Care Home: Oakwood House

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What the care home does well The home is clean and tidy and provides a pleasant environment for residents and their visitors. Standards of cleanliness throughout the home were high. There was also evidence of an ongoing programme of decoration and refurbishment. Residents spoke highly of the environment and some residents took pride in showing how they had personalised their private bedroom space. Comments from residents and relatives about the home and the staff team were very positive. Comments included: "Staff here are brilliant, they look after my relative first class. Anything at all. They keep me informed and the care is genuine- the staff are great".- relative "Staff are very good. It`s a nice small friendly home. I can talk to staff and I feel well informed".-relative. "All staff look after us very nicely and if you want to tell them anything, they listen to you".- resident. "I like living here. I can please myself when I get up and go to bed. Staff are very good, I wouldn`t change them. I would tell them if there was anything wrong".resident. Observations of staff showed that they were a very caring team with a good knowledge and understanding of individual care needs. Staff were seen engaging with residents and enjoying meaningful conversations with them. They were seen offering sensitive and caring support when it was needed. What has improved since the last inspection? Continual improvements have been made to the fabric of the building which ensures that residents benefit from a pleasant environment. Assessments are now completed prior to arranging an admission to the home. This means that residents moving into the home can be confident that their assessed needs can be met and that staff will have the information they need to support them appropriately. Some improvements have been made to the care plans, but the manager also recognised that these improvements need to be ongoing so that all care needs identified include a plan of care which focuses on how the individual wants to be supported. The training programme had been reviewed and staff had received training in key aspects such as safeguarding adults. This improvement means that residents can feel confident that they will be supported by a well trained staff team. Medication had been reviewed and improvements were noted on how the administration of medication was managed by this service. Staff responsible for the administration had received updated training. This means that residents will received their medication safely. What the care home could do better: Further work is required to develop care plans and care plan recordings so that staff have information on how each resident wants to be supported. Residents and relatives were critical about the lack of activities in the home. One person said that the lack of stimulation for residents resulted in them falling asleep. One relative said, "I think they could do with more staff as there`s not enough time for activities and stimulation for residents". One resident said, " There`s no activities going on and there`s no one to do them. When I was in hospital we did exercises, I liked that, I wish we could do that here. There`s too much sleeping here and nodding off". A meaningful activity programme needs to be introduced so that resident benefit from an enriched lifestyle. The activities should reflect the information in the service user guide which states that activities are available in the home. The service needs to note their contractual obligations to the local authority where leisure activities can form part of the contract and also included in the care manager care plans. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Oakwood House 400a Huddersfield Road Stalybridge Tameside SK15 3ET     The quality rating for this care home is:   two star good 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: Ann Connolly     Date: 2 6 0 2 2 0 0 9 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 26 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Oakwood House 400a Huddersfield Road Stalybridge Tameside SK15 3ET 01613032540 01613032540 mannion.s@sky.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Stephen Mycroft,Ms Sheila Mannion care home 18 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability sensory impairment Additional conditions: Service Users to include up to 18 (OP); up to 14 (DE) (E); up to 14 (PD) (E) and up to 1 (SI) (E) Date of last inspection Brief description of the care home Oakwood House is an appropriately converted, large detached building, set back from a fairly busy main road. There are public transport links to the centre of Stalybridge. Oakwood House is owned by two people, one of whom is also the registered manager. It offers accommodation for up to 18 older people, on two floors, Care Homes for Older People Page 4 of 26 Over 65 14 18 14 1 0 0 0 0 1 6 0 9 2 0 0 8 Brief description of the care home mainly in single bedrooms. There is a lounge and a large dining room on the ground and first floor. Oakwood House charges fees from 278.16 to 364.78 pounds at the date of this visit. Care Homes for Older People Page 5 of 26 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: This was a key inspection that included a site visit to the home. The manager was not told beforehand that we were coming to inspect, this is called an unannounced inspection. This inspection looked at all the key standards and included a review of all available information received by the Commission for Social care (CSCI) about the service provided at the home since the last inspection. During the site visit a selection of records, care plans, policies and procedures were examined. Discussions took place with the manager, staff working in the home, and some relatives. Discussion took place with them to find out what they thought about the home and what they felt about how the staff supported them. A tour of the building took place and residents were asked for their comments and views about the environment. Before the inspection, we also asked the manager of the service to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they Care Homes for Older People Page 6 of 26 did well, and what they needed to do better. This is one of the ways that we get information from the manager of the service about how they are meeting outcomes for people using the service. Surveys were sent out to residents and staff and the information in these gave us more information about this service. Since the last inspection visit which took place on 16th September 2008, the Commission have not received any recent complaints about the service. There was evidence during this visit that the manger was handling complaints well and followed correct polices and procedures for manging complaints and safeguarding issues. What the care home does well: What has improved since the last inspection? Continual improvements have been made to the fabric of the building which ensures that residents benefit from a pleasant environment. Assessments are now completed prior to arranging an admission to the home. This means that residents moving into the home can be confident that their assessed needs can be met and that staff will have the information they need to support them appropriately. Some improvements have been made to the care plans, but the manager also recognised that these improvements need to be ongoing so that all care needs identified include a plan of care which focuses on how the individual wants to be supported. The training programme had been reviewed and staff had received training in key aspects such as safeguarding adults. This improvement means that residents can feel confident that they will be supported by a well trained staff team. Medication had been reviewed and improvements were noted on how the administration of medication was managed by this service. Staff responsible for the administration had received updated training. This means that residents will received Care Homes for Older People Page 8 of 26 their medication safely. 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.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 9 of 26 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 26 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. Residents care needs are assessed prior to moving into the home. Evidence: It was noted that improvements had been made in the way new people were admitted to the home. There was evidence that the service was following procedures in ensuring that assessments of care needs were undertaken prior to arranging an admission to the home. Five care plans were looked at, including the file of a resident recently admitted to the home. Each file contained an assessment of need. Some information on the files was in more detail than others, and provided staff with a clearer overview of individual assessed needs. It is important to maintain continuity and consistency in the way assessments are undertaken so that there is sufficient information to develop the care plans and record how residents want to be supported. Care Homes for Older People Page 11 of 26 Evidence: It was evident from talking to staff that they had a good knowledge of individual care needs and how individuals wanted to be supported. Care Homes for Older People Page 12 of 26 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. The healthcare needs of residents are managed in a way that ensures they receive the care and attention they need. Evidence: Five care plans were looked at during this visit. All care plans were presented in files with an index system for easy reference. Information was divided into sections to include basic information, care plans, reviews and risk assessments. There was evidence that work had been undertaken to improve care plans. Some care plans were in detail and provided staff with the information they need to meet assessed needs. There were other examples where assessed care needs had not been included in the care plan. One example of this was in the case of a resident who presented with problems of anxiety. This had been detailed in the assessment and the care manager had provided strategies to support this person but it had not been included in the care plan. The staff were observed whilst they were supporting this resident, and it was evident that they had a good understanding of his needs. Their support was sensitive and focused on reassuring him. However,it is important that staff have access to written documentation that gives them information in detail about individual care Care Homes for Older People Page 13 of 26 Evidence: needs and how to support people in a way that is preferable to them. This will ensure that care needs are not overlooked. The manager told us that care plans were still under review and that they were developing a person centred approach where documentation would show that residents were consulted about lifestyle preferences and consultation took place with them about how they wanted to be supported. Staff who were spoken to showed a high level of commitment to their caring role. The feedback from residents and their relatives was complimentary about how the staff provided care and support. Comments included: The staff are brilliant, they look after dad first class. They keep me informed and the care is genuine Staff are very good, its a nice friendly home. All staff look after us very nicely, if you want to tell them anything they listen to you, I like my carer, she does a lot of things for me. The staff are responsible for making daily recordings which relate to the care plan. It was accepted by the manager and staff that these need to be developed so that the recordings are meaningful and relate to care plans. Medication was looked at during this visit and significant improvements were noted on how medication was managed. The medication was administered using a monitored dosage system in blister packs. The medication administration record (MAR) was appropriately signed by staff and records were in place for the receipt and disposal of medication. There was a list of sample signatures of the staff responsible for the administration of records. This helps the manager when carrying out an audit of medication practice in the home. Records showed that staff have received recent training in the administration of medication. The manager is in the process of developing an audit tool to use for checking medication procedures. This will help to ensure that residents receive medication as detailed on the prescription and in a safe way. A new cupboard for the storage of medication had been installed. Care Homes for Older People Page 14 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are encouraged to maintain contact with family and friends. There is a lack of provision of social activities that means residents do not have the opportunities to participate in stimulating and meaningful activities of their choice. Evidence: During this visit there was very little evidence to show that residents were offered activities which provided interest and stimulation. In discussions with residents they told us that there was very little to do during the day except go to sleep or watch television. The dependency levels of residents meant that staff had very little spare time to sit down and and support residents to participate in activities. One relative who was complimentary about the care in the home, added that she thought residents would benefit from having additional staff to carry out activities in the home. One person told us that all residents seemed to do was sleep and she thought that this was because they were bored as there was no stimulation. Other residents said, Theres no activities here and theres no one here to do them. The information in the service user guide states that activities are available , however, in reality this does not happen on a regular and consistent basis. A recommendation has been made for the manager to provide appropriate activities which will help to ensure Care Homes for Older People Page 15 of 26 Evidence: that residents benefit from an enriched lifestyle experience. The menu provided is on a weekly cycle which seems to present limited choice. However, when speaking with residents they all told us that this was their preferred choice and that they liked knowing what was on the menu. Many of the meals on the menu were traditional favourites. All residents were complimentary about the meals served in the home. Comments included: The meals are nice, its a regular menu, but I like it like that. I like not having to cook. The food is nice here, just like you would have at home. The meal served during this visit was meat and potato pie with carrots and cauliflower. The second course was chocolate sponge and custard. The meal was sampled and was well presented and wholesome. The food was freshly prepared using fresh produce and the meat and potato pie was home made. The cook told us that alternatives were always available if someone did not like the menu of just preferred something different. Relative spoke highly of the home and said they felt that they could visit any time. All of them said they were always made to feel welcome by the staff. Care Homes for Older People Page 16 of 26 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. Procedures are in place to ensure that residents are protected. Evidence: Since the last inspection visit there has been one complaint made directly to the home. The home followed their policies and procedures for investigating this complaint. The Commission has not received any recent complaints about this service. Staff who were spoken to had a good understanding of adult safeguarding and knew what to do in the event of an allegation of abuse. The training records showed that nine members of staff had recently attended safeguarding training. Care Homes for Older People Page 17 of 26 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. The home is appropriately maintained and provides residents with a clean and pleasant environment. Evidence: A tour of the building took place and all areas were found to be clean and tidy. The standard of cleanliness was high with all areas of the home smelling clean and fresh. All residents spoke highly of their surroundings and felt that there were spaces in the home that provided a place for quiet relaxation. Some residents said they enjoyed the privacy of their room where they felt they could listen to music or read and entertain friends and family. Most rooms were personalised to reflect personal preferences. Comments from residents included: I like my room, I can please myself when I go there, I get up when I want and go to may room when I want. I Like it here, I like the cleanliness. Since the last visit, the programme of renewal and re-decoration has been ongoing. These improvements provide a pleasant place for residents to call their home. Care Homes for Older People Page 18 of 26 Evidence: Fire records were checked, and showed that systems were being maintained. the information in the Annual Quality Assurance document confirms that equipment in the home is maintained. Nearly all staff have completed training in infection control. Care Homes for Older People Page 19 of 26 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. Residents receive care and support from staff that they like and who have the skills to support them correctly. Evidence: During this visit the staff on duty were able to meet the needs of the residents living in the home. There were times when staff appeared rushed, and one visitor said that sometimes she felt they needed more staff so that they could spend quality time with the residents. The dependency levels of residents was looked at, this showed that a number of residents in the home required assistance from two staff, and three residents required the use of a hoist. As dependency levels increase it is important that the manager continually reviews staffing levels and provides evidence that there are sufficient staff to meet the changing care needs of residents in the home. Staff who were on duty told us that they had plenty of opportunity for ongoing personal development, and that there was a training programme in place. The training record was looked at and showed that training was ongoing. Nine members of staff recently completed training in safeguarding adults, nearly all staff had completed training in infection control; and five staff had undertaken training in risk assessments. A sample of staff files were looked at and provided evidence of recruitment procedures Care Homes for Older People Page 20 of 26 Evidence: which protected people in the home. All files looked at contained the appropriate documentation and checks, for example Criminal Record Bureau (CRB), application forms and two written references. Staff were observed whilst carrying out their duties. At all times they related to residents in a warm and sensitive manner showing respect to them. They were seen engaging in meaningful conversations with residents and they were seen to intervene and provide support when it was appropriate. All residents and relatives who were spoken to spoke highly of the staff. One relative said, The care is genuine, the staff are great. Care Homes for Older People Page 21 of 26 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. Recent improvements in management arrangements show that the health, safety and welfare of residents and staff are promoted. Evidence: The registered manager has several years experience in a management role. The registered manager is also one of the two owners of the business. Since the last visit to this service in September 2008, there have been some improvements in the day to day running of the home. Management hours have been increased so that there is time allocated for the manager to carry out managerial and administrative tasks, which include the day to day monitoring of care practices in the home. Improvements were noted on admission assessments and medication practices. The manager is aware that these improvements must be sustained so that residents can be confident that their welfare is promoted and protected. Staff who were spoken to said that the manager was very approachable and Care Homes for Older People Page 22 of 26 Evidence: supportive. They confirmed that they were in receipt of regular supervision. Supervision records confirmed that formal supervision arrangements were in place. Information in the AQAA states that systems are in place to maintain equipment. Records showed that regular checks were made on fire safety equipment. Care Homes for Older People Page 23 of 26 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 24 of 26 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 3 Consistency needs to be maintained when undertaking an assessment of care need prior to admission so that there is sufficient information to generate a care plan which reflects the needs and preferences of the individual resident. Care plans need to be regularly reviewed so that all care needs that are identified are included in the care plan. Recordings in the care plan need to be relevant and reflect the care and support given to residents. Activities should be provided so that residents have the opportunity to participate in stimulating and meaningful activities of their choice. Staffing levels need to be continually reviewed and monitored so that residents in the home can be confident that there are sufficient staff on duty to meet their changing and increasing dependency levels. 2 3 4 7 7 12 5 27 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or 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) 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. 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