Inspection on 09/08/05 for High Oaks (1)

This inspection was carried out on 9th August 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 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

High Oaks (1) 23/07/08

High Oaks (1) 30/07/07

High Oaks (1) 26/04/06

High Oaks (1) 13/01/06

High Oaks (1) 09/02/05

High Oaks (1) 14/10/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 High Oaks (1) 1 High Oaks St Albans Hertfordshire AL3 6DJ Lead Inspector Jeffrey Orange Unannounced 9 August 2005 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 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 Stationary 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. High Oaks (1) I52 s19422 high oaks v243789 090805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 1 High Oaks Address 1 High Oaks St Albans Hertfordshire AL3 6DJ 01727 844523 01727 844523 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Walsingham Vacant Care Home 6 Category(ies) of LD Learning Disability - 6 registration, with number PD Physical Disability - 6 of places High Oaks (1) I52 s19422 high oaks v243789 090805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: This home is registered for 6 people with learning disability or physical disability (when associated with learning disability) Date of last inspection 9 February 2005 Brief Description of the Service: 1 High Oaks is registered to provide care and accommodation for up to six young adults with a learning disability. It is maintained and operated by Walsingham and is situated in a residential area of St.Albans, Hertfordshire. The accommodation comprises a lounge/dining area, kitchen, bathroom, utility room, toilet and one bedroom on the ground floor.(This bedroom would be suitable for a resident with a physical disability in association with a learning disability.) On the first floor are five bedrooms, a bathroom and the office/staff sleeping accommodation. The home has ample parking area to the front with a large garden to the rear which has seating areas accessible to residents. If they choose to, residents can help maintain the garden and grow a variety of fruit and vegetables for use in the home. High Oaks (1) I52 s19422 high oaks v243789 090805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a positive inspection in terms of the care outcomes seen. The residents appeared at ease and had a comfortable and appropriate relationship with the staff present throughout this unannounced inspection. The medication and financial records checked were in order and the general standard of the care plan documentation seen was good, with some reservations about the way some information is recorded. Previous requirements have been addressed, although the comments made about the decorative condition of some areas of the home in February still apply. There are some relatively minor issues with food hygiene and housekeeping, but overall the home provides a pleasant and suitable environment for its residents together with a good standard of personal care. What the service does well: What has improved since the last inspection? Service user involvement continues to be developed and expanded. The “Person Centred Planning” approach to care planning has begun to be put in place with appropriate accompanying documentation clearly provided in a format that enables users of the service to be increasingly involved. High Oaks (1) I52 s19422 high oaks v243789 090805 stage 4.doc Version 1.40 Page 6 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. High Oaks (1) I52 s19422 high oaks v243789 090805 stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection High Oaks (1) I52 s19422 high oaks v243789 090805 stage 4.doc Version 1.40 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 standard(s) 1,2,3,5 Information for service users and prospective service users is comprehensive and provided in a format that enables them to understand and participate in the assessment and contractual process appropriately. EVIDENCE: The statement of purpose, service user guide and assessment documentation have been seen previously and contained the necessary information in a clear and accessible format. There have not been any new admissions into the home since the last inspection in February 2005. The “Person Centred Planning” approach of the home is clearly focussed on establishing and meeting the needs and aspirations of those using its services. High Oaks (1) I52 s19422 high oaks v243789 090805 stage 4.doc Version 1.40 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 standard(s) 6,7,8,9 The residents are increasingly being involved in the process of planning and delivery of their care and are encouraged to fully participate in decisions that affect their lives. EVIDENCE: Residents’ meetings records were seen, together with evidence of the involvement of advocacy organisations in resident’s forums to help and facilitate in this process. The Person Centred Planning approach and documentation that is being introduced, together with appropriate staff training, provides evidence that the home is genuinely attempting to put the service user at the heart of decision making in the home High Oaks (1) I52 s19422 high oaks v243789 090805 stage 4.doc Version 1.40 Page 10 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 standard(s) 12,13,14,15. The home’s service users are encouraged and enabled to access a range of appropriate social, leisure and educational activities within the community and to maintain and develop personal and family relationships wherever possible. EVIDENCE: Care plan documentation seen and talking to service users and staff during the inspection, provided ample evidence of the participation by service users in a varied range of activities and community facilities. High Oaks (1) I52 s19422 high oaks v243789 090805 stage 4.doc Version 1.40 Page 11 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 standard(s) 18,19,20 All service users are assisted as required with their personal care needs and to access the community health services they require. EVIDENCE: Care plan documentation records the involvement of a range of community health professionals and where appropriate hospital services. Care plans tracked showed that assessed requirements such as weight monitoring are carried out regularly and recorded. It is recommended that a consistent use of either metric or imperial measures be used to assist the monitoring process. Those medication records checked were accurate and complete. High Oaks (1) I52 s19422 high oaks v243789 090805 stage 4.doc Version 1.40 Page 12 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 standard(s) 22,23 Efforts are made to ensure that those using this service are able to comment on it, that their views are taken fully into account and that independent advocacy services are provided to facilitate this process. EVIDENCE: The involvement of Pohwer, an independent advocacy organisation, is documented in care plans and residents’ meetings notes. The home has an Adult Protection Procedure and a whistle blowing policy to enable staff to understand the issues around adult abuse and to act appropriately in the event that it is suspected to have taken place. Those financial records checked during this inspection were accurate and subject to a robust system of audit and control. High Oaks (1) I52 s19422 high oaks v243789 090805 stage 4.doc Version 1.40 Page 13 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 standard(s) 24,28,30 Although the overall impression of the home is comfortable and homely there are concerns over routine maintenance and cleanliness that need to be addressed in order to maintain a pleasant and safe environment for both residents and staff. EVIDENCE: Requirements made in February in respect of the decoration and refurbishment of certain areas of the home, for example the dining room, lounge and kitchen have not been met and are carried forward from this inspection. Some kitchen cupboards, the cooker and some ovenware were in an unacceptably dirty condition. There were well-established cobwebs evident in the stairwell and black marks around the light fitting in the kitchen. High Oaks (1) I52 s19422 high oaks v243789 090805 stage 4.doc Version 1.40 Page 14 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35,36 Staff skills and numbers are adequate to meet the assessed needs of the home’s service users. EVIDENCE: Although there are vacancies within the staff team, agency staff, who are familiar with the service, are engaged to ensure staffing levels are maintained at previously agreed levels. The home have a good system in place to ensure that agency staff receive the information they require in order to understand the individual needs and preferences of the service user group. Supervision records were seen which indicate that permanent staff are currently receiving at least six individual supervision sessions per year, together with regular team meetings. High Oaks (1) I52 s19422 high oaks v243789 090805 stage 4.doc Version 1.40 Page 15 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39,42 Although the home is currently without a registered manager, the acting management team are maintaining an effective service for residents. EVIDENCE: Development of the Person Centred Planning approach to the provision of care was evident in new documentation being introduced and in, for example, the service user forums being facilitated with the help of an independent advocacy organisation. On the day of this inspection it was found that not all food had been dated upon opening. It is suggested that a generic risk assessment should be completed to support the lack of window restrictors to some first floor windows. High Oaks (1) I52 s19422 high oaks v243789 090805 stage 4.doc Version 1.40 Page 16 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 3 3 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x x x 3 x 2 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 x x Standard No 31 32 33 34 35 36 Score x x x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 High Oaks (1) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 2 x I52 s19422 high oaks v243789 090805 stage 4.doc Version 1.40 Page 17 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 YA24 Regulation 16(2)(g) Requirement Kitchen units must be made safe/refurbished. This requirement is carried forward from the previous inspection, with a short extension of the timescale to enable the implementation process described to the inspector to be completed Decoration to the hallway, lounge,dining room and kitchen must now be completed within the revised timescale set. The oven and all cooking utensils must be kept clean and hygienic and all areas of the home must be kept clean. All food containers should be dated on opening. Timescale for action By 30.10.05 2. YA24 23(2)(d) By 30.10.05 From 9.8.05 and thereafter. From 9.8.05 and thereafter. 3. YA30 13(3) & 16(2)(j) 13(3) 4. YA42 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations Consideration should be given, during the introduction of I52 s19422 high oaks v243789 090805 stage 4.doc Version 1.40 Page 18 High Oaks (1) 2. 3. YA19 YA42.3(v) new care plan documentation, as to how best to record the involvement of health professionals so as to provide an easy reference point for staff. To assist monitoring of weight gains and losses, weight records should be consistently in either metric or imperial units, not a mixture of both. A risk assessment should be completed and recorded in respect of first floor window restrictors. High Oaks (1) I52 s19422 high oaks v243789 090805 stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City AL7 3BQ 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 High Oaks (1) I52 s19422 high oaks v243789 090805 stage 4.doc Version 1.40 Page 20 - 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. 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