Inspection on 06/12/05 for Limber Oak

This inspection was carried out on 6th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

Other inspections for this house

Limber Oak 26/02/09

Limber Oak 24/10/06

Limber Oak 13/07/05

Limber Oak 22/02/05

Limber Oak 13/10/04

Limber Oak 19/03/04

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Fairways

Treloar College

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

CARE HOME ADULTS 18-65 Limber Oak Crookham Common Nr Newbury Berkshire RG19 8DH Lead Inspector Lucy Martin Announced Inspection 6th December 2005 10:00 Limber Oak DS0000011213.V256906.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 Limber Oak DS0000011213.V256906.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. Limber Oak DS0000011213.V256906.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Limber Oak Address Crookham Common Nr Newbury Berkshire RG19 8DH 01635 871213 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 Pamela Mary Eales Ms Lyn Allen Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Limber Oak DS0000011213.V256906.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Learning disability, some of whom may also have a physical disability. Date of last inspection 13th July 2005 Brief Description of the Service: Limber Oak is a spacious two storey building, built on a slope, therefore presented as two bungalows. The home is situated in a lane with no through traffic for ease of walking and wheelchair access. The amenities of Thatcham and Newbury are close by and there is a shop and public house within walking distance. Limber Oak provides accommodation and care for up to seven service users, aged between eighteen and sixty-five years of age, who have a learning disability and some of whom also have a physical disability. Limber Oak DS0000011213.V256906.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine announced inspection which started at 10am and finished at 3.20pm. The inspector spent time with the Proprietor and Manager and one other member of staff was spoken with individually. All of the six service users currently living at the home were seen and greeted. A brief tour of the premises was made which included one of the service user’s bedrooms and the newly completed garage conversion. Samples of records, including service users’ files, were seen. What the service does well: What has improved since the last inspection? What they could do better: This home met all the standards inspected except in one area. Most staff have attended training in the abuse of vulnerable adults but the home does not identify this area as a core training need and there are some staff who have worked at the home for over a year who have not attended training covering this topic. It is recommended that adult protection training is recognised as a core training need for all staff. Limber Oak DS0000011213.V256906.R01.S.doc Version 5.0 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. Limber Oak DS0000011213.V256906.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 Limber Oak DS0000011213.V256906.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 New service users are admitted only on the basis of a full assessment. EVIDENCE: There are six service users currently living at the home and all have lived at the home for a minimum of three years and most have lived at the home since 1999. Since the last inspection, the number of service users the home can accommodate has increased from 6 to 7 as the garage conversion has been completed which provides an additional bedroom. The home is in the process of taking referrals for the vacancy and has a referral and admission procedure. It is usual that any service user moving in would have a Care Manager and any assessments undertaken by professionals are seen as well as the home making an assessment as to whether they can meet the prospective service user’s needs. The care planning system ‘Qualsat’ used by the home is started right at the beginning of them getting to know each other so a clear picture of the service users support needs are known. Family members and advocates are encouraged to visit as well as the prospective service user. Limber Oak DS0000011213.V256906.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 Service users care plans are reviewed every six months and there is good evidence of choices and decisions made by service users. Service users finances are well managed. EVIDENCE: At the last inspection care plans were looked at and it was found that although meetings to review care plans were regularly being held every six months, there were a number of written plans that had yet to be updated following the review meetings. It was made a recommendation that the service users written care plans are reviewed and updated every six months. This has been done and the two service users files seen had up to date written care plans in place. There was good evidence seen on the care plans of the individual choices made by service users. They were clearly documented and illustrate how service users can make decisions about their day-to-day lives. None of the service users are able to manage their own finances and there are robust systems in place for ensuring the financial security of service users money. There is a clear audit trail and monitoring of the records maintained. All the service users keep a small amount of money in a locked drawer in their bedrooms which Limber Oak DS0000011213.V256906.R01.S.doc Version 5.0 Page 10 ensures that there is quick and easy access for trips out to the shops and cafes. Limber Oak DS0000011213.V256906.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): 15, 16, 17 Service users are able to maintain family links and the food menus are varied and homemade. EVIDENCE: All the service users maintain contact with family members, most of whom visit on a regular basis. There are good relationships between the staff team and service users family and there were some very positive comments about the staff and the care given in the comment cards completed by relatives prior to this inspection. Families and friends can visit at any time and service users can see them in private if they wish. In addition to family visiting, there are some friendships with service users in other homes owned by the same proprietor who regularly visit, and one service user has made a friend who attends the same college course who has visited. There is a feeling that this is an open home and the staff team are happy for the service users to receive regular visitors. The service users are free to spend time in the communal areas or in their own bedrooms if they wish. Staff spent time with service users and know them well. There is genuine warmth shown by the staff to the service users and a Limber Oak DS0000011213.V256906.R01.S.doc Version 5.0 Page 12 keenness to ensure that service users are as independent as possible and that their individual rights are respected. The home employs a cook which ensures that the staff spend as much time as possible with the service users. The food menus were seen which were varied and wholesome. The food is homemade and of good quality. One day a week one of the service users chooses the evening meal and shops and helps prepare this meal. It was noted that the food menus were kept up to date and any changes made were clearly marked. Limber Oak DS0000011213.V256906.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, 20 Personal support is provided to service users in a sensitive way and the procedures in place for the administration of medication work well. EVIDENCE: All the service users require some personal support and the care plans include preferences and details of how service users like these tasks to be undertaken. The staff team has a good gender balance and discussions took place regarding cross gender care. Advice was given to write a procedure and to ensure that service users personal preferences are always considered. The home uses other professionals as required such as psychiatrists and occupational therapists. There is good staff consistency and continuity of support for service users with a regular staff team who know the service users well. The medication was seen which is stored in a locked wooden cabinet in a locked room. The Boots Monitored Dosage System is used for most of the medication and accurate medication administration records are kept, including some medication to be administered as required. All the staff undergo an internal assessment prior to administering medication and two staff have undertaken external training in medicine management. Limber Oak DS0000011213.V256906.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): 23 Service users are protected from abuse and most staff have received training in this area. However, there is a need for this training to be undertaken as a core area by all new members of staff. EVIDENCE: The home has procedures on adult protection and most staff have undertaken training in this area. However, no staff have attended training in adult protection in the last year and it is not a course which is prioritised for new staff to attend. It is a recommendation of this report that training in adult protection is a core training course for all new staff. As stated earlier in this report, the home has robust procedures in place for ensuring that service users finances are safeguarded. Limber Oak DS0000011213.V256906.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, 25 The home is comfortable and well decorated and maintained. The garage has been converted into a new bedroom and sitting room for one existing service user. EVIDENCE: The home now provides accommodation for seven service users and in practice, this is divided into three distinct areas. The upstairs accommodation is for 4 service users, downstairs for 2 service users who have their own lounge and dining area to eat their meals and there is now the new bedroom with a lounge area and dining room table. All of the areas seen were comfortable, warm and well decorated and maintained. The home has an annual development plan which includes a maintenance and decoration programme. Since the last inspection the garage conversion has been completed. This provides an additional seventh bedroom with an en-suite bathroom as well as a self-contained lounge and eating area. The plan is for one of the existing service users to move into this bedsitting room in the near future. The work has been carried out to a high standard and will provide a virtually selfcontained area for the service user. All the necessary documentation relating to the building works was seen on this inspection. Limber Oak DS0000011213.V256906.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): 33, 35, 36 There is a core group of experienced staff who know the service users well. A variety of training courses have been undertaken by the staff team including NVQ. Members of staff receive regular supervision. EVIDENCE: The home has a large staff team currently comprising of 21 members of staff and a couple of bank workers. Staff numbers on shift remain at a minimum of five staff on duty on the two daytime shifts and one waking member of staff at night and one sleep-in. There will need to be a review of the staffing numbers needed when the seventh service user moves in. There is a good gender balance within the staff team as well as good levels of continuity and consistency for service users. There are currently two vacancies within the team and advertisements will be placed in the near future. No agency staff are used. The staff team have attended a variety of training during the past year including first aid, food hygiene, continence issues, communication, rectal diazepam, and learning needs. One member of staff who has worked at the home since August 2005 has attended six training courses covering key areas. As stated earlier in this report, it is recommended that training in the abuse of vulnerable adults is included in key training. Six members of staff currently have NVQ level 2 or above and a number of staff are part-way through courses. Limber Oak DS0000011213.V256906.R01.S.doc Version 5.0 Page 17 The supervision of staff is now undertaken by five members of staff, all of whom have received training in this area. The record detailing when sessions have taken place was seen and shows that sessions are taking place on a regular basis, mostly once every two months. Annual appraisals take place on a regular basis. Limber Oak DS0000011213.V256906.R01.S.doc Version 5.0 Page 18 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): 39 The home has effective quality assurance systems in place and seek the views of service users whenever possible. EVIDENCE: The proprietor visits the home on a regular basis and completes the monthly Regulation 26 reports. In addition, an annual development plan is written for the home. Feedback is sought from families and visiting professionals and a short questionnaire has been devised asking for comments about the environment, care and staffing in the home as well as for ideas regarding improvements. Those questionnaires seen were overwhelmingly positive and any comments made for improvement are acted upon. Most of the service users do not communicate verbally and so their views are gained in other ways. There was evidence that the staff are well aware of how each service user communicates and gives their views. This information is recorded in service user’s files and in addition monthly reports are written. Limber Oak DS0000011213.V256906.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 x 3 x x x Standard No 22 23 Score x 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 x x x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x 3 x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Limber Oak Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x x x DS0000011213.V256906.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 YA23 Good Practice Recommendations Training in the adult protection is recognised as a core training need and all staff attend training covering this area. Limber Oak DS0000011213.V256906.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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 Limber Oak DS0000011213.V256906.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. 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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