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Inspection on 13/10/05 for Oakhouse Residential Care Services

Also see our care home review for Oakhouse Residential Care Services for more information

This inspection was carried out on 13th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service provided meets the majority of the National Minimum Standards, while providing a high quality care and support for the service users. The home is attractive and welcoming. The service users said that they liked living at the home and that it contrasted positively with other homes in which they had stayed. The Registered Person has created a caring environment that that safeguards the service users and enables them to lead fulfilling and enjoyable lives.

What has improved since the last inspection?

Four requirements were made at the last inspection. All have been met. A clear enhanced CRB check was obtained for holiday relief care worker; the adult protection policy amended to incorporate the London Borough of Barnet`s definition of abuse and lockable safes placed in service users` bedrooms. The medication arrangements have been reviewed and a new contract established with Boots Chemist.

What the care home could do better:

The home requires a fire risk assessment and an evacuation plan.

CARE HOME ADULTS 18-65 Oakhouse Residential Care Services 69 Station Road Finchley London N3 2SH Lead Inspector Margaret Flaws Unannounced Inspection 09:00 13 October 2005 th Oakhouse Residential Care Services DS0000010466.V249274.R01.S.doc Version 5.0 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 Oakhouse Residential Care Services DS0000010466.V249274.R01.S.doc Version 5.0 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. Oakhouse Residential Care Services DS0000010466.V249274.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Oakhouse Residential Care Services Address 69 Station Road Finchley London N3 2SH 020 8346 0666 020 8346 0666 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) Mrs Bernadette Oyindamola Thomas Mrs Bernadette Oyindamola Thomas Care Home 2 Category(ies) of Learning disability (2), Mental disorder, registration, with number excluding learning disability or dementia (2) of places Oakhouse Residential Care Services DS0000010466.V249274.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Limited to 2 people of either gender who have a mental disorder, excluding learning disability or dementia (MD) or a learning disability (LD). 28th January 2005 Date of last inspection Brief Description of the Service: Oakhouse is a small private care home registered to provide care for two people with learning disabilities. The home is owned by Mrs Bernadette Thomas. The house is divided into two flats. The two service users have a large single bedroom each and share the communal lounge, kitchen and bathroom. There is a pleasant garden to the rear as well as a patio area with seating. Mrs Thomas lives in a flat on the first floor and has a small office within her flat for the purposes of running the home. Oakhouse is in an attractive residential area close to shops, services and a tube station. Oakhouse Residential Care Services DS0000010466.V249274.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day. It was undertaken by Inspector Margaret Flaws, as part of the routine schedule of inspections for the home. The home manager and the two services users were spoken to on the day of the inspection. No relatives visited during the inspection. A tour of the buildings and grounds, inspection of service user files, general home records and policies and procedures formed the basis of the inspection. Comment cards were received from two relatives and two service users. Two new requirements were made on this inspection and none were restated from the last inspection. What the service does well: 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. Oakhouse Residential Care Services DS0000010466.V249274.R01.S.doc Version 5.0 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Oakhouse Residential Care Services DS0000010466.V249274.R01.S.doc Version 5.0 Page 7 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 Oakhouse Residential Care Services DS0000010466.V249274.R01.S.doc Version 5.0 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Service users can be confident that their needs will be fully assessed. EVIDENCE: Both service users have lived at the home for several years. Oakhouse Residential Care Services DS0000010466.V249274.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Service users know that their assessed needs are documented and care planned consistently with full consultation. Any risks to them are regularly assessed. EVIDENCE: The care plans for both service users were examined. They contained current and retrospective information on the service users’ assessed and changing needs. Each file was set out in sections and was easy to follow. There was evidence of recent care reviews by the placing authorities and by community mental health professionals and the Community Learning Disabilities Team. The Registered Person described how she was working with mental health and social care professionals to support one service user with particular needs at present. Both service users described how the Registered Person supported them. They were active in identifying their own needs and goals and working with the Registered Person in planning how to meet these. They said they were sufficiently comfortable to identify areas of concern where they needed assistance. All their care needs are fully documented in their files. Oakhouse Residential Care Services DS0000010466.V249274.R01.S.doc Version 5.0 Page 10 The service users said that they were free to make their own decisions in all aspects of their lives. They both lead active and full lives. Both service users now have up to date risk assessments. Oakhouse Residential Care Services DS0000010466.V249274.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Service users have opportunities to take part in appropriate activities and pursue a lifestyle of their choice. They participate in their local communities, maintain family relationships and eat well. EVIDENCE: The service users described their daily lives to the inspector. Both have active friendships, social activities and attend church. One service user attends college, is part of a health promotion groups and is an active lobbyist for the needs of people with learning disabilities. The other service user undertakes voluntary work for a local organisation. Both have lived in the area all their lives and have good community relationships. Both said they are able to pursue a range of leisure activities, including music and drama, and are able to come and go as they please. One service user has had a holiday this year and the other is due to go on holiday. They also go out for dinner regularly, have a monthly Chinese meal out with the Registered Provider and enjoy barbeques and celebrations with her family. The service users described their relationships with their families and significant others, which they found fulfilling. Oakhouse Residential Care Services DS0000010466.V249274.R01.S.doc Version 5.0 Page 12 The service users’ flat has a fully equipped kitchen. One service user cooks for herself most of the time, which she did on the day of the inspection. The Registered Person provides a varied and healthy diet, the daily menus created together are interesting and they all share a Sunday roast lunch together. Both service users do their own small scale daily shopping and go with the registered person to do the weekly shop. Oakhouse Residential Care Services DS0000010466.V249274.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Service users receive appropriate personal support according to preference, their health needs are met and their medication is safely managed. EVIDENCE: The Registered Person provides some personal care to each service user and other support in the manner of prompting where needed. Both service users said that she treated them with respect and sensitivity. The service users’ care plans provide detail of how their physical and mental health needs are met. Community Mental Health teams, Learning Disabilities teams and a psychologist, provide support and preventative health care appointments are scheduled and documented. The medication policies and procedures have improved. In response to a requirement made at the previous inspection, they have been reviewed and a contract signed with Boots Chemist to have medication blister packs made up and delivered monthly. The service users now have lockable safes in their rooms for medication storage. The service users administer their own medication with prompting from the Registered Person. Oakhouse Residential Care Services DS0000010466.V249274.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): There is a clear and understood complaints procedure to support service users and adult protection policies and procedures are in place to protect them . EVIDENCE: The complaint book was examined. There have been no complaints since the last inspection in January 2005. Both service users said they were comfortable raising concerns with the Registered Person and understood the process. The adult protection policy has been updated, as required, to include the London Borough of Barnet’s definition of abuse and a copy of their adult protection policy obtained. Oakhouse Residential Care Services DS0000010466.V249274.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Service users benefit from a clean and safe home. EVIDENCE: The service users’ flat was inspected in their company. This included a visit to their bedrooms. The communal and private spaces were attractive, clean and comfortable. The bedrooms were pleasantly furnished and enable the service users to spend as little or as much personal leisure time there or in the communal lounge and garden. A cleaner cleans the flat weekly and the service users do day to day cleaning and tidying. One service users does their own washing and the other has some support with this task. Oakhouse Residential Care Services DS0000010466.V249274.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 35 Service users are very well supported by the Registered Person, who is very competent for the role and by holiday back-up from relief care workers. EVIDENCE: The Registered Person is the main carer and has a lifelong background in nursing and nurse training. She lives in the first floor flat and is available for the service users 24 hours a day. She is supported by a small number of holiday relief care workers when she goes on holiday. The relief care workers know the service users well and are able to meet their needs. Two are registered nurses. All holiday relief care workers have had enhanced CRB checks, including the new care worker, who was required to obtain this at the last inspection. Oakhouse Residential Care Services DS0000010466.V249274.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 There are good mechanisms for feedback to support the service users in this well run home. Health and safety standards are good, but there needs to be more written planning for potential fires. EVIDENCE: The Registered Person is due to complete the Registered Manager’s Award in April 2006 and is making good progress towards the award. Service users said they feel confident express their views about the quality of the service to the Registered Person and to advocacy groups which they are involved in. They were due to be interviewed for their views on their care by the London Borough of Barnet and said they were satisfied with their care and support and appreciated the positive impact living at Oakhouse had had on their lives. The health and safety certificates for the home were examined and were in order. These included fire equipment, gas installation, central heating and insurance. The fire drill records were inspected – fire drills are held monthly Oakhouse Residential Care Services DS0000010466.V249274.R01.S.doc Version 5.0 Page 18 and the fire alarm is tested weekly. An environmental health inspector visited in April 2005 and reported satisfaction with the home’s standards. The inspector and the Registered Person discussed the fire safety arrangement in the home. The service users participate in regular fire drills and there is a verbally agreed evacuation plan. This needs to be formalised in writing, along with a fire risk assessment. One of the main risks is one service user’s smoking, which is restricted to the bedroom. It is a requirement for a fire safety risk assessment to be undertaken and a fire evacuation plan drawn up. Oakhouse Residential Care Services DS0000010466.V249274.R01.S.doc Version 5.0 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score N/A 3 N/A N/A N/A Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 N/A 3 N/A Standard No 24 25 26 27 28 29 30 STAFFING Score 3 N/A N/A N/A N/A N/A 3 LIFESTYLES Standard No Score 11 N/A 12 3 13 3 14 N/A 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score N/A 3 N/A N/A 3 N/A CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oakhouse Residential Care Services Score 3 3 3 N/A Standard No 37 38 39 40 41 42 43 Score 3 N/A 3 N/A N/A 2 N/A DS0000010466.V249274.R01.S.doc Version 5.0 Page 20 No 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 42 Regulation 13 (1) Requirement The Registered Person must ensure that a fire risk assessment is completed for the home The Registered Person must ensure that a written fire evacuation plan is drawn up for the home Timescale for action 01/12/05 2 42 13 (1) 01/12/05 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 Oakhouse Residential Care Services DS0000010466.V249274.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA National Enquiry Line: 0845 015 0120 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 Oakhouse Residential Care Services DS0000010466.V249274.R01.S.doc Version 5.0 Page 22 - 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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