Inspection on 14/06/06 for 15 Oaklands Road

This inspection was carried out on 14th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

15 Oaklands Road 20/05/08

15 Oaklands Road 16/01/06

15 Oaklands Road 11/10/05

15 Oaklands Road 25/01/05

15 Oaklands Road 17/08/04

Similar services:

Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

15 Bramble Close

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 15 Oaklands Road 15 Oaklands Road Bedford Bedfordshire MK40 3AG Lead Inspector Mr Pursotamraj Hirekar Unannounced Inspection 14/06/06 15.00 15 Oaklands Road DS0000014940.V297590.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 15 Oaklands Road DS0000014940.V297590.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. 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 15 Oaklands Road Address 15 Oaklands Road Bedford Bedfordshire MK40 3AG 01234 347822 01234 352427 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) Community Care Solutions Limited Care Home 7 Category(ies) of Learning disability (7), Physical disability (7) registration, with number of places 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One resident may have an additional physical disability The manager must complete an NVQ 4 in care and registered manager`s award by 31 August 2006. 16th January 2006 Date of last inspection Brief Description of the Service: Oakland’s is a detached house situated in a residential area of Bedford owned by Community Care Solutions Ltd. The home is approximately one mile from Bedford town centre and is close to a bus route into the town. There is a shop/post office close to the home and pubs and places of worship nearby. The accommodation is on two storeys, with two bedrooms, shower room, lounge, kitchen/diner, activity room and conservatory on the ground floor. There are a further five bedrooms and a bathroom and shower room on the first floor. The home has an attractive garden to the rear. The home is registered for 7 adults with learning disabilities. At present the home had a new manager, who was in the process of making an application to the commission for registered manager. A condition of registration number 2 was meant for the previous manager, who no longer works for the home. The minimum fee per service user was £ 1040/-per week and the maximum fee per service user was £ 1660/- per week. 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the report of the unannounced key inspection carried out on 14/06/06 over 4 hours by pursotamraj hirekar. The method of inspection included review of outstanding requirements and recommendations, notified incidents, study of a sample of care plans, risk assessments, discussion with the service users’, staffs on duty, manager, partial tour of the premises and observations. The manager coordinated the entire inspection. What the service does well: What has improved since the last inspection? What they could do better: The registered person must ensure that all service users’ risk assessments and care plans were reviewed on time. The registered person must ensure that information is maintained in the home on each member of agency staff with regard to their statutory checks. 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 Page 6 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. 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 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 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 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): EVIDENCE: There was no new admission since the last inspection dated 16/01/06. 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 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 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The risk assessment and care plans of service users’ were reviewed and updated to incorporate changing needs of individual service users’. However, the outstanding reviews need to be completed on time. EVIDENCE: The home had made appropriate arrangements for regular review and update of care plans of service users. The service users’ were encouraged through various activities to enable them to lead independent lifestyles. The service users’ appeared quite relaxed and fresh. Service users’ whose care documents were reviewed are as follows: Service user – 1 parents, social worker, key worker, manager, and advocate have participated in the annual review and basing on the outcomes of the review the care plans were updated. Service user – 2 care plan was reviewed by service user, area manager, manager, and social services. The assessment was made for supported living and the risk assessment and care plans update was half way through. Service user – 3 Annual reviews was outstanding and the manager continue to chase social services for participating in the review. Service user – 4 parents, social services, service users, key worker, manager and area manager have 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 Page 10 participated in the care plan and risk assessments review. The care plans were updated basing on the outcomes of the review conducted. Service user – 5 social services, mother, area manager, manager, and key worker have participated in the assessments with social services to judge whether the service user can move closer to her parents. Service user – 6 risk assessments and care plans review was outstanding. Service user – 7 had risk assessments and care plan reviewed and update basing on the outcomes of the review conducted. The manager had planned to complete the review of all the outstanding risk assessments and care plans before 15th of July 2006. 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had revisited the range of activities of all the service users’ and had made appropriate changes that enable service users to improve their quality of life. EVIDENCE: The home had an internal review of all the service users with regard to their daily life styles and activities had made positive changes in consultations with the service users’. The details of the activities of the service users’ are as follows: Service user – 1 attends college on Mondays, Tuesday, Thursday and Friday attends day centre, visits sister every other weekend, participates in the kitchen, helps prepare vegetables and dinner on Tuesday. Service user – 2 goes to garden carers on Monday, Tuesday, Thursday and Friday. Wednesday he was supported to do his bed room tidy and laundry. Attends sparkle social club on Wednesday evening, visit his parents every third weekend. Also, visits town on most Saturdays for shopping independently. Participates in the kitchen to help prepare dinner on Saturdays when he is at the home. Service user – 3 attends beds garden carers Wednesday, Thursday and Fridays. She had started swimming on Mondays and going to play badminton on Tuesdays this was a recent initiative followed by a recent care plan review. 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 Page 12 Service user – 4 goes to the berry’s day centre on a Monday, Tuesday activity for relaxation, Wednesdays goes to sparkles, Thursdays drama, Fridays open day to meet parents or visits park or doctors appointment. Service user – 5 on Mondays, Wednesday, Fridays goes to St. Marks drop in day centre, Tuesday activity for relaxation, Thursday goes to drama, visits every other weekend to mom’s place. She participates in the kitchen on every Wednesday. Service user – 6 on Tuesday participate in an activity for relaxation, drama on Thursday. The manager continued to make effort to develop her day care activities considering her disability. Service user – 7 Wednesday and Tuesdays afternoon attends college, Thursday attends drama, Friday morning meets her advocate, continues to keep in touch with mom through faxes almost every Friday. All service users’ have common lunch and dinner time which was mutually decided by service users’. However, the breakfast had open timings. All the service users’ who were spoken to appeared relaxed and clean. 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 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 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had made appropriate efforts to revisit personal and health care support services of service users’ and had ensured that the service users’ assessed needs were met. EVIDENCE: The home had made appropriate arrangements to look after the service users’ personal and healthcare. The details of the service users’ are as follows: service user – 1 attends twin woods – psychiatric centre normally every 4 – 6 weeks, attends the dementia clinic every month which got delayed because the doctor was not available. Visits GP as and when required. The staff regularly monitored medication review and the staff administer the medication as prescribed. Service user – 2 attends twin woods psychiatric centre normally every 4-6 weeks, she had received the professional support of the dietician and was on special diet. She visits the GP as and when required. The staff regularly monitored medication review and the staff administer the medication as prescribed. Service user – 3 attends dementia clinic every three months as planned. Because of the recent incident at the home, was attending fracture clinic every fortnight at the moment, visits the GP as and when required. The staff regularly monitored medication review and the staff administer the medication as prescribed. Service user - 4 uses the services of a practice nurse 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 Page 14 for a contraceptive injection every twelve weeks, visits the GP as and when required, at present awaiting an appointment to see psychiatrists at twin woods. The staff regularly monitored medication review and the staff administer the medication as prescribed. Service user – 5 sees psychiatrists every 8 weeks at twin woods, blood was tested regularly every 4 weeks for prescription of medication. Visits the GP as and when required. The staff regularly monitored medication review and the staff administer the medication as prescribed. Service user – 6 visits twin woods psychiatrists every 6-8 weeks, visits GP as and when required. The staff regularly monitored medication review and the staff administer the medication as prescribed. All service users’ have separate documentation in their care plans on the health care needs and action points, which is a good practice. The manager and staff were seen administering oral medication to the service users’ on this inspection, which was managed professionally. 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 Page 15 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): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had a comprehensive complaints policy and procedure that would protect the interests of the service users’. EVIDENCE: The home had reviewed and updated the Adult protection policy and procedures to be used by the home, which was comprehensive. There were no complaints recorded in the complaints register since the previous inspection till the date of this inspection. 2 Service users’ have said that they feel comfortable and safe at the home and their views were listened with regard to their choice of shopping, food and college activities. They have also said that the manager and the staffs were cooperative and helpful. 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had made wideranging improvements with regard to the redecoration of the home and the service users’ were comfortable. EVIDENCE: At the time of this inspection the redecoration work was in progress. The landing and halls stairs were repainted. 2 - Service users bedroom were repainted. 1 service user had new curtain rail fitted another service user’s curtain rail was scheduled to be replaced. Kitchen and hall were schedule to have new flooring in the next week. Rubbish bins in the kitchen and the breadbin and vegetable rack were replaced. The home was in the process to replace the dining table and chairs in the coming weeks. 2 new door guards were fitted to the 1-service users’ room and 1 in the lounge. All hot water temperature, electrical appliances checks have been carried out regularly. The manager plans to introduce electrical appliance check every month from July 2006. 1- service user’s bedroom carpet needs shampooing, which the manager said that the quotes have been invited. 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 Page 17 EHO’s visit report of 16/05/06 recorded that the home was generally found to be satisfactory, and suggested to apply HACCP principles for the risk assessment of the food. The home manager had referred to the company’s health and safety officer who was expected to write the new risk assessments based on the HACCP principles, This was scheduled to be completed before three months from now. The home was clean and tidy. 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 Page 18 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, 34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service users’ were benefited with the well-trained and supervised staff. However, there were no details available on this inspection with regard to the statutory checks of the agency staff working at the home. EVIDENCE: The home did not have the details of the agency staffs working at the home with regard to their statutory checks, qualifications and experience. The manager had said that the agency staffs that work at the home were appointed by the sister concern of the company Home Care Solutions. Staff training: the home had carried out staff training needs assessment and had scheduled a training calendar to impart training in the areas of food hygiene and infection control, manual handling, emergency first aid, epilepsy and rectal diazepam, non-abusive psychological physical intervention, pova, key working and shift leading scheduled for the months of June and July 2006. The home had also introduced the monthly staffs training which were thematic in nature that includes communication, dementia, fire safety, epilepsy, infection control, food hygiene and emergency first aid. The thematic trainings were conducted using video presentation followed by discussion. As a policy the home had planned to do the fire training with the staffs every three months that was scheduled to start on 22nd of June 2006. 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 Page 19 Discussion with the staffs on duty: staff member – 1works as a support worker, working since June 2005, assist Service user in their personal needs, cook food, help in administering medication, escort service users’ to appointments. Staff member was aware of the service users’ care plans and understand their history and needs, which needs to be attended. Was trained in medication, food and hygiene, dementia, pova, first aid and manual handling. Had quarterly supervision and was with the work and has no suggestion for now. Staff member – 2 was working as support worker since October 2006, helping the service users’ in bathing, cooking, cleaning, tidying lounge. Was aware of the service users’ care plan and had understood what the service users’ need and how they have to be met. Training received in pova, manual handling, infection control, first aid, person centred planning, NVQ2, Had supervision in April 2006 and was schedule to move to an other home 7 Kimbolton Ave from 17/06/06. Happy with the work at the home and has no suggestions for improvements. 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 Page 20 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had new manager, who was able to develop working relationships with the service users’ and colleagues in short span and were able to meet outstanding requirements and improve care delivery. EVIDENCE: The home had recently concluded Quality assurance report, which was received by the commission. The quality assurance report was comprehensive and had important pointers for improvements of service delivery. The home had a new manager who had started on the 03/04/06 and had introduced positive changes as a follow-up to the service users’ care plans review outcomes and had made considerable progress. Which were initiated in consultations with the service users and have been recorded in the service users’ care plans. 5 service users’ care plans were yet to be signed by the parents’. However, the service users’ have signed. 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 Page 21 Staffs’ supervisions were scheduled and carried out as planned. However, 1staff member supervision was scheduled for 15/06/06. All staffs’ annual appraisals have been planned to take place in the months of June and July 2006. 1- Service user had a fall on 10th of May 2006 and the following morning the wrist was swollen and was sent to GP and an x-ray was taken and discovered that there was a fracture. After the incident the home had carried out the risk assessment on the service user’s mobility and challenging behaviour which included areas such as transferring in and out of bed, slips trips and falls, transferring manual handling tasks, walking frame, wheel chair, arm chair and being around when moving in corridors with other service users’. Basing on the outcomes of the risk assessment the home ad taken appropriate steps by training the staffs and enabling them to attend the service user’s reassessed needs. The manager was in the process of making an application to the commission for registered manager. 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 Page 22 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 X 2 X 3 X 4 X 5 X 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 Page 23 Yes 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 YA6 Regulation 15(2) (C) (d) Requirement The registered person must ensure that all service users’ risk assessments and care plans were reviewed on time. The registered person must ensure that information is maintained in the home on each member of agency staff with regard to their statutory checks. Timescale for action 15/08/06 2. YA34 19 Schedule 2 and 4 15/08/06 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 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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 15 Oaklands Road DS0000014940.V297590.R01.S.doc Version 5.2 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!