Inspection on 21/08/08 for Oakwood Lodge

This is the latest available inspection report for this service, carried out on 21st August 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Extracts from inspection reports are licensed from CQC, this page was updated on 09/02/2009.

CARE HOME ADULTS 18-65 Oakwood Lodge 20 Argyle Road Ilford Essex IG1 3BQ Lead Inspector Stanley Phipps Announced Inspection 21st August 2008 10:55 Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 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 Oakwood Lodge DS0000071559.V369672.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 Adults 18-65. 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. Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakwood Lodge Address 20 Argyle Road Ilford Essex IG1 3BQ 020 8478 7472 020 8478 7472 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) Kulwant Singh Mann Irene Luton Care Home 7 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7) of places Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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: 2. Mental disorder, excluding learning disability or dementia - Code MD The maximum number of service users wo can be accommodated is: 7 Date of last inspection N/A Brief Description of the Service: Oakwood Lodge is a registered care home providing accommodation, and practical and emotional support for seven (7) residents with a mental health problem. The home aims to support residents in order for them to access and participate in mainstream as well as specialist resources in the community in which they live. This is despite the impact of their illness, as each individual is supported and enabled to achieve a sense of fulfilment. Oakwood Lodge is a semi-detached property situated in the Ilford area of the London Borough of Redbridge. The area is well served by public transport, close to the high street amenities and there are many other easily accessible facilities within the local area. There are seven bedrooms six of which have en-suite facilities. Residents also have access to a communal lounge, dining area, kitchen, a laundry facility and a rear garden. A Statement of Purpose and Service User Guide is available at the time of assessment .and to all residents. The current fees are £800.00 to £1150.00 per week, depending on service users’ needs. Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 5 Additional charges are made for personal items such as hairdressing and toiletries and service users also pay for all outside leisure activities such as bowling, cinema etc. Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 6 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. The inspection took place on the 21st August 2008. It was announced, as it was the first inspection of the service since its registration. At the time of the visit both the responsible individual and the registered manager were available to contribute to the inspection process. There were also two service users that had recently moved into the home from another care home that is registered by the Commission. As this was the first inspection of the service all the national minimum standards were assessed including the key standards in each of the outcome groups. An assessment was also made of: medication practice, menus, policies and procedures, records required by regulation, service user plans and the environment The inspection also considered information from the Annual Quality Assurance Assessment (AQAA) document that was provided by the registered persons prior to the visit. It must be noted that at the time the time the document was submitted to the Commission there were no service users living in the home. Discussions were held with the registered manager and several members of staff, and verbal feedback was obtained from an external professional. Written feedback was also provided from two main sources – the service users and staff working in the home. The inspection found that although this was a relatively new service – sound practices were in place to enable service users to experience good quality outcomes. The joy and contentment on their faces told the story of how well they were settling into their new environment. What the service does well: Provided a homely environment for service users. Involved service users from very early on, in determining how they would like to spend their time living at Oakwood Lodge and, in personalising their private and communal spaces. Staffing engagement with service users has been positive and dignifying throughout the course of the inspection – a sentiment that was echoed by service users. Sound training plans and support systems are in place for staff to enable them to provide good quality care to service users. Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 7 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. Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): (1,2,3,4,5) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users and their relatives have access to information in making a decision about the suitability of the home, although this could be improved. They benefit by having detailed assessments carried out on them and have opportunities to view the service before deciding to live there. Once admitted service users are assured that their needs would be met and, having a statement of their terms and conditions ensures that the provider’s obligations are made clear to them. EVIDENCE: Service users have access to information through the home’s statement of purpose and service user guide, the latter of which is given to each individual. Feedback received from service users confirmed that the service user guide provided them with accurate information about the home. The documents do make reference to the specialist services that are provided at Oakwood Lodge. However, on closely examining the statement of purpose there were several areas that needed improving, which included: the removal of reference to the service being a nineteen - bedded service for elderly people and, the inclusion of the room sizes - for the benefit of both current and prospective service users. One individual said that his social worker helped in identifying the home for him and drew the information to his attention, which he was grateful for. Both documents were in formats that were suited to the communication needs of the service user group. Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 10 The admission documents of both service users were assessed and found to be very detailed. There was evidence that information was gathered from referring agencies prior to admitting service users to the home, which is part of the admissions process. The two service users were involved in their assessments, although it became apparent that they were given little support from their previous carers from a registered care home. Service user plans were developed from the assessments, which outlined the actions required to achieve each of the individual’s objectives. As part of delivering a safe service, risk assessments were linked to the service user plans to ensure that service user’s independence was promoted without compromising their safety. This is good practice. The home accepts emergency placements and so the admissions’ protocols are slightly different in this case. Generally, admissions to the service are unrushed. This ensures that service users along with their relatives /social workers are given the opportunity thoroughly examine the suitability of the home. Due consideration is given to the admissions criteria and the ability of the staffing expertise/skills to meet the needs identified from the assessments. It was noted that the registered persons are keen to stay within their eligibility criteria, and so seek the views of service users already living in the home, regarding new admissions. It was clear from the service users’ comment cards and from talking to them - they were confident that their needs could be met at Oakwood Lodge. The registered persons have a system in place to ensure that every service user is given an opportunity to visit the home prior to deciding to live there. In doing so they get to meet with the staff team, and experience what it like to live in the home. This could take the form of coming in for tea initially, then weekend stays graduating to being enabled to have weekly stays. In this way service users have the opportunity to view the operations of the home on a wider scale. Feedback from service users indicated that this was a positive experience as it gave them an opportunity to compare their previous experiences with their former and prospective homes. This is good practice From assessing the files of service users, copies of contracts were on file for each individual. In each case the service user signed their contract and, this ensured transparency and user involvement. The contracts detailed information about fees and the rights/obligations of service users and, the registered provider. This therefore gives some protection to both parties and is in keeping with the national minimum standards for the service user group. The documents seen were in a format that the service users could relate to, which is positive. Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): (6,7,8,9,10) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users benefit from having their needs (including their mental health needs), reflected and reviewed in their individual plan. In doing this, they are actively involved in the process as part of determining what is best for them. They are given opportunities to participate in various aspects of the home and are supported to maximise their independence within a risk management framework. Policies and procedures along with a formal staff induction ensure that their (SU) confidentiality is promoted and preserved. EVIDENCE: From the initial stages, all service users are involved in planning their care, which ensures that they are not only aware, but accept responsibility for their direction. As part of this they have the benefit of a key worker that works closely with them in setting up and reviewing their individual plan. All plans viewed were updated as they had only but recently moved into the home. They came under sections such as: ‘Senses of self’, ‘Contributions to the home’, ‘Social and Community networks, ‘Communication,’ ‘Support with Personal care’, ‘Behaviour’ and ‘Health Promotion’. ’However, there was evidence that professional input was available e.g. social worker and mental health professionals to ensure that things w ere going as per intention. Reviews had Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 12 already been planned and this included the input of a social worker. Service user plans were individualised, detailing the specific needs of service users and were borne out of the assessments carried out initially with them. Staff interviewed had a good understanding of the service users’ needs, as well as the ability to develop service user plans reflecting those needs. As such service user plans were used as working tools and arrangements were in place to involve service users in any changes to these plans. As a matter of fact, the registered persons and the staff were quite keen to promote user involvement in decisions around their life at Oakwood Lodge. Both service users were aware of their individual plans and, were well aware of their key workers and the external professionals involved in their care. As a part of promoting independence, plans are also in place to assist service users to budget their finances and in general to develop life skills. There are systems in place to take into account the activity choices of each individual, which records service users’ levels of engagement and this feeds into reviews carried out with them. Key work sessions and regular service user meetings were just some of the mechanisms available to promote and develop service users’ involvement in life in the home. Evidence of this was seen at the inspection in which a birthday celebration was held for one individual. The key to what was a successful event was the fact that the individual was consulted and involved throughout the whole process. As a result he was overly satisfied with the outcomes both his friend that had moved in around the same time as he did – and himself. There is information on advocacy services for the benefit of service users that may wish to use such services. At the time of the visit, service users had the support of the management and staff in issues that affected them arising from their previous placement. The two individuals were supported and encouraged to manage their finances independently and they can if required choose to use the security storage in the home for safekeeping, possessions for example benefit books. In discussion with the staff and management, it was clear that as much of the control remains with the individual. Accurate records were in place to evidence this. There was evidence that plans were in place to engage service users in various aspects of the home, e.g. menu planning, activities, outings, how they spend their time and the frequency of their meetings. It was noted that they had access to a range of policies and procedures, a copy of which is kept in their main lounge. Service users spoken to felt expressed that the format of these policies were suitable and could be easily related to. Given that the home was relatively new quality assurance systems such as service user surveys were not carried out. However, service users were informally consulted and in their meetings about various matters in home. It was clear that the foundation was in place to enable service user participation in the home. Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 13 At Oakwood Lodge risk assessments form an integral part of promoting service user safety and independence. As such they were in place for each individual living at the home. More importantly, risk assessments were reviewed, linked to the service user’s plans and generally kept updated. On examining the risk assessments closely, actions were recorded to keep the risks to a minimum and this forms an important part of safeguarding adults. In a discussion with an individual, there was an awareness of a limitation that was in place, however the basis was understood and agreed to with the person concerned. A missing persons procedure is in place at the home and staff had knowledge of this. This is a positive aspect of the homes operations. A policy on confidentiality is in place for the benefit of service users and staff. From interviews held with two staff members, they demonstrated a sound understanding in how information held on service users, should be handled – both internally and, with external bodies. Service users’ records were securely maintained and updated. The home’s confidentiality policy makes clear how and when information is shared with third parties. This ensures that service users best interests are considered at all times. Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): (12,13,14,15,16,17) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users benefit from having a range of opportunities for their personal development. They are also encouraged to participate in; their community, appropriate activities and, are able to maintain and develop social and personal networks of their choosing. Service users are supported to exercise their rights, which are respected and promoted by staff in the home. Oakwood Lodge provides meals that are reflective of service users’ choice and nutritional requirements. EVIDENCE: Service users were supported to continue developing their practical life skills, and one of the ways of doing this is by agreeing their contributions to the home in areas such as; handling their laundry or clearing the dinner table. Staff were observed working closely with service users as individual skill levels are varied, but each service user has the opportunity to contribute and learn. For both individuals this was to ensure that their confidence is develops, particularly as they had both moved from an environment where operations and expectations were different. Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 15 In keeping with the personal development aspect, both service users were supported to continue in activities in which they were previously involved prior to moving to Oakwood Lodge. An example of this is where one individual continues to attend the Brentwood Mind on a Wednesday and he was quite happy to continue with this. One of the great benefits of this is that his networks were maintained as evidenced by the numbers that turned up to a birthday party held in his honour. This is positive. Although both service users had recently moved into the home, sound arrangements were in place to ensure that they take part in activities that were best suited to them. This included both social and personally chosen activities. Service users make their choices known via their user meetings, key work sessions, reviews or informal approaches to staff. Internally they are able to choose from; arts and craft classes, video evenings, a range of board games, chess, parties and in-house entertainment. Both service users were British and so had been given opportunities to undertake activities that were consistent with their culture. Despite this, there was evidence of a multi-faith calendar on the wall, which outlines various cultures and associated activities at various points in the year. During a short interview with one of the service users he described his experience of going out shopping in the Ilford area recently with staff support, as being enjoyable. Arrangements are in place to support them to attend places of worship if they so desire, cinema, the theatre, the local park, banks and any community – based resource relative to their needs. I was indeed early days in terms of living in the home so the uptake on some of the community based resources were not that high at the time of the site visit. Both service users thought that the opportunities available to them at Oakwood Lodge - were satisfactory. There was good evidence to support the fact that the management and staff support service users to maintain their family friends network. This was observed on the day of the inspection during the course of a birthday party that was held for one of the service users. There were pictures that were taken with smiles from the celebrant and the guests alike. This made for quite a happy and healthy atmosphere – one that was thoroughly enjoyed by all. During the course of the inspection it was clear that the rights of service users were respected throughout various aspects of their lives. Service users contributions for their parts in the home were recorded in their individual plans. Both individuals were actively and positively engaged in various aspects of life in the home, as they were encouraged and supported to retain as much of their independence as possible. Advocacy information is available to both service users and plans were in place to engage this specialist service – given some concerns that were identified around their finances in the home that they were placed previously. It was also observed that the service users were called Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 16 by their preferred names and the staff sought their permission when accessing their private spaces, which is positive. From the written and verbal feedback received, service users expressed the view that staff respected them Service users have unrestricted access throughout the home and there were clear guidelines in place for staff to follow, should restrictions be required in the promotion of service user safety and independence. Staffing interaction and engagement with service users was of a good standard and this included the recognition of their individuality. Satisfactory arrangements are in place to ensure that service users open their mail as a matter of course and would engage staff as and when they needed them. There was evidence that menus were drawn up with service users and they were pre-determined at service user meetings. Although lunch was not observed on the day a variety of meals were prepared for the birthday celebrations. Service users however commented positively on the meals that they had been provided with, thus far in the home. From the menus viewed, it was evident that meals were varied, diverse and in line with the cultural requirements of the service users currently residing at the home. Service users had access to hot and cold drinks, as well as snacks throughout the course of the day. There was also a good supply of food in the home including, fruits and vegetables. Food storage was of a good standard and arrangements are in place to enable service users to be involved, as far as possible in their food preparation. Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 17 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): (18,19,20,20) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users enjoy personal support in a manner that is best suited to them. Sound arrangements are in place to meet their physical and emotional needs. This is enhanced by the staffing input and support with medication. Policies and procedures are in place to ensure that the wishes of service users regarding death and dying are taken into account. EVIDENCE: Discussions with both service users indicated that they were quite pleased with the way in which staff supported them with personal care. This is generally coordinated through the key worker system used in the home. Both service users had their individual style of dress, which was consistent with their choice, culture and personality. Staff were observed interacting and engaging with the individuals in a positive manner, which was embraced by the individuals concerned. The staffing make up is mixed and in terms of ethnicity and so should go a long way into catering for a diverse service user group in this respect. At the time of the inspection up to five staff were employed, although one individual had worked just for one day and went off on sick leave. As part of his ongoing recruitment the registered provider would have to consider the gender mix of his staff to ensure that a wider choice of male staff is available should this be an expressed preference that is made by a service user. Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 18 Both service users were given good support to ensure that their health needs are provided for. Arrangements for registration with a General Practitioner had been made and from the records examined, there was evidence that arrangements were in place for them to see other health care professionals, such as; the dentist, chiropodist, opticians and the psychiatrist. On the day of the visit, two professionals were on site discussing the transition with the service users, more or less to see how they were settling in. This was quite reassuring to both service users, as the professionals answered most of their questions. It must be stated that the second professional was brought along, as he was going to be take over the case management from the leading officer. Good records were kept regarding service users actual e.g. A CPA meeting 29/08/08 or planned engagements with healthcare professionals. There were also good records for monitoring the mental state and for managing behaviours that may be distressing, to individual service users. From interviewing the manager and one staff member, it became clear that both parties understood the specialist needs of the service users. At the time of the visit both service users were receiving support with their medication, although there are systems in place to support them to undertake this independently. A satisfactory medication policy was in place for the benefit of staff and service users alike and the management if medication was good at the time of the visit. This included the acquisition, storage, dispensation and recording to include stock control. There was evidence that medication training had been provided for staff on the 13the and 15th August 200. This for the staff for staff that are designated to support service users in this area. Both service users were pleased with the support provided by staff in the home with their medication. A policy on death and dying is in place and is available for the benefit of service users and staff. The home had been recently opened and as such the process of death and dying had not been realised. However, plans are in place to afford service users the opportunity to say how they would like to spend their final moments in the home. The guidelines also equip staff with clear procedures to support relatives that may become distressed, as is usually the case during such occurrences. Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): (22,23) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users and their relatives are assured that when complaints are raised – that they would be acted upon. Good arrangements are in place to ensure that service users are protected from abuse. EVIDENCE: A satisfactory complaints procedure is in place at the home and both service users were aware of this. From discussions held with them, they both felt able to raise issues of concern should they feel the need to. One individual outlined the range of staff he would complain to starting with his key worker then, the manager and finally ending up with the registered provider. It was empowering to see that he new the names of all the players involved should he be unhappy. He did also mention that he would inform his social worker and/or raise an issue in his review or Care Programme Approach meeting. Staff interviewed were also very clear of service users right to raise concerns and outlined ways in which they would support them to so do. In discussion with the manager, she indicated that she viewed complaints as a way of improving or quality assuring the service. She also informed that service users are enabled to raise concerns at any time – informally or otherwise, which is positive. At the time of the visit there were no safeguarding issues in the home and a satisfactory ‘safeguarding adults’ protocols was in place for staff to follow. At the time of the visit safeguarding training had been planned for staff. All staff had the benefit of a thorough induction, which covered safeguarding adults. From the staff interview held, it was clear that she had a good understanding of the steps required to: deal with allegations or suspicions of abuse, prevent abuse, as well as to report issues using the whistle blowing procedure. Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): (24,24,26,27,28,29,30) People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users live in a clean, and suitably designed home that matches their needs and lifestyles. They are comfortable in their surroundings, which are homely and personal – particularly in relation to their bedrooms. The communal areas are spacious designed with service users in mind in terms of accessibility and the promotion of independence. The home is fit for purpose. EVIDENCE: This was the first inspection of the service and as such the home was almost spotless, carried a warm ambience, with many contemporary decorations. Both service users expressed their satisfaction with the quality and layout of the environment. The registered persons ensured that the furnishings and fittings were of a good quality and it was clear that the experience of having another related service played a positive part in ensuring that Oakwood Lodge was prepared to a high standard. The home met the requirements of: the local fire, environmental health, and, the Building Acts and Regulations. Service user bedrooms were very personalised to individual likes and in speaking to them – they were extremely pleased with their private spaces. It was clear that from the layout of the rooms that service uses could be ably Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 21 supported in their private spaces without compromising their personal safety and their privacy. This is positive. The furnishings and furnishings in the bedrooms were of a high standard and service users were allowed to bring their personal effects and possessions. Service users did not feel restricted in what they could put in their rooms, which they were quite pleased with. All bedrooms had electrical outlets that complied with the national minimum standards and there were lockable drawers in each room. The registered persons informed that service users are supported to choose their room colours which is positive. There were toilets and ad bathing facilities on both floors that were in excess of what is required by the national minimum standards, which means that service users could have more choice as to where they could use. All facilities had good ventilation, as well as a good supply of hot and cold water. The lighting was more than adequate and the facilities were designed to promote the privacy and independence of the service users living there. There are large communal areas for dining, relaxation and, activities on the ground floor. The kitchen and laundry is of a domestic size with good accessibility to enable service users to develop their skills in daily living activities. There is a large garden that would more than meet the needs of the service user group. Discussions held with both service users informed that they were pleased with the size, quality and layout of the communal areas in the home. The service does not aspire to provide a service for people with a physical disability. However, there is scope for adaptations to various aspects of the home that would enable an individual depending on the complexity of their physical disability – to live at Oakwood Lodge. The registered persons would have to undertake an occupational assessment, as well as an environmental risk assessment should they decide to provide care and support for an individual with such a special need. The laundry facilities were designed to promote the service users independence as far as feasibly possible. An infection control policy is in place and, service users and staff are encouraged to work within all elements of this e.g. hand washing. The laundry equipment is designed to cater for soiled linen and appropriate arrangements are in place for their maintenance. The layout of the home is such that soiled laundry is well away from the kitchen area. The services and facilities comply with the Water Supply Regulations 1999 Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): (31,32,33,34,34,36) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users receive care and support from a staff team that understand their responsibilities and are motivated to work with them. Their welfare and best interests are promoted by ensuring that: staffing levels reflect their needs, and through the provision of supervision and training for staff. Recruitment practices ensure that service users remain safe from staff that may unfit to work with them. EVIDENCE: From the interview held with one member of staff, it was clear that she understood the aims and philosophy of the service. More importantly she understood her role in delivering care and support that was in line with the aims and philosophy of care. There was also a clear understanding of the use of care plans, which was described as the mechanism for identifying and monitoring service users’ personal goals and achievements. The staff concerned was aware of the General Social Care Council’s code of conduct and the registered provider was in the process of acquiring copies for the benefit of all staff. Both service users were confident about the staffing ability to meet their needs. Discussions held with an external professional indicated that she was also confident in the home’s ability to meet the needs of the two service users placed there. Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 23 From observing the staffing engagement with both service users, it was clear that they treated them with respect, sensitivity and dignity. As stated earlier both individuals had recently moved into the home, under difficult circumstances in that the referring home did not easily cooperate with the transition process. So in many respects these early days did present with several anxieties and the management and the staff team did well to alleviate them. Both service users needed quite a bit of reassurance and this was evident throughout the inspection. However, they looked happy and from the feedback they gave, were settling in, to life in their new home. At the time of the visit twenty-five per cent of the staff team had achieved an NVQ Level 2 in Care and plans were in place for others to start their training to achieve that qualification. From examining the rosters, there was evidence that the staffing mix, including the numbers on each shift were adequate to meet the needs of the two service users that were in the home at the time. The registered persons informed that the staffing levels would be kept under review, as the home increases its’ numbers and/or the needs of service users change. Initially meetings were held with staff on a weekly basis, but plans are in place to space them out less frequently, once the numbers increase and staff acquire a stronger grip on the homes operations. Due to the early stages of the homes operation the staffing recruitment is ongoing. However, the recruitment records of the staff in post were assessed and found to be generally in order. There was but one case in which one reference was on file, but this was rectified shortly after the visit. All staff had a POVA first check along with a full CRB check on file and completed application forms were also held for each person employed. Service users were not involved in the staffing recruitment, but this is something the registered persons could develop in the future. All staff are subject to a probationary period and some staff were undergoing that process at the time of the inspection. The registered persons did have a training profile for each individual staff member. At the time of the visit they were in the process of developing the training and development plan for the staff team. Staff are encouraged to play an active part in this process. In discussion with the service users they were of the view that staff had the skills to provide them with the care and support they need. At the time of the visit formal supervision had started and plans were in place for this to be carried out on a regular basis, now that service users had moved into the home. Plans were also in place to carry out annual appraisals on staff, once they get closer to achieving one year of service. Staff spoken to were aware of the grievance and disciplinary procedures. They were also aware of the protocols around dealing with aggression and violence. Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): (37,38,39,40,41,42) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Good management systems are in place to provide a quality service at Oakwood Lodge. This includes systems for; quality assurance, record – keeping, policy review, financial management and, the promotion of health ad safety in the home, although the latter could be improved. EVIDENCE: The registered manager is experienced in her role as a manager and has quite good support from an extremely experienced registered provider. She has achieved her Registered Manager’s Award and has had recent training in the Mental Capacity Act. Together the registered manager and registered worked closely at ensuring that the service gets off to the best start possible and so they are almost quality assuring the service as they go along. Although registered in March 2008, the first service users came in during the summer and the registered persons were adept to the challenges of having service users in for the first time along with new staff. It must be said that both the Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 25 service users and the staff were quite pleased with the management style at the home and pledged their support for the service. Given that the service was in the first months of operation, its quality assurance mechanisms could not be fully tested. However, there were systems in place to ensure that service users views are gathered and that of the staff. The development plan for the service is current and sound arrangements were in place for service user reviews. The registered provider was aware of the need to carry out monthly provider monitoring visits and policies and procedures were in date. It is fair to say that adequate arrangements were in place for quality assuring the service. Most of the policies and procedures were updated as they had been recently developed. Plans are in place to monitor the staff adherence to the policies and procedures through supervision, team meetings and annual appraisals. Service users have access to these policies and procedures so that they have an awareness of what is expected of staff in delivering a service, which impacts upon them. Staff feedback is obtained in various forums formally and informally. All records viewed were updated and secure. In this respect service users’ interests are protected. As stated earlier the service is relatively new and the requirements for health and safety prior to registration had been satisfied. It is quite early in the life of the service and from the inspection there was but one breach of health and safety. This was in relation to carrying out risk assessments for safe working practices. Apart from that a satisfactory set of health and safety policies were in place as well as arrangements to monitor their compliance. All appliances and equipment were in their first year of life and hence, either had their guarantees or arrangements for their repair. Staff had the benefit of health and safety training as part of their induction. The registered provider has demonstrated the ability to plan and develop the service, which was evidenced from the plan presented at the inspection. Systems are in place to ensure the smooth financial operations of the home. Private arrangements are in place to audit the business accounts and the accounts and the insurance cover was in line with the minimum requirements set by this standard (NMS). It was anticipated that feedback from service users’ surveys would inform the development plan for the service in the ensuing year. Service users spoken to were aware of the overall structure of the home, as it is well – stated in the statement of purpose and service user guide. Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 3 26 4 27 4 28 4 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 2 3 3 3 3 Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 27 N/A Are there any outstanding requirements from the last inspection? 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. 1 Standard YA1 Regulation 4 Requirement The registered persons are required to review the statement of purpose to ensure that it meets the requirements of Schedule 1 (Number 16). This is to ensure that both current and prospective service users have the most accurate information about the service. The registered persons are required to carry out risk assessments on safe working practice topics. This is to ensure that all considerations are taken in making Oakwood Lodge a safe environment. Timescale for action 20/01/09 2. YA39 24 20/01/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Oakwood Lodge DS0000071559.V369672.R01.S.doc Version 5.2 Page 29 - 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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