Care Home: Oakworth Manor

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What the care home does well People said they liked the home. Comments included: "I was very pleased to come to Oakworth Manor" "Thank you for making my latter time enjoyable, it was as good as a hotel" "It makes a family feeling- feels like a big family" "I am happy with the home" "It`s all grand" "It`s lovely". People who live at the home said they were very happy with the care they receive. Their comments included: "The carers are very good with the residents, having time to talk and show compassion when needed" "The home does well caring for my needs" "Always someone to talk to if you need it" "Takes good care of all the patients" "Help`s always there when you need it" "You can have a bath at any time you like" "Nothing to grumble about here, we get what we want when we need it". People have their own supply of cold drinks attached to their chairs in the sitting room. This makes sure that staff can regularly offer people drinks to make sure they keep well hydrated. It also allows staff to monitor how much fluid people have had and to encourage people if needs be. Fruit is also readily available for people to help themselves. People who live at the home were very positive about the food. Their comments included: "Good food provided" "The food is lovely" "They get to know what you like and make sure you get it" "If you don`t like something you can always have something else" "We have plenty of drinks, snacks and cakes". People who live at the home are involved in choosing their own staff by sitting on the interview panel. People who live at the home spoke highly of the staff. Their comments included: "They do their best" "I am content with what the staff do for me" "Staff are kind" "The staff are very kind and caring" "They couldn`t treat us better if we were royalty" "They are a good lot, you can have a laugh, they are never misrable". Staff said they received good training and felt well prepared for their job. One said, "New training is always available to staff and more information on care and medication is there when we need it" and "The induction pack is really good and helps a lot when you start work here". Staff spoke highly of the support they get from the manager. Their comments included: "She is very fair and approachable" "Lets you know what she wants and also what she doesn`t want" "Good support from our manager and she thinks a lot of the residents". Staff also said how much they enjoyed working at the home. They said:"It is a good friendly place with a good atmoshere" "Oakworth Manor is a really good place to work we are all like a family, staff and service users, it`s very nice" "The home and people who work here are very friendly". What has improved since the last inspection? The manager and staff team have worked hard to address and meet the requirements and reccomendations that we made at our last visit of the home. Pre-admission assessment information is now in more detail and includes some life history information, making the assessments very individual to the person and giving good information of people`s support needs. The manager has introduced a new format for care planning. This is a computerised system for recording people`s needs and care management plans. Although there is still work to be done on these, we found them, in the main, to be person centred and individual to each person. Some plans had clear and detailed instruction on how the needs of people who use the service are to be met. In the AQAA, the manager told us the service had improved by saying, `Activities coordinater in post, menu changes and mealtimes discussed in service users meetings`. Most staff have received training in safeguarding adults. This means they are able to protect people from abuse better. A number of bedrooms have been re-decorated and re-furbished, making them more comfortable for people. A number of improvements have been made to staff`s training. Records showed most staff`s training was up to date. Courses included, health and safety, food hygiene, first aid, dementia awareness, manual handling, medication administration, food hygiene and adult protection. The manager has developed a training plan based on the needs of the service and is in the process of booking further training so that it remains on-going and available to staff. Also, the manager now runs the induction training on the skills for care common induction standards as we recommended at our last visit to the home. Almost half of the staff team have achieved or are working towards an NVQ (National Vocational Qualification) in level 2 or above. This is good practice and means the home has staff who are qualified to carry out their job. The manager has sent out questionnaires to relatives of people who live at the home asking for their views on any improvements that could be made. She has acted on suggestions made. For example, she has introduced a new system for laundry to make sure people get the opportunity to wear the variety of their clothes. Accident or incident reports are completed and kept in the home. These are now sent promptly to CQC and the manager looks at these every month to see if there are anypatterns or trends or if there is anything that can be put in place to minimise the risk of accidents. For example, movement sensor mats for people who may be at risk from falls. She is also looking to introduce hip protectors for those people who wish to wear them. This will give people further protection if they do fall. More staff have now been trained in First Aid, making them more able to make decisions on what to do in the event of accidents or injuries. Good records are now kept of the finances of people who live at the home and their monies are kept safe. The manager has introduced a more effective system and makes sure monies and receipts are checked regularly. What the care home could do better: People who live at the home should have more detailed care plans and risk management plans, clearly outlining all their support needs. This will make sure they receive person centred support that meets their needs fully. Handwritten entries on MAR (Medication Administration Records) sheets should be checked and countersigned by a second person to make sure the information is correct and people receive the right medication. The whistleblowing policy should include the contact details for agencies to contact outside of the organisation if staff wish to report concerns. Work must be completed on the upstairs bathroom in the home. This will make sure there are enough bathing facilities for the number of people living in the home. We reccommend that staff are booked on training courses at the time of their induction so they gain the knowledge to enable them to work through their induction fully. Application to register the manager with CQC should be made. This will ensure there is accountability for the day to day management of the home. Some consideration should be given to extending the quality assurance surveys to people who live at the home and any visiting professionals. Feedback from the surveys should be analysed, the results published and used to form a development plan for improving the service provided. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Oakworth Manor Oakworth Manor Colne Road Oakworth Keighley West Yorks BD22 7PB     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: Dawn Navesey     Date: 1 1 0 6 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 33 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 33 Information about the care home Name of care home: Address: Oakworth Manor Colne Road Oakworth Manor Oakworth Keighley West Yorks BD22 7PB 01535643814 F/P01535643814 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Christine Lynn Flood care home 21 Number of places (if applicable): Under 65 Over 65 1 17 3 dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home 0 0 0 Oakworth Manor is located in the middle of the village of Oakworth a bus ride away from the town of Keighley. It is a detached adapted property set in its own grounds in the centre of the village of Oakworth. It is conveniently placed for local shops and a bus route. There is adequate parking close to the building. There is level access available to the rear of the building and people can easily access two patio areas from the lounges. There are three separate communal rooms comprising of two lounges and a dining room. Bedrooms are located on the ground and first floor. Access to the first floor is by a stair lift. Care Homes for Older People Page 4 of 33 Brief description of the care home Accommodation is provided for up to twenty-one people over the age of 65. The weekly fees range from three hundred and seventy seven pounds to four hundred and thirty five pounds weekly. Additional charges are made for chiropody and hairdressing. This information was provided by the manager in June 2009. Information about the services provided by the home is available in the Service User Guide. Care Homes for Older People Page 5 of 33 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 quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The Care Quality Commission (CQC) inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.cqc.org.uk This visit was unannounced and was carried out by one inspector who was at the home from 11:45 - 18:40 on the 11 June 2009. The purpose of the inspection was to make Care Homes for Older People Page 6 of 33 sure the home was operating and being managed for the benefit and well being of the people living there. And also to monitor progress on the requirements and recommendations made at the last inspection. Before the inspection evidence about the home was reviewed. This included looking at any reported incidents, accidents and complaints. This information was used to plan the visit. An AQAA (Annual Quality Assurance Assessment) was completed by the home manager before the visit to provide additional information. Survey forms were sent out to people living at the home, staff and health care professionals. A number of these have been returned and comments made have been used in the preparation of this report. During the visit a number of documents and records were looked at and some areas of the home used by the people living there were visited. Some time was spent with the people who live at the home, talking to them and interacting with them. Time was also spent talking to staff and the manager. Feedback at the end of the visit was given to the manager. The last inspection of this home was on 18 June 2008. What the care home does well: People said they liked the home. Comments included: I was very pleased to come to Oakworth Manor Thank you for making my latter time enjoyable, it was as good as a hotel It makes a family feeling- feels like a big family I am happy with the home Its all grand Its lovely. People who live at the home said they were very happy with the care they receive. Their comments included: The carers are very good with the residents, having time to talk and show compassion when needed The home does well caring for my needs Always someone to talk to if you need it Takes good care of all the patients Helps always there when you need it You can have a bath at any time you like Nothing to grumble about here, we get what we want when we need it. People have their own supply of cold drinks attached to their chairs in the sitting room. This makes sure that staff can regularly offer people drinks to make sure they keep well hydrated. It also allows staff to monitor how much fluid people have had and to encourage people if needs be. Fruit is also readily available for people to help themselves. People who live at the home were very positive about the food. Their comments included: Good food provided The food is lovely They get to know what you like and make sure you get it If you dont like something you can always have something else We have plenty of drinks, snacks and cakes. People who live at the home are involved in choosing their own staff by sitting on the interview panel. People who live at the home spoke highly of the staff. Their comments included: They do their best I am content with what the staff do for me Staff are kind The staff are very kind and caring They couldnt treat us better if we were royalty They are a good lot, you can have a laugh, they are never misrable. Staff said they received good training and felt well prepared for their job. One said, New training is always available to staff and more information on care and medication is there when we need it and The induction pack is really good and helps a lot when you start work here. Staff spoke highly of the support they get from the manager. Their comments included: She is very fair and approachable Lets you know what she wants and also what she doesnt want Good support from our manager and she thinks a lot of the residents. Staff also said how much they enjoyed working at the home. They said: Care Homes for Older People Page 8 of 33 It is a good friendly place with a good atmoshere Oakworth Manor is a really good place to work we are all like a family, staff and service users, its very nice The home and people who work here are very friendly. What has improved since the last inspection? The manager and staff team have worked hard to address and meet the requirements and reccomendations that we made at our last visit of the home. Pre-admission assessment information is now in more detail and includes some life history information, making the assessments very individual to the person and giving good information of peoples support needs. The manager has introduced a new format for care planning. This is a computerised system for recording peoples needs and care management plans. Although there is still work to be done on these, we found them, in the main, to be person centred and individual to each person. Some plans had clear and detailed instruction on how the needs of people who use the service are to be met. In the AQAA, the manager told us the service had improved by saying, Activities coordinater in post, menu changes and mealtimes discussed in service users meetings. Most staff have received training in safeguarding adults. This means they are able to protect people from abuse better. A number of bedrooms have been re-decorated and re-furbished, making them more comfortable for people. A number of improvements have been made to staffs training. Records showed most staffs training was up to date. Courses included, health and safety, food hygiene, first aid, dementia awareness, manual handling, medication administration, food hygiene and adult protection. The manager has developed a training plan based on the needs of the service and is in the process of booking further training so that it remains on-going and available to staff. Also, the manager now runs the induction training on the skills for care common induction standards as we recommended at our last visit to the home. Almost half of the staff team have achieved or are working towards an NVQ (National Vocational Qualification) in level 2 or above. This is good practice and means the home has staff who are qualified to carry out their job. The manager has sent out questionnaires to relatives of people who live at the home asking for their views on any improvements that could be made. She has acted on suggestions made. For example, she has introduced a new system for laundry to make sure people get the opportunity to wear the variety of their clothes. Accident or incident reports are completed and kept in the home. These are now sent promptly to CQC and the manager looks at these every month to see if there are any Care Homes for Older People Page 9 of 33 patterns or trends or if there is anything that can be put in place to minimise the risk of accidents. For example, movement sensor mats for people who may be at risk from falls. She is also looking to introduce hip protectors for those people who wish to wear them. This will give people further protection if they do fall. More staff have now been trained in First Aid, making them more able to make decisions on what to do in the event of accidents or injuries. Good records are now kept of the finances of people who live at the home and their monies are kept safe. The manager has introduced a more effective system and makes sure monies and receipts are checked regularly. 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 10 of 33 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 11 of 33 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 who use the service can be sure that the home will meet their needs following assessment. Evidence: We looked at the assessments for the most recently admitted people to the home. Referrals had been made from care managers and the manager had made sure an up to date care management assessment of peoples needs was obtained. The manager said this information was then used as part of their assessment in making sure they were able to meet peoples needs. The home also carry out their own pre-admission assessment to make sure they can meet peoples needs properly. The manager and the senior support workers complete these assessments for people. The information within them is now in more detail and includes some life history information, making them very individual to the person and Care Homes for Older People Page 12 of 33 Evidence: giving good information of peoples support needs. The manager said they can carry out the assessments in peoples own homes or if people are in hospital. She also said that people thinking of moving in to the home can visit with their families as much as they like before making any decisions about moving in. She said they always try to offer people reassurrance and acknowledge it can be a difficult time for people, making the adjustment from moving from their own home. We also looked at contracts that people have with the home. These are documents that outline the terms and conditions and costs for staying at the home. These were up to date and had been signed to show that people were in agreement with them. Also, most people who returned a survey to us said they had a contract with the home, which outlined the terms and conditions. People said they liked the home. Comments included: I was very pleased to come to Oakworth Manor Thank you for making my latter time enjoyable, it was as good as a hotel It makes a family feeling- feels like a big family I am happy with the home Its all grand Its lovely. Care Homes for Older People Page 13 of 33 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. Overall, the health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: People look well cared for clean, tidy and well groomed. Attention had been paid to detail. People had clean glasses, women had their nails painted if they wanted and people had their hair styled as they wished. Staff were patient, gentle and kind when interacting with people. They were discreet and respectful of peoples dignity when attending to any personal care needs. They gave reassurance and explanations for any tasks that they needed to support people with. This seemed to give people confidence in the staff. One person said, I trust each and everyone of them here to do anything for me. We looked at care plan and risk assessment records for some people who live at the home. The manager has introduced a new format for care planning. This is a computerised system for recording peoples needs and care management plans. We Care Homes for Older People Page 14 of 33 Evidence: found them, in the main, to be person centred and individual to each person. Some plans had clear and detailed instruction on how the needs of people who use the service are to be met. There were however, some shortfalls with some care plans and risk management plans. Some plans did not give the detail of how care needs are carried out. Terms such as monitor, needs support and needs assistance do not tell staff how much support a person needs and could lead to needs being overlooked. We recommend that care plans and risk management plans are reviewed to make sure people using the service have an up to date, detailed care plan. This will make sure that people receive person centred support that meets their needs. Despite the gaps in care plan and risk management documentation, staff were familiar with peoples needs and could talk confidently about the support they give. Staff were able to describe peoples preferred routines with regard to their personal care and what works well for people. Staff have a good knowledge of peoples individual needs. Some staff said they did not always have time to read the care plans. We thought some of the care plans were sometimes repetetive and could be reviewed and streamlined to make them more accessible to staff. We discussed this with the manager who agreed to do this as part of her review of the plans. People who live at the home said they were very happy with the care they receive. Their comments included: The carers are very good with the residents, having time to talk and show compassion when needed The home does well caring for my needs Always someone to talk to if you need it Takes good care of all the patients Helps always there when you need it You can have a bath at any time you like Nothing to grumble about here, we get what we want when we need it. Staff, when asked what the home does well, made the following comments: Provides excellent care for each and every service user The home cares well for each individual needs of service users Caring for residents to a very high standard. Relatives visiting the home were satisfied with the care people receive. One said, (name of person) always looks lovely, clean and tidy, hair cut nice. A health care professional who returned a survey said they were satisfied with care given at the home. Help and advice is sought from health care professionals to make sure that people get Care Homes for Older People Page 15 of 33 Evidence: the special help they need to maintain their health. People are escorted to appointments or health care professionals such as district nurses, attend the home as required. Staff have been trained to meet the specific health needs of people who use the service. Staff said they had recently completed training in dementia awareness and meeting nutritional needs. Individual training is arranged according to peoples needs. For example, the district nurse giving training on a persons diabetes management. The manager said she was also in the process of arranging training with the tissue viability nurse to give training on maintaining good skin care for people at the home. The home uses a monitored dosage pre-packed system for medicines. There are now good ordering and checking systems in place. The manager makes sure that prescriptions come back to the home before going to the pharmacy for medication to be dispensed. This means they can be checked and any errors avoided. We checked some medication administration records (MAR) sheets. These were found to be in reasonable order. However, the MAR sheets did not have records of medication carried forward from the previous month. This means it is difficult to audit stocks of medication or find out if any errors have occurred. The manager and senior support worker agreed to make sure this system was introduced. We also noticed that some entries on the MAR sheets had been handwritten. It is good practice to make sure these entries are checked and countersigned by a second person to make sure the information is correct and people receive the right medication. The manager told us that the medication policy was now reviewed and in line with the Royal Pharmaceutical Society guidance. Care Homes for Older People Page 16 of 33 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. People who use the service are able to make choices about their lifestyle. Social, cultural and recreational activities meet peoples expectations. They also benefit from a good, healthy and varied diet. Evidence: In the AQAA, the manager told us the service had improved by saying, Activities coordinater in post, menu changes and mealtimes discussed in service users meetings. The activities co-ordinater has just recently returned to the home after a period of leave. People who live at the home said they were glad she was back. We saw that activity was provided in small groups or for one to one activity with people. People were enjoying manicures, reading the paper, playing board games or doing some art work with the activitiy co-ordinater. Staff also had time to just sit and have a chat with people throughout the day. One person told us how the staff had helped them celebrate their birthday, providing a cake and a party. The manager said she was intending to improve the service by introducing reminiscence therapy. She said she was also looking for some training on this and Care Homes for Older People Page 17 of 33 Evidence: other activities for her and the activities co-ordinater. This will make sure the manager keeps activities under review. People who live at the home were, in the main, positive about what they do at the home. Their comments included: We seem to be getting more entertainers these days I like the bingo and playing games I enjoy doing the baking. One person who lives at the home said they thought there could be more staff to enable them to get out more. Staff said they felt they had enough staff to provide people with a decent amount of activity and said they didnt feel people were bored at the home. They said: We all muck in, singing, reading, skittles, nails, baking, we do all sorts We made cards with people at Christmas We respect if people prefer their own company We can provide for peoples cultural needs and preferences. Staff said a Roman Catholic priest visits the home to give communion every two weeks and there is a fortnightly interdenominational Christian service that all people can attend if they wish. One staff member spoke of a person who came to the home for respite care and was able to use her own language as one of the staff also spoke this. The staff member said they introduced some basic words and language to other staff within the team to make this persons stay more enjoyable for them. The atmosphere in the home is relaxed and life seems to go at the pace of people who use the service. People are free to move about the home as they wish and are able to have their things around them. Everyone we spoke to said it felt like home. People were sat in small social groups to encourage conversation and interaction. One person said, We have an agreement between ourselves, those that want the television sit at that end and those of us who like to chat sit at this end. People who live at the home were encouraged to make choices throughout the day. Staff said they always ask people what they want to do, what to wear and make sure people can get up and go to bed when they want. Staff said there are no rigid routines for people. This is good person centred practice. Staff said, Care Homes for Older People Page 18 of 33 Evidence: The home is the service users home and all staff respect that Activities and entertainment are provided regularly People who live at the home were very positive about the food. Their comments included: Good food provided The food is lovely They get to know what you like and make sure you get it If you dont like something you can always have something else We have plenty of drinks, snacks and cakes. People have their own supply of cold drinks attached to their chairs in the sitting room. This makes sure that staff can regularly offer people drinks to make sure they keep well hydrated. It also allows staff to monitor how much fluid people have had and to encourage people if needs be. Fruit is also readily available for people to help themselves to. Menus are arranged based on likes and dislikes of people. This information is gained from people at the home, their relatives and staff. There is plenty of choice for people. If people refuse food, alternatives can be prepared quickly for them. Meals can be served in peoples bedrooms, sitting rooms or in the dining areas. Staff are sensitive to the needs of people who find it difficult to eat and need help and encouragement with this. Staff sit with people helping them feel comfortable and unhurried which helps people relax and respond in time. Food looked appetizing and people were offered as many choices as required to encourage them to eat. Care Homes for Older People Page 19 of 33 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. In the main, people who use the service are able to express their concerns and are protected from abuse. Evidence: Most people who returned a survey said they knew what to do if they were unhappy about anything and knew how to complain. They also said that staff listen to them and act upon what they say. One person said, I have nothing to grumble about here. A relative said they had been given information on how to complain if they needed to. It was clear from staffs interactions with people that the people who live at the home seemed confident to raise their wishes or concerns. The home has not received any formal complaints since the last inspection. The complaints procedure is reviewed and up to date and is displayed in the entrance hall of the home. The manager said they did not as yet produce the complaints procedure in any different formats but would be considering how to do this in the future to make it more accessible. Most staff have received training in safeguarding adults. They were able to say what action they would take if they suspected abuse or had an allegation of abuse made to them. They were also able to describe the different types of abuse. All staff were clear Care Homes for Older People Page 20 of 33 Evidence: on their responsibility to report abuse or allegations of abuse. They were familiar with the whistle blowing procedure and said they would have no hesitation in using it if they thought they needed to raise concerns outside of the home or organisation. The homes safeguarding adults policy does not however, contain the contact numbers to enable staff to do this. The manager and senior support worker were familiar with the local authority safeguarding referral system. This means people are properly protected. Care Homes for Older People Page 21 of 33 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall, the environment is homely, comfortable and safe for people who live at the home. Evidence: A tour of the building was carried out. Communal areas, bathrooms and bedrooms were visited. The home was clean, tidy and homely. Some bedrooms are for single use and a number are shared. Privacy screening is provided in the shared rooms. There are two lounges available for people to sit in. This means that people can socialise in small groups. They are also able to receive and entertain their visitors here. Staff work hard to make sure the home is kept clean. There are no malodours in the home. The manager has made sure there are good cleaning routines in place to make sure the home is clean and fresh smelling. People who returned a survey said the home was always fresh and clean. People who live at the home were pleased with their bedrooms and had personalised them with their own things such as furniture and pictures. Some bedroom doors had pictures on them to help people who have memory loss to orientate themselves. A number of bedrooms have been re-decorated and refurbished, making them more comfortable for people. The last time we visited the home we said that the use of peoples bedrooms for Care Homes for Older People Page 22 of 33 Evidence: communal hairdressing should be reviewed. The manager has looked at this and is planning to rennovate the downstairs bathroom to make it more useful for this. However, this has not started yet and we noticed the upstairs bathroom is currently out of order, which means there is only one bathroom available in the home for people at the moment. The manager agreed to have the upstairs bathroom operational within the next three months as work is also required on it. She said they would then be in a position to use the downstairs bathroom for hairdressing. The environmental health department visited the home in December 2008. The home were awarded five out of a possible five stars from this visit. Clinical waste is properly managed. Staff have received training in infection control as part of their induction and were able to say what other infection control measures are in place. Hand washing and hand drying facilities were available in all areas of the home. Liquid soap or paper towels were available. This ensures good hygiene practice. Care Homes for Older People Page 23 of 33 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. Staff in the home are trained, skilled and in sufficient numbers to support people who use the service and to support the smooth running of the home. Evidence: People who live at the home spoke highly of the staff. Their comments included: They do their best I am content with what the staff do for me Staff are kind The staff are very kind and caring They couldnt treat us better if we were royalty They are a good lot, you can have a laugh, they are never misrable. There are usually three care staff and one senior support worker on duty throughout the day on each shift. The manager is also available most days too. At night there are two staff on duty. Staff said they felt they had enough staff, that they never felt rushed and could meet peoples needs well. In addition to this there are two cleaners and a cook on duty every day. The activity-co-ordinater also works three days per week. People who live at the home said there was enough staff and they didnt have to wait long for staffs attention if they needed them. They also said: Care Homes for Older People Page 24 of 33 Evidence: They are there if you need them Its all grand, they get you up give you good help. Staffs interactions with people who live at the home were very respectful, caring and gentle. They showed they had respect for peoples individual needs and dignity. We looked at the recruitment process for people working at the home. The files had the relevant information to confirm these recruitment processes were properly managed. This included application forms, references and CRB (criminal records bureau) checks. The manager said she also checks references by telephone to further protect the interests of people who live at the home. This is good practice. We recommend that the manager also records when she has done this. The manager has also involved people who live at the home in interviews for new staff to get their involvement in choosing their own staff. We also looked at staffs training records. These records showed most staffs training was up to date. Courses included, health and safety, food hygiene, first aid, dementia awareness, manual handling, medication administration, food hygiene and adult protection. The manager has developed a training plan based on the needs of the service and is in the process of booking further training so that it remains on-going and available to staff. The manager now runs the induction training on the skills for care common induction standards as we recommended at our last visit to the home. We now reccommend that staff are booked on training courses at the time of their induction so they gain the knowledge to enable them to work through their induction fully. Staff said they received good training and felt well prepared for their job. One said, New training is always available to staff and more information on care and medication is there when we need it and The induction pack is really good and helps a lot when you start work here. Staff were able to talk with confidence about how training had affected their practice. One said, they felt much better equipped to support people who have dementia since doing the awareness training. They said, It shows you the importance of communication, especially non-verbal for people with memory loss. Almost half of the staff team have achieved or are working towards an NVQ (National Vocational Qualification)in care in level 2 or above. This is good practice and means the home has staff who are qualified to carry out their job. Staff also said how much they enjoyed working at the home. They said: Care Homes for Older People Page 25 of 33 Evidence: It is a good friendly place with a good atmoshere Oakworth Manor is a really good place to work we are all like a family, staff and service users, its very nice The home and people who work here are very friendly. Care Homes for Older People Page 26 of 33 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. Overall, the home is well managed. The interests of people who use the service are seen as important to the manager and staff and are safeguarded and respected. Evidence: The manager has been acting up as the manager of the home since April 2008. She has now been made the manager and is currently working towards her NVQ 4 in leadership and management which will mean she has a qualification to run the home. The manager has a number of years experience in working in social care. She is not however registered with the CQC as yet, to be the registered manager. The provider of the service told us this would be done in May 2009. At the time of the visit, it was agreed with the manager and provider that an application to be the registered manager would be submitted by the end of June 2009. The manager had already got the application pack and has had her CRB check done by us and said she is committed to making the application. Care Homes for Older People Page 27 of 33 Evidence: Staff spoke highly of the support they get from the manager. Their comments included: She is very fair and approachable Lets you know what she wants and also what she doesnt want Good support from our manager and she thinks a lot of the residents. Staff said they regularly had discussions with the manager to discuss their roles and see how they were working. The manager has sent out questionnaires to relatives of people who live at the home asking for their views on any improvements that could be made. She has acted on suggestions made. For example, she has introduced a new system for laundry to make sure people get the opportunity to wear the variety of their clothes. We now recommend that the manager extends the questionnares to people who live at the home and any visiting professionals to get further feedback on how the service could improve. We received the AQAA from the manager when we asked for it. It gave some of the information we asked for but was brief when asked about improvements made to the service and what the home does well. Arrangements are in place to make sure of safe working practices. The home has a range of health and safety policies and procedures in place. The manager is aware of the need to review these to make sure they are still relevant to the service. She said she was starting to review the environmental risk assessments first. In the AQAA, the manager said that all equipment used in the home has been serviced or tested as recommended by the manufacturer or other regulatory body. For example, the hoist and electrical wiring. Accident or incident reports are completed and kept in the home. These are now sent promptly to CQC and the manager looks at these every month to see if there are any patterns or trends or if there is anything that can be put in place to minimise the risk of accidents. For example, movement sensor mats for people who may be at risk from falls. She is also looking to introduce hip protectors for those people who wish to wear them. This will give people further protection if they do fall. More staff have now been trained in First Aid, making them more able to make decisions on what to do in the event of accidents or injuries. Records are kept of the finances of people who live at the home and their monies are kept safe. The manager has introduced a more effective system and makes sure Care Homes for Older People Page 28 of 33 Evidence: monies and receipts are checked regularly. Care Homes for Older People Page 29 of 33 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 30 of 33 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 21 23 Work must be completed on 30/09/2009 the upstairs bathroom in the home. This will make sure there are enough bathing facilities for the number of people in the home. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 People who use the service should have detailed care plans and risk management plans, clearly outlining all their support needs. This will make sure they receive person centred support that meets their needs fully. Handwritten entries on MAR sheets should be checked and countersigned by a second person to make sure the information is correct and people receive the right medication. The whistleblowing policy should include the contact details for agencies to contact outside of the organisation if staff wish to report concerns. Application to register the manager with CQC should be Page 31 of 33 2 9 3 18 4 31 Care Homes for Older People made. This will ensure there is accountability for the day to day management of the home. 5 33 Some consideration should be given to extending the quality assurance surveys to people who live at the home and any visiting professionals. Feedback from the surveys should be analysed, the results published and used to form a development plan for improving the service provided. Care Homes for Older People Page 32 of 33 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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