Care Home: Oaktrees Care Home

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What the care home does well The people I spoke to said they were happy with the care and support they receive. One person said `I would give this place a score of ten out of ten, it is great` Another said that the staff are `lovely and very hard working`. The pre-admission assessments are thorough and the majority of people commented that they had sufficient information about the home before choosing to live there. The people who live at the home and their relatives confirmed that they know how to raise a concern or make a complaint, if they needed to. One person said `I would tell the staff or the manager if I have a problem but I`ve never had one. I know the new manager would sort things out anyway, she is lovely`.The staff are aware of their responsibilities if they believe that neglect or poor care practice is taking place and were confidant that if they raised any issues the manager would investigate. All the staff receive a range of training to equip them with the skills and knowledge they need to do their work properly. Staff were happy with the way in which the home is ran and said they felt very supported in their work by the manager. What has improved since the last inspection? A new manager has been appointed to the home. All the visitors and staff who were spoken with at the inspection said `what a good job` she was doing. The new manager has reviewed care plans. They contain sufficient detail so staff can deliver planned care. Medication audits are taking place and the recording of medication administration had improved, plans are underway to change to a new system of medication administration, that will offer more choice and control for people who live at the home. A refurbishment program is under way and communal areas are getting decorated and some furnishings are being renewed. What the care home could do better: The manager and staff team must continue to maintain and build upon the good service it is providing for the peope who live at the home. Key inspection report Care homes for older people Name: Address: Oaktrees Care Home Main Street Alne York North Yorkshire YO61 1TB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Bridgit Stockton     Date: 0 8 0 5 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 22 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 22 Information about the care home Name of care home: Address: Oaktrees Care Home Main Street Alne York North Yorkshire YO61 1TB 01347838262 01347838986 susan.tunstall@fisherpartnership.com John.fisher@fisherpartnership.com The Fisher Partnership Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Gill Adele Thew-Twaites Mrs Susan Elizabeth Tunstall Type of registration: Number of places registered: care home 45 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 45 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 category: Old age, not falling within any other category - Code OP, maximum number of places: 45 Date of last inspection Brief description of the care home Oaktrees is a care home, which can care for up to 45 residents who require personal or nursing care. It is owned by the Fisher Partnership It is situated in the centre of the North Yorkshire village of Alne, near York. It is an older property, in red brick and was previously a domestic dwelling and converted and extended for to its present purpose. Care Homes for Older People Page 4 of 22 Over 65 45 0 Brief description of the care home It has two floors including ground and a vertical lift provides level access to the first floor. Parking is provided to the front west facing aspect and there is an enclosed garden area to the rear of the site. Care Homes for Older People Page 5 of 22 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The purpose of this inspection was to assess the quality of the care and support received by the people who live at the Care Home. The methods I used to gather information included a visit to the home, conversations with the people who live there, their relatives, healthcare professionals and the staff. I looked in detail at the care and records of four people, examined other records and looked around the home. I spent six hours at the home. The manager also completed some paperwork for us called an annual quality assurance assessment. This provides valuable information to help me form a judgement about the quality of service offered at the home Care Homes for Older People Page 6 of 22 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 22 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 8 of 22 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 are properly assessed to ensure their needs could be fully met, prior to being offered a permanent placement at the home. Evidence: The care plans I looked at showed that comprehensive pre-admission assessments had been carried out before offering someone a place. This is to make sure that the home can meet the persons needs. A senior member of staff, usually the manager visits the person at home, or in hospital to discuss their care needs. Social Services assessments are also used to determine this as well; these were also available to look at. People are welcome to visit the home before reaching a decision. The home does not provide intermediate care. Care Homes for Older People Page 9 of 22 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. Good systems are in place to ensure that health care needs of the people are met. People can be confident that their privacy and dignity is protected and that they are treated with respect. Evidence: I looked at three care plans in detail, to make sure that peoples health and personal care needs are being met in the way the person prefers. I found the plans to be comprehensive and well written. Careful and thoughtful strategies to address particular needs or problems were well documented and sensitively written. The plans demonstrated that people are in receipt of individual planned care and support. There was evidence of involvement of specialist healthcare people such as the community psychiatric nurse, the dietitian and continence nurse. During my visit I looked at how peoples medication was looked after by the staff at the home. Administration of medication is carried out properly and audited by the manager on a regular basis. A new system is about to be implemented at the home Care Homes for Older People Page 10 of 22 Evidence: regarding the administration of medication. Each person is to have a secure cabinet in which to store there own medication held within there own bedrooms. This is very good practice and will enable people if they wish to take some control over there own medication. People were treat with dignity and respect. People were dressed properly, everyone looked clean and well presented. Relatives confirmed that they were kept up to date with any changes or incidents that effected the care of their relative. One person told me how staff had been very supportive when they felt down and upset Care Homes for Older People Page 11 of 22 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recreational and social needs of people are well catered for which enables them to make daily choices and promotes independence. Evidence: During my visit the atmosphere in the home was friendly and welcoming, with visitors coming and going throughout the day. Some people were enjoying chatting with each other; some were listing to music or else reading. During the afternoon some residents were visited by P.A.T. dogs and the residents really enjoyed this. An activities program was on display. The program was varied and included church services, bingo and sing-a-longs. The manager intends to develop activities in the home to include more community based activities. In addition a garden project is underway to assist some residents who would like to do gardening. It is planned to have raised beds with easy access for residents who wish to partake in this activity One person said they could have a sleep in when ever they liked and another person said the staff are superb. People told me that the food was lovely another person said I eat very well the food is great. The lunch time meal looked really nice. People told me it was lovely, one person said I have asked for seconds the pudding is lovely. The dining tables were nicely set and there was an option of two dining areas, in addition some people chose Care Homes for Older People Page 12 of 22 Evidence: to have there meals in their own bedrooms. Care Homes for Older People Page 13 of 22 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. People can be confident that concerns are listened to and acted upon, and that procedures are in place to keep people safe. Evidence: There are adequate written policies and procedures in place to deal with complaints and the care staff spoken to confirm they were aware of these. Staff knowledge of these help ensure that they were able to address any issues or anxieties of the residents, relatives and visitors to the home. People who live at the home told me they would speak to the manager or any of the staff if they had any concerns or complaints. One visitor said I would not have any hesitation in speaking up if I wasnt happy. The manager is always around and is lovely, I know she would sort things out. Staff told me that training has taken place in the protection of vulnerable adults in abuse. I looked at four personnel files and found that staff recruitment procedures were adequate and staff were employed and deployed following appropriate checks. Some of the records were not all held at the home(criminal record bureau checks) but at head office. It is important the manager sees the original records before appointing people. These records ideally need to be kept at the home, so that they are readily available for inspection. Care Homes for Older People Page 14 of 22 Evidence: The manager and staff team were clear and confident in the protection of vulnerable adult procedures. Care Homes for Older People Page 15 of 22 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 live in a safe, clean and comfortable environment. Evidence: All the bedrooms that I saw reflect the persons individual preferences and taste. There is a programme of redecoration for the bedrooms, as well as for the rest of the home. The corridors at the home are about to be redecorated and new carpets are to be fitted. Several bedrooms and some communal areas have recently been redecorated and look fresh and attractive. The bedroom doors all have locks. This means that people can keep their belongings private and secure. The home is fresh, clean, comfortable and well looked after. Care Homes for Older People Page 16 of 22 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. There are enough skilled and knowledgeable staff on duty to meet the needs of the people who live at the home Evidence: The rotas and staff numbers suggest that there are enough staff on duty at all times to meet the needs of the people who live at the home. People told me that staff were available and that the call bells were answered quickly. The manager makes sure that staff have the necessary training to help them do their work as well as possible. There is a wide range of courses available and the records confirmed that the staff are allowed the time to attend. The home has a training coordinator who organises training events for the staff at the home. Care Homes for Older People Page 17 of 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is safe and well managed and people who live and work at the home can contribute to the decision making processes. Evidence: The manager has the qualifications and the skills to manage the home effectively. Visitors to the home told me that she is lovely and so kind and caring Residents and relative meetings are held and people are asked how they view the service and what improvements they would like to see. The provider visits the home and carries out audits, to make sure the home is operating to company policy. The home manages some peoples personal allowance. This was checked and found to be in order. Policies and procedures are kept up to date; to make sure they provide relevant information to guide staff on how to act in every situation. All the regular health and safety checks for the home are carried out in a timely manner. Staff have basic health and safety training. All these measures make sure Care Homes for Older People Page 18 of 22 Evidence: that the health, safety and welfare of the people who live at the home is promoted and safeguarded. Care Homes for Older People Page 19 of 22 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 20 of 22 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 1 18 17 All documents associated with the recruitment of staff must be available at the home for inspection. To ensure that people are being recruited properly and safeguarding checks have been carried out to protect vulnerable people 03/07/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 21 of 22 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 22 of 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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