer Holy Communion as appropriate and requested. Relatives and friends again confirmed that they felt positively welcomed in the home by staff, and indeed the home does have a pleasant informality about it. There were plans to furnish a Guest Room by December 2008 for relatives from a distance to be able to stay overnight where that would be of benefit. People living at Oakleigh are free to wander along corridors and meet with others - even onto other units - though it is important that they return to their home unit for familiar events such as mealtimes. The home is noted for the generally relaxed atmosphere, this clearly a sign of service users feeling safe and comfortable. Telephone calls can be made from cordless phones from points throughout the home, or from their own room. There is no charge for such calls to British landlines. Service users take meals on their individual units; the small dining areas are cosy and lend a domestic feel to such occasions. Food seen again appeared tasty and was well presented. Both the lunch and teatime menu offered a choice, which is offered daily, with dietary needs such as vegetarian and low fat diets being catered for. Care staff undertake the service of meals, and provide any appropriate assistance to individuals, where required. Staff members were concerned to ensure that everybody received sufficient nutrition. A Nite Bite menu has been introduced to provide food for people who may feel they require something cooked during the nighttime hours from 9pm to 7am. There are four night staff carers on duty, so this excellent aspect of the homes catering is feasible. Care Homes for Older People Page 17 of 29 Evidence: The home has been awarded a Heart Beat Award from Environmental Health in recognition of the menu being low in fat, sugar and salt. Additionally, the Food Standards Agency Scores on the Doors rating scheme has awarded a four star, very good, rating to the home for good food safety management in September 2008. Care Homes for Older People Page 18 of 29 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. Relatives and people using the service can be confident that expressions of complaint will be taken seriously, and fully addressed through the homes, and the Boroughs, comments and complaints procedure. People can confidently expect that the service they receive is based on an ethos of safeguarding adults, ensuring their protection, and seeking to protect the dignity and rights of each vulnerable individual. Evidence: The home has handled one complaint relating to the respite care service in the past twelve months, which was investigated and substantiated. In line with the Boroughs policy, all complaints were dealt with within the stated timescale of 28 days. The Commissions questionnaire revealed that relatives / friends still, it seems, need informing about the Boroughs formal complaints procedure - almost a quarter were unaware of it. A recommendation in this report encourages a renewed campaign of information giving in this regard. Staff have received training in Safeguarding issues and the home is fully conversant with the revised Sutton Borough policy and procedure. The home is clearly not reluctant to use the safeguarding procedure when it will ensure a full and thorough exploration of issues arising. Care Homes for Older People Page 19 of 29 Care Homes for Older People Page 20 of 29 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. People living at the home can rely upon the home being clean and well maintained to a safe and comfortable level, with good facilities to meet their individual needs, and to promote their health and safety, through adequate ongoing input from the homes staff, Borough officers and other professionals. Evidence: The home is divided into six units with their own lounges, kitchens, dining rooms, toilets and bathrooms. Overall, the home has 29 single rooms and additionally 6 larger rooms (which were previously double rooms but are now in single occupancy). The service is divided into Units on each floor, five units providing for long-term care, whilst the Balmoral Unit provides respite care for up to five people. A wide variety of assisted bathing facilities, and a shower, are available for personal hygiene. The front garden has been renovated and is now an attractive sensory garden set out with stimulation, pleasure, safety and interest in mind. The rear garden has also been improved to provide another pleasant sitting area. Substantial works in recent years have ensured that the home has been upgraded, with the fire alarm system, some flooring, lighting, central heating, unit kitchens, lounges, bathrooms being upgraded, and the provision of some new services in each bedroom being provided, whilst the laundry was also expanded. Care Homes for Older People Page 21 of 29 Evidence: Internally, following the recent involvement of people living at the home in consultation, new curtains and flooring has improved the decor, alongside corridors being refurbished and made more attractive. Outside each residents bedroom, a memory box shows something of that persons character along with familiar items and sometimes a photograph to connect the person with the room. All bedrooms now have door knockers. Kitchen areas have had their equipment and fittings improved and made more dementia friendly. The home has worked with advice from the Alzheimers Society to ensure that refurbishment approaches promote a dementia care friendly environment. Each floor has gained a room, through reorganisation, to provide a sensory and reminiscence area for use and this is another bolthole for peace and quiet outside those structured times. Two rooms in the Respite Unit are to be equipped with the telecare alarm system, in order to introduce or familiarise people who are generally still living in the community with such equipment, this aiming to have a long term effect of maintaining people in their own homes for longer. The entire house is well maintained, odour free and all necessary health and safety checks and maintenance visits were seen to be up to date. Records are well kept in this regard. The premises have improved substantially in recent years, despite the home not undergoing its expected full closure and refurbishment in 2007. Attempts are being positively made to ensure that as best as possible, a good quality environment is created, that is both familiar and stimulating to the people living with dementia who use it. Care Homes for Older People Page 22 of 29 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. The staffing input at the home is provided in numbers and skills mix to a level that generally meets the assessed and recorded needs of people using the service. The registered provider supports the home, through its recruitment and employment procedures and practices, to ensure that equality and diversity are promoted and that people are protected from potential abuse. Staff members are trained, both in local and vocational disciplines, and provided with supervision to ensure that the people using the service are in safe and competent hands at all times. Evidence: The permanent staff team consists of the Manager, an Assistant Manager, currently five Senior Care Workers and forty Day Care and Night Care Workers. Cooks and Kitchen Domestics, Floor Domestics, an Administrator, Laundress, and Handyperson complete the staff complement. The staffing levels meet the Department of Health Residential Forum staffing levels formula. There are sixty-seven staff in total. Staffing is allocated at one carer to each unit with a carer floating and being available for assisting carers where necessary. There is also a duty manager / senior available Care Homes for Older People Page 23 of 29 Evidence: at all times. As well as daily handover meetings, regular staff meetings minutes were seen and all areas of concern, as well as day to day issues were discussed. Minutes are typed and distributed or displayed for all staff to see. There were five 21 hour carer posts vacant at the time of the inspection, alongside the assistant managers post, and with a domestic worker post available also. Staff vacancies are filled by appropriate competitive interview - and the full establishment staffing level is being targeted. The home benefits from the backup of the Boroughs Personnel Department who handle much of the recruitment process. All staff are only appointed after full references and checks including CRBs are satisfactorily returned. All new staff are inducted using the nationally agreed Common Induction Standards. The manager stated that, of the forty care staff (night and day), thirty are now qualified to NVQ in Care at minimally Level 2 or above. Further training is ongoing with eight staff to raise that figure to a higher level. All staff at the home have mandatory Food Hygiene Awareness training completed, alongside training in Moving and Handling. Sufficient staff are trained in First Aid to cover the house throughout the entire week, 24 hours per day. All staff were very positive about the level and quality of training available and were happy with the recruitment and induction process. Support for staff is provided through regular group meetings and also one to one supervision provided by line managers. Staff responded in their questionnaires that this was one are where improvement was needed, the immediate needs of the service being cited as the reason for lack of individual support. Management should ensure that the supervision process for staff on a one to one basis is supported to be effective. There was evidence of such sessions being held, but consistency is important - especially for the carer staff who work independently on units for the majority of their time. One staff member did report that her line manager fed back praise when it was received, the general feeling was that greater recognition and support for staff would be beneficial. This issue appears as a recommendation in the management section of this report. Relatives and friends commented that they felt staff were in the main well trained to look after people with dementia properly, whilst recognising the needs of the individual. Staff were described as being very dedicated, friendly, willing to help and very welcoming to visitors. Care Homes for Older People Page 24 of 29 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. The management and ethos of the home serves the best interests of people using the service, with the homes philosophy of care & staff members approach being appropriate and sensitive; there is a strong concern for each service users holistic wellbeing. The home benefits from good line management and external scrutiny, this ensuring that issues arising are appropriately addressed and staff members are supported to provide the best service. The home is subject to independent unannounced visits to examine the conduct of the home, this resulting in positive, proactive change to the homes conduct. People can be confident that their financial interests will be safeguarded by the thorough management and accounting / financial procedures. The registered provider positively promotes the health & safety of both service users and staff - through regular maintenance and checks of facilities. Care Homes for Older People Page 25 of 29 Evidence: The registered manager, Rick Mayne, is now well installed as the manager of Oakleigh, having been the manager of Franklin House which has now amalgamated with this establishment. He is well qualified with the registered Managers Award at NVQ Level 4 and has a portfolio of other training which is relevant to the service. Since arriving at Oakleigh, the management style of the service has changed and there is a good sense of developing purpose and vision at the home. One innovative piece of project work that the home has produced in the past year was a joint project with the London Centre for Dementia care which resulted in a film made by the residents and Salmagundi Productions that enabled them to tell their stories through reminiscence and animated sequences. The resulting short film was powerful and inspiring, and clearly engaged the participants in a positive and enjoyable activity. Quality Assurance is underpinned by the Borough meeting its regulatory obligation through various management representatives undertaking unannounced visits to the care homes in its ownership. An annual audit conducted by the charity, Friends of the Elderly, provides an independent assessment of the quality of service provided from a relative or carers point of view. General maintenance and servicing of equipment within the house is constant, and all necessary documentation was available to evidence the highest levels of safety for Oakleigh as both a home and a workplace. Borough property officers also influence the ongoing agenda for the fabric of the establishment. A Sutton Borough Health and Safety audit report of September 2008 was complimentary about the standards of recording and good health and safety management throughout the home. Oakleigh has a clear strategic focus for the future, this being encapsulated in an ongoing development plan, which was seen at the time of the inspection. Care Homes for Older People Page 26 of 29 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 27 of 29 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 1 2 16 36 That relatives, carers and friends should be again informed about the Boroughs Complaints Procedure. That staff supervision should be made a major focus, monitored and fully developed, to fully engage and support individual staff members. Care Homes for Older People Page 28 of 29 Helpline: 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 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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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