Care Home: The Oaks Residential Care Home

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What the care home does well The Oaks provides a clean, homely environment and is generally well maintained and decorated. The menu in the home provides people with a well-balanced and varied diet that takes individual likes and dislikes into account. Staff provide good home cooked food that is enjoyed by people living in the home. Relatives and friends of people living in the home are made welcome and there is good communication between the manager and visitors. People living in The Oaks benefit from living in a calm and relaxed atmosphere. What has improved since the last inspection? Overall record keeping has improved since the last inspection and significant work has been done in improving and developing care plans. The care plans contain sufficient detail to ensure that people living there receive care in the way that they need and want. Credit must be given to the new manager and the staff team for updating and making improvements to record keeping. Some areas throughout the home have been redecorated; refurbishment has been carried out in one of the bathrooms and a new kitchen has been installed. What the care home could do better: The providers should ensure a permanent manager is registered with us at the Commission. CARE HOMES FOR OLDER PEOPLE The Oaks Residential Care Home 14 St Mary`s Road Aingers Green Great Bentley, Colchester Essex CO7 8NL Lead Inspector Ray Finney Unannounced Inspection 10th January 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Oaks Residential Care Home Address 14 St Mary`s Road Aingers Green Great Bentley, Colchester Essex CO7 8NL 01206 250415 01473 785062 ffch@talktalk.net Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Florence Care Homes Limited Post vacant Care Home 30 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0) of places The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Old age not falling within any other category - code OP. Service users with Dementia - Code DE. The Maximum number of service users who can be accommodated is 30. Date of last inspection 21st February 2007 Brief Description of the Service: The Oaks is a two storey detached property, situated in a quiet residential area, approximately one mile from the village of Great Bentley, near Colchester. The home provides care and accommodation for 30 older people. A good-sized garden surrounds the home, with additional seating and patio areas. Parking can be found to the front of the property. The home is owned by Florence Care Homes Limited, the Directors being Mr and Mrs Malhotra. The home has recently employed a new manager. The home charges between £374.50 and £495.00 per week for the service they provide. There are additional charges at normal retail prices for items such as newspapers, toiletries and chiropodist or hairdresser services. This information was given to us in January 2008. Information about the home can be obtained by contacting the manager. Inspection reports are available from the home and from the CSCI website www.csci.org.uk The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. A range of evidence was looked at when compiling this report. Documentary evidence was examined, such as menus, staff rotas, care plans and staff files. The manager completed an Annual Quality Assurance Assessment with information about the home. This document will be referred to as the AQAA throughout the report. A visit to the home took place on 10th January 2008 and included a tour of the premises, discussions with people living in the home, the manager, members of staff and a visiting relative. Observations of how members of staff interact and communicate with people living there have also been taken into account. On the day of the inspector’s visit the atmosphere in the home was relaxed and welcoming and the inspector was given every assistance from the manager, the proprietors and the staff team. What the service does well: The Oaks provides a clean, homely environment and is generally well maintained and decorated. The menu in the home provides people with a well-balanced and varied diet that takes individual likes and dislikes into account. Staff provide good home cooked food that is enjoyed by people living in the home. Relatives and friends of people living in the home are made welcome and there is good communication between the manager and visitors. People living in The Oaks benefit from living in a calm and relaxed atmosphere. The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People choosing to live at The Oaks may be confident their needs will be assessed before admission. EVIDENCE: The AQAA states that they have updated their pre-admission assessment form and this is confirmed in the sample of care plans examined on the day of the inspection visit. The new assessment form has a tick box format and covers a range of needs including diet and nutrition, the person’s likes and dislikes, daily living needs and night time wishes. There is also a Mental Status Questionnaire in place. During discussions, the manager demonstrated a good awareness of the importance of a thorough pre-admission assessment. The home does not offer intermediate care, therefore standard 6 is not applicable. The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in The Oaks may be confident that their health and personal care needs will be met. EVIDENCE: Considerable work has been done since the last inspection to update and improve the care plans. The AQAA states that they, “have created a more in depth care plan with client history”. A sample of three care plans examined show that they are now well organised and individualised with photographs on the front. Care plans are signed by either the person living in the home or their representative, which demonstrates that people are consulted about how they are to be supported. The care plan starts with a social history that gives carers background information that may be important to understand their wishes around their lifestyle. Records examined confirm that risk assessments are completed as part of the care planning process, including a Moving & Handling risk assessments. Although the care plans have been improved and it was seen that staff are The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 10 using the care plans and updating the daily records, a discussion with the manager confirms that the process of care planning will continue to be developed so that there is enough detail in the plans to ensure people are supported consistently with all their needs. As before, care plans contain evidence of input from a range of healthcare professionals including G.P. and district nurse visits. Information relating to healthcare needs such as a nutritional assessment and checks on the person’s weight are recorded in the care plan. The manager and staff spoken with are able to demonstrate they are aware of the importance of making sure they access whatever services are required to meet people’s healthcare needs and help them maintain good health. As at the last inspection, the home operates a monitored dose system for the handling of medication. Medication is stored securely in a locked metal cabinet. On the day of the inspection a member of staff was observed administering lunchtime medication and good practices were seen to be followed. Medication Administration Record (MAR) sheets examined were all completed correctly. Staff are able to demonstrate a good awareness of their responsibilities around safe storage and administration of medication. Overall there are good procedures in place around the storage, recording and administration of medication, which should ensure people are protected. As reported at the last inspection, the procedures followed in the Oaks ensure that people living there have their rights to privacy and dignity upheld. Observations on the day of the inspection confirm that staff are courteous and treat people with respect. Records examined contain evidence that people’s wishes around privacy are documented in care plans. A tour of the premises shows that bedroom doors are fitted with locks if people wish to use them. The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in The Oaks have opportunities to participate in activities that are appropriate to their needs and they are supported to build and maintain relationships. People have varied diet that they enjoy. EVIDENCE: The AQAA states that they “have put more person centered activities in place” and will “put a structured activities plan in place to take account of all clients abilities needs and wishes”. Discussions show that the manager is looking at ways of developing activities; currently the type of activities taking place include quizzes, skittles and memory games. Observations on the day of the inspection show that people appear relaxed and some were enjoying socialising. Staff were seen to interact well with people living in the home and chat to people when they are carrying out tasks such as laying tables. The manager confirmed that people can have visitors at any time and receive them in any of the communal areas or in the privacy of their own rooms. Visitors spoken with on the day of the inspection said that they are always made welcome. As previously reported, records show that they support people The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 12 to maintain close links with relatives and friends. A relative spoken with said they are kept informed of what is happening. Care plans provide information that people are encouraged to make choices and maintain some control over their lives. Increasing elderly needs may mean that making informed choices is difficult for some people living there. The manager confirmed that they ensure relatives are involved in the process where people have difficulty in making decisions and advocacy services will be sought for anyone who may need them. The Oaks continues to provide people living there with a varied, nutritious diet. There is a range of food available including fresh vegetables and fruit. A tour of the premises shows that the kitchen is clean and foods are stored appropriately. The home has two dining rooms, both of which are comfortable and where people can eat their meals in relaxed and pleasant surroundings. People spoken with on the day of the inspection said they like the food and the lunchtime meal was observed to be enjoyed. The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service have access to an effective and understandable complaints procedure that ensures that they are listened to. There are procedures in place to protect the people who live there. EVIDENCE: As at the last inspection, The Oaks has an appropriate policy and procedures in place for dealing with complaints. The AQAA states that, “Staff have received more training to provide greater skills and reduce complaints about the service delivery”. The manager is able to demonstrate a good understanding of the importance of dealing with minor issues that can make a difference to people’s happiness. There have been improvements since the last inspection and the complaints log now records minor concerns. Relatives spoken with are confident that any issues they may have will be dealt with appropriately. Observations on the day of the inspection show that staff listen to people and communicate well with them, which should help ensure that people’s concerns are dealt with promptly. As at the last inspection, The Oaks has a safeguarding policy and procedure in place that follows local guidelines relating to actions that should be taken in reporting abuse. The manager is able to demonstrate a good awareness of their responsibilities around safeguarding vulnerable adults. Records examined confirm that staff have received Protection of Vulnerable Adults (POVA) training. Personnel records examined confirm that people applying to work at The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 14 the home have a Criminal Records Bureau (CRB) check before being confirmed in post. The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in The Oaks benefit from a comfortable environment that is well maintained and clean. EVIDENCE: The AQAA states that “communal areas have been decorated with clients picking the colours used”. There is a handy man to carry out minor repairs who is employed on a part-time basis and it was seen on a tour of the premises that the premises are well maintained. The communal rooms are comfortable and furniture is of good quality. All bedrooms are individual and show evidence of personal possessions such as ornaments and photographs. Furnishings are domestic and comfortable and people living in The Oaks benefit from the homely surroundings. There are three bathrooms and, as stated in the AQAA, one has been renovated. Since the last inspection, a new kitchen has been installed as part of the ongoing programme of renovation. The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 16 A tour of the premises shows that there is a good standard of hygiene throughout the home, with no offensive odours. Observations on the day of the inspection confirm that staff are provided with personal protective equipment, including gloves and aprons and they follow good practices around infection control measures such as hand washing. The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in The Oaks benefit from a competent, well trained staff team. The recruitment procedures in the home provide the safeguards that ensure appropriate staff are employed. EVIDENCE: As previously reported, staffing levels at The Oaks continue to be calculated according to the assessed needs of people living there. Observations on day of the inspection visit confirm that the number of staff on duty were meeting the needs of people living in the home and staff were seen to spend time with people and not provide support in a hurried manner. Discussion with the manager shows that they are committed to supporting members of staff to obtain National Vocational Qualification awards. One member of staff has got a National Vocational Qualification (NVQ) at level 2, a further two are in the process of completing the award and two others are waiting to have places confirmed to start NVQ level 3. This is below the level of 50 of staff with NVQ as recommended in the National Minimum Standards. Efforts should continue to ensure further care staff are supported to obtain an NVQ qualification. The Oaks continues to have a robust procedure around the recruitment of staff. The manager said that they only employ staff after receiving two written The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 18 references and carrying out Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks. Personnel records examined confirm that appropriate checks are carried out and relevant documentation is in place. The recruitment process in place ensures people living in the home can be confident that they are protected by the home’s procedures for recruiting staff. As previously reported, the home has a training programme in place that includes Protection of Vulnerable Adults (POVA), Moving & Handling, Health & Safety and Food Hygiene. The AQAA states that “eight staff have started distance learning course in level two dementia care and four staff already have the qualification”. Staff spoken with are able to demonstrate a sound knowledge of their roles and responsibilities. The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Oaks is competently managed and run in the best interests of the people who live there. The health and safety of individuals living and working there is promoted and protected. EVIDENCE: Since the last inspection The Oaks has a new manager in post who is suitably qualified to run the home. She has a number of years experience as a registered manager and has obtained the Registered Manager’s Award (RMA). In the few months that the new manager has been at the home, it is apparent that she has used the time well to get to know the home and has made good progress with improving and updating the record keeping. The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 20 The manager has not yet been registered with us at the Commission and a discussion confirmed that the proprietors will be dealing with the application for registration. It is apparent from discussions with the manager and the proprietors that the service takes the views of people living in the home into account. There is a quality assurance system in place and surveys are distributed to obtain people’s opinions of the service provided. Relatives and members of staff spoken with are confident that their views are listened to. There is a process in place to support people with small amounts of spending money. The process is robust and ensures people living at The Oaks are protected. Individual records and small amounts of money are stored separately and securely. Certificates relating to the annual maintenance of equipment to comply with Health & Safety regulations were examined. Records relating to the electrical system in the home, testing of portable electrical appliances (PAT), gas, water, hoists and the lift are in order. The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP28 Good Practice Recommendations The providers should continue to support staff to achieve NVQ qualifications. The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Oaks Residential Care Home DS0000017971.V357617.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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