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Key inspection report

Care homes for adults (18-65 years)

Name: Oakdene Care Centre

Address: Stacey Road MansfieldNottinghamshireNG19 7JJ

The quality rating for this care home is: two star good service

A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection.

Lead inspector: Date:

Susan Lewis 0 5 1 1 2 0 0 9

Care Homes for Adults (18-65 years) of 28

This is a review of quality of outcomes that people experience in this care home. We believe high quality care should

• Be safe• Have the right outcomes, including clinical outcomes• Be a good experience for the people that use it• Help prevent illness, and promote healthy, independent living• Be available to those who need it when they need it.

The first part of the review gives the overall quality rating for the care home:

• 3 stars - excellent• 2 stars - good• 1 star - adequate• 0 star - poor

There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people.

There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service.

After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.

Outcome area (for example Choice of home)

These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them:

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.


We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service.

Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop

The mission of the Care Quality Commission is to make care better for people by:• Regulating health and adult social care services to ensure quality and safety

standards, drive improvement and stamp out bad practice• Protecting the rights of people who use services, particularly the most

vulnerable and those detained under the Mental Health Act 1983• Providing accessible, trustworthy information on the quality of care and

services so people can make better decisions about their care and so that commissioners and providers of services can improve services.

• Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money.

Reader Information

Document Purpose Inspection report

Author Care Quality Commission

Audience General public

Further copies from 0870 240 7535 (telephone order line)

Copyright Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified.

Internet address www.cqc.org.uk

http://www.tso.co.uk/bookshop


Information about the care home

Name of care home: Oakdene Care Centre

Address: Stacey Road MansfieldNottinghamshireNG19 7JJ

Telephone number: 01623655123

Fax number: 01623655123

Email address: Oakdeneprime-life.co.uk

Provider web address: [email protected]

Name of registered provider(s): Prime Life Ltd

Type of registration: care home

Number of places registered: 40

Conditions of registration:

Category(ies) : Number of places (if applicable):

Under 65 Over 65

mental disorder, excluding learning disability or dementia

40 0

Additional conditions:

The maximum number of service users who can be accommodated is:40

The registered person may provide the following category of service only: Care home only Code PC To service users of the following gender:Either. Whose primary care needs on admission to the home are within the following categories: Mental Disorder Code MD excluding learning disabilities or dementia.

Date of last inspection 2 6 0 2 2 0 0 9

Brief description of the care home

Oakdene is a modern two storey building, which opened in 2009. It provides residential care for adults with mental health needs. There is a lift as well as the staircase, providing access between the floors.Currently there is a large communal living area, this has been divided to provide smaller seating areas, there is also another room with a pool table and television. The dining area is bright and there is a small kitchenette area to the side for people to make their own drinks and snacks during the day. The pleasant enclosed garden area at the rear of the building is accessible from the dining room and the pool room.


Brief description of the care homeThe fees start from £322 per week and vary according to each persons assessed needs.


SummaryThis is an overview of what we found during the inspection.

The quality rating for this care home is: two star good service

Our judgement for each outcome:

Choice of home

Individual needs and choices

Lifestyle

Personal and healthcare support

Concerns, complaints and protection

Environment

Staffing

Conduct and management of the home

peterchart

Poor Adequate Good Excellent

How we did our inspection:

The quality rating for this service is 2 star. This means that people who use the service experience good quality outcomes. The focus of inspections undertaken by the Care Quality Commission is upon outcomes for people who use the services and their views on the service provided. This process considers the provider's capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. We ask managers to fill in a questionnaire called an Annual Quality Assurance Assessment, which tells us how well their service provides for the people who use it and how they intend to improve their service. We used the information it provided us with to assist in planning our visit and deciding what areas to look at.


We also reviewed all the information we have received about the service since it opened in May 2009 and we considered this in planning the visit and deciding what areas to look at. The main method of inspection we use is called 'case tracking' which involves us selecting a number of people who use the service and looking at the quality of the care they receive by speaking with them, observation, reading records and asking staff about their needs. We spoke with two staff on duty, the manager, three people who use the service to form an opinion about the quality of the service being provided. We also read documents, and medication was inspected to form an opinion about the health and safety of people who use the service. A copy of the latest inspection report can be found by visiting the Care QualityCommission web site at www.cqc.org.uk


What the care home does well:

Oakdene is a purpose built care home that was recently refurbished, providing people with a comfortable and safe environment. Staff receive a wide range of training and support to ensure they provide a good service to people who live there. The manager is skilled and knowledgeable and runs the service in the best interests of the people who live there.

What has improved since the last inspection?

This was the first key inspection of this service which opened in May 2009

What they could do better:

People who use the service could be more involved in the creation and review of their care plans. A copy of the mal administration of medication procedure could be available for staff to ensure they have clear instructions to follow. Accident records should be stored according to The Data Protection Act 1998.

If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4.

The report of this inspection is available from our website www.cqc.org.uk.

You can get printed copies from [email protected] or by telephoning our

order line 0870 240 7535.


Details of our findings

Contents

Choice of home (standards 1 - 5)

Individual needs and choices (standards 6-10)

Lifestyle (standards 11 - 17)

Personal and healthcare support (standards 18 - 21)

Concerns, complaints and protection (standards 22 - 23)

Environment (standards 24 - 30)

Staffing (standards 31 - 36)

Conduct and management of the home (standards 37 - 43)

Outstanding statutory requirements

Requirements and recommendations from this inspection


Choice of home


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, what they hope for and want to achieve, and the support they need.

People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person and the care home that includes how much they will pay and what the home provides for the money.


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.

Admissions to the home only take place if the service is confident staff have the skills, ability and qualifications to meet the assessed needs of the prospective resident.

Evidence:

The written information provided to us by the manager told us 'We provide good quality, easily understandable information to all clients including a Statement of Purpose, a Service User Guide. All referrals to our care home are assessed by a senior member of staff, we discuss with the clients and their advocates their needs, and as to how their needs will be addressed. We seek to achieve positive outcomes, we encourage our clients irrespective of ability where possible, either alone or with assistance to attempt to achieve their own ambitions and to meet as much of their personal needs as possible, we of course provide positive support where it is necessary. All clients are invited to view our care centre and the available accommodation, we provide them with an opportunity to speak with other clients and relatives as a source of comfort and advice'. As part of the case tracking process, we looked at the files of two people who


Evidence:

currently live at the service, including the most recent person to move to the home. Both files contained pre admission assessments completed by the manager. These assessments were detailed and informative and had been used to inform and create the care plan, which was completed following the admission of the person. We looked at the Service User Guide and Statement of Purpose and found these to be comprehensive and informative, providing people with relevant and useful information. We spoke with people who use the service who told us that they had been given opportunity to visit the home before deciding to move in. The manager also told us that he checked every referral made to ensure that they were suitable to be admitted to the service and refused referrals where he assessed the person would not fit in with existing residents. During the course of this inspection Prime Life applied to vary the registered number of places that the service can provide from 17 to 40. The service has sufficient communal space on both floors to accommodate the increase in numbers. The Care Quality Commission agrees that a 40 bedded home for people with a mental disorder is in danger of being viewed as an institution. However the layout of the building combined with the philosophy of the service should serve to minimise this. From information received from Prime Life the application has been approved.


Individual needs and choices


People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions.

People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow.


Judgement:


People's needs are met in the way that they want them to be, and they havechoice and control over their daily lives.

Evidence:

The written information provided to us by the manager told us 'We deliver person centred care, we work together with each client to research their background, their current presentation and their aspirations to make sure that the needs that we identify are those supported or necessary for the client. We encourage the clients to be as independent as possible and to take control of their lives, to make sure that their lifestyle is purposeful and fulfilling'. The care files we looked at both contained very detailed and thorough care plans. They did lack evidence to show that people who used the service were involved in creating and updating them. People spoken with about their care plans either did not know they existed or did not know they could look at them.


Evidence:

One person said 'Now I know I can look at them I will ask to see it'. The files we saw contained varied and detailed risk assessments, which addressed all aspects of risk for each individual. The care plans and risk assessments were up to date and had been reviewed on an on going basis, they reflected any changes that may have occurred in the persons needs and where possible, each person's goals and aspirations were recorded. They provided detailed information for staff on any actions they should take and what behaviours they may need to monitor to maintain people's safety. Staff spoken with said they found the plans useful 'They tells us about a person and what's important to them'. We observed the staff interact with people in a respectful manner whilst maintaining their dignity.


Lifestyle


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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them.

People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities.


Judgement:


People benefit from the person centred arrangements for meals and mealtimes, and they are able to participate in a range of activities that suit their wishes.

Evidence:

The written information provided to us by the manager told us 'We work with our clients to encourage them to live a meaningful lifestyle, and to be involved in both individual and group leisure activities, whilst respecting that some clients may wish to be more private and withdraw. We combine both structured and pre-planned opportunities with more spontaneous events, but we ensure that our care centre is a vibrant and exciting place in which to live, offering choice and opportunity. We attach great importance to our catering provision,we ensure that our meals are nutritious and tasty, but served in a flexible, relaxed and unhurried fashion'. People living at the service have full use of all the facilities at any time, including a


Evidence:

pool table and Wii playstation. People are encouraged to go out as much as possible with staff or on their own to access community facilites. Each person is provided with information in their bedroom about the local community including what local activities and clubs are available, with contact details, any amenities such as libraries and leisure centres and transport information. This information is also located throughout the home for people to access at any time. Staff spoken with knew what people liked to do and were involved in creating activities that were meaningful to people who used the service. People spoken with said that they could do what they want and were able to go out during the day to visit local shops. One person told us 'I come and go as I want'. Another person said 'I choose what to do and I can play pool with the staff or be quiet on my own if I want to'. Mealtimes are flexible to cater for the wishes of the people living at the home and a wide choice of nutritious and well prepared food is available. People may choose to eat in their own rooms or in the dining room, which is light and airy and has access to the well maintained garden. There is also a small kitchenette area where people can make their own hot drinks and snacks throughout the day. One person told us 'We have everything we need, we can even make drinks and something to eat if we want to'.


Personal and healthcare support


People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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.

If people are approaching the end of their life, the care home will respect their choices and help them to 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.


Judgement:


People receive personal and healthcare support using a person centred approach.

Evidence:

The written information provided to us by the manager told us 'We provide choice to the client, with regard to how they receive their care, and as to who delivers that care, to make sure that it is gender sensitive and personal to the client. We involve the clients in decisions with regard to their personal care, in choosing their preferred General Practitioner, and we support the client to gain access to all primary health care facilities. We observe our clients, discretely, and we offer help and support to adapt their care delivery specific to changes in mood and presentation, and their physical condition'. As part of our case tracking process we looked at the care plans for two people living at the service. Both contained thorough and person centered plans of care. These had all been reviewed on an on going basis and any changes had been entered into the plans. There were also comprehensive risk assessments in place where an associated risk had been identified.


Evidence:

Staff spoken with had a clear understanding of people's needs and what may indicate someone was becoming unwell. Diary notes showed that people were able to see their consultant and Community Psychiatric nurse when they needed to. We looked at the Medication Administration Records for the people we case tracked. These were completed correctly and signed. However there was no copy of the procedure to tell staff what to do in the event of giving the wrong medication to someone. No one currently living at the service has been assessed as able to manage their own medication. Staff told us that they are always provided with up to date information about people living at the service and care plans and files are in the office for them to consult. We observed staff knocking on people's doors before entering and speaking with people in a polite and respectful manner. People spoken with told us that staff helped them when they needed it and were happy with how much support they got. One person told us they were due to move bedrooms as it was more suitable to their needs and staff were being very helpful about it. People we spoke with said staff were there to help and were 'really nice'.


Concerns, complaints and protection


If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations.

There are no additional outcomes.


Judgement:


The home has an open culture that allows people to express their views and concerns in a safe and understanding environment.

Evidence:

The written information provided to us by the manager told us 'We promote a culture that is important to capture the concerns, complaints and suggestions of all who support our service, clients, families and staff members alike. We ensure that all clients on admission have a copy of our complaints and comments procedure. Our staff are fully trained with regard to abuse, what may constitute abuse, how to observe, how to report, i.e. whistle blow, and how to participate in any investigation'. We looked at the record of complaints and the manager told us that they have yet to receive a complaint. The Commission has not received any complaints about this service. We spoke to people who use the service and they told us that they would speak to the manager or their key worker if they wanted to complain about anything. 'I know if I complain it will be sorted out'. We spoke with two members of staff and they all told us that they had received training in 'safeguarding adults'. They were all able to demonstrate a clear knowledge and understanding of this including what was the 'whistle blowing policy for the home.


Evidence:

(Safeguarding Adults is a process of identifying and reporting suspected or potential abuse of vulnerable people and provides a framework of consistency to protect those individuals at risk.) We looked at staff training records and this confirmed that staff had received appropriate training to support people who are vulnerable. We looked at financial records for people who live at the service and saw that they were well maintained and people had access to their money in a safe manner. Where people were subject to a court of protection order this was recorded and identified who was the responsible person.


Environment


People stay in a safe and well-maintained home that is homely, clean, comfortable, 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. People have enough privacy when using toilets and bathrooms.


Judgement:


The home provides a physical environment that is appropriate to the specific needs of the people who live there.

Evidence:

The written information provided to us by the manager told us 'Our accommodation is continually maintained and upgraded, by our in-house Estates Department. All mechanical and electrical systems within the home are maintained to the highest quality. We strive to provide a clean, fresh smelling and comfortable environment, we operate policies to promote infection control'. We conducted a partial tour of the service where we looked at some bedrooms, bathrooms, communal areas, the laundry and kitchen. All areas of the home were clean, tidy and hygienic. The atmosphere was light and airy and there were no unpleasant odours. People we spoke with told us that the home is always clean and fresh. The communal areas were furnished in a modern, comfortable manner, as were people's bedrooms. People spoken with said that they liked their bedrooms and were able to personalise them.


Evidence:

We saw the maintenance log book that told us all the necessary Health & Safety checks on services and equipment are up to date. A handy person is employed and the staff we spoke with told us that they know how to report anything that is broken or in need of attention. They also told us that it is usually repaired quickly. The laundry area is not domestic in nature and people who use the service would not be able to use the machines without support. The manager told us that they are looking at space within the home to create a more domestic laundry facility for those people who want to be able to wash their own clothes.


Staffing


People have safe and appropriate support as there are enough competent, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers.

People are supported by an effective staff team who understand and do what is expected of them.


Judgement:


People are supported and protected from harm by well trained staff in sufficient numbers to meet their needs.

Evidence:

The written information provided to us by the manager told us 'We ensure that we provide sufficient staff by number and skill to achieve our aims and objectives, to ensure the staff team as a whole are appropriate to meet our clients needs. We have robust recruitment and induction procedures. We have a comprehensive induction procedure that positively introduces new staff members to the group, delivers basic knowledge and training, and all new staff members are provided with a mentor to assist through their early days learning'. We looked at two staff files and found evidence that all the correct procedures had been followed and all necessary documents were in the files, including references and evidence of Criminal Record Bureau checks. Staff we spoke with confirmed that they all had pre employment checks before starting work. The staff we spoke with also told us that they had received a thorough induction, where they shadowed more experienced staff and got to know the people who lived at the service before being allowed to work independently.


Evidence:

Records show that staff are trained in subjects such as fire safety, protecting people, health and safety, medication, and moving and handling. The majority of staff hold a nationally recognised care qualification at various levels, and other staff are working towards the qualification. Staff told us that the manager is very supportive of them training. Staff spoken with said that they found Oakdene a positive place to work. 'We are trained to do our job and we feel safe'. 'We are supported through training and supervision with the manager'. Staff spoken with said that there are enough staff employed for the number of people currently living at the home. On the day of the inspection there was two care workers and the manager. Staff said that there is one waking night staff and again they think at the moment this is enough.


Conduct and management of the home


People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done.


Judgement:


The home is well managed and is being run in the best interests of the peoplewho live there.

Evidence:

The written information provided to us by the manager told us 'We are constantly reviewing the service that we deliver, addressing the weakest aspects and making them stronger. We communicate well, with our clients and our staff group, and with other agencies with whom we work, we promote a culture of openness and sincerity, we provide the role model for others to follow. We supervise and encourage reflection on practice, through our spot checks and through our Quality Assurance monitoring procedures, we ensure that records are maintained of the processes that we provide'. The manager is registered with the Care Quality Commission as 'fit person' to be a manager. He has previous experience within the Prime Life group of homes as a manager. We saw from training records that he undergoes regular training to maintain his knowledge level.


Evidence:

We found that the Health and Safety testing and servicing has been undertaken as required and staff told us that their Health and Safety is well protected as well as the people who live at the service. They told us that they are up to date with all statutory courses and this was confirmed by training records. We looked at the accident book and saw that any accidents were recorded, however they were not currently being stored according to the Data Protection Act 1998. Regulation 37 notices are completed where appropriate and sent to the Care Quality Commission. (This is a regulatory process which informs us of any reportable incidents that occur at the service.) The manager showed us the internal quality monitoring system in place, however as the service is new and not yet operating to capacity the manager has only just started to send out the questionnaires. On the day of the inspection we saw a healthcare professional being given a questionnaire to complete. People spoken with said that they felt they could talk to the manger if they had any concerns and staff said the manager very approachable and had an 'open door policy so you could discuss anything with him'. Staff also told us that they felt the manager ran the home in the best interests of the people who lived there.


Are there any outstanding requirements from the last inspection?

Yes £ No R

Outstanding statutory requirementsThese 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


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

RecommendationsThese 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 Where possible people who use the service could be involved in the creation and review of their care plans.

2 20 A copy of the homes mal administration of medication policy should be available to staff to support them in case such an event occurs

3 41 Accident records should be stored in accordance of the Data Protection Act 1998.


Helpline:

Telephone: 03000 616161

Email: [email protected]

Web: www.cqc.org.uk

We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website.

Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified.

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