Inspection on 25/07/06 for Little Oaks Residential Home

This inspection was carried out on 25th July 2006.

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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Little Oaks Residential Home 25/06/09

Little Oaks Residential Home 13/10/08

Little Oaks Residential Home 21/04/08

Little Oaks Residential Home 04/10/07

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Little Oaks Residential Home 22 Bridgwater Road Taunton Somerset TA1 2DS Lead Inspector Pippa Greed Unannounced Inspection 25th July 2006 09:05 Little Oaks Residential Home DS0000066384.V304501.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 Little Oaks Residential Home DS0000066384.V304501.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. Little Oaks Residential Home DS0000066384.V304501.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Little Oaks Residential Home Address 22 Bridgwater Road Taunton Somerset TA1 2DS 01823 322427 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 Parminder Kaur Degun Mrs Parminder Kaur Degun Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Little Oaks Residential Home DS0000066384.V304501.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The Responsible Individual / Registered Manager achieves an NVQ4 in Care and Management by 1 April 2007 The service users’ bedroom on the first floor (known as Bedroom No 4) is not used for people with a mobility difficulty. This is Little Oaks first Key inspection under new ownership. Date of last inspection Brief Description of the Service: Little Oaks Residential home is a one storey detached bungalow dating back to the 1930’s. The home is situated in a residential area of the town and is a short walk from local shops. There is adequate parking and good sized gardens. The home is registered with the Commission for Social Care Inspection (CSCI) to provide personal care for up to four people with learning disability between the age of 18 and 65 years who require personal care. The registered person is Mrs Parminder Degun. Little Oaks Residential Home DS0000066384.V304501.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced Key inspection was conducted over one day (7.5hrs) by CSCI Regulation Inspector Pippa Greed. On the morning of the inspection two support workers were on duty and during the afternoon there was a support worker. The deputy manager assisted with the inspection process. On the day of the inspection four service users were at home. One service user left around late morning to go to work. The inspector viewed all communal areas and also some service users rooms. The inspector met with all four and engaged with two service users. The Inspector met with two staff members, deputy manager and a health care professional. A selection of records was examined. The Inspector would like to thank the service users, staff, and deputy for their time and assistance with the inspection process. The current scale of charge is £323 to £956.86. Four requirements and five recommendations have been raised at this inspection. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. What the service does well: The aim of the home is to support and encourage service users to maintain and develop independent living skills. The home is situated in a residential area and is only a few minutes walk from local shops. Service users are enabled to lead independent lives where possible and attend local colleges and/or work locally. Service users are consulted with regarding the daily running of the home, and are encouraged to exercise choice. The home is maintained to a good standard of cleanliness. Little Oaks Residential Home DS0000066384.V304501.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Little Oaks Residential Home DS0000066384.V304501.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 Little Oaks Residential Home DS0000066384.V304501.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): 1, 2, 3, 4, 5 The quality in this outcome group is good. Service users and their families are provided with relevant information regarding the home. Social and health assessments are being completed to ensure that the home will be able to meet service users’ needs. EVIDENCE: The home has an updated Statement of Purpose that provides details of the services and facilities provided at Little Oaks. The service users care plan included a contract, which outlined what the service provides. These have been read and signed by the service users. Updated social and health assessments are being completed by the manager to ensure that the home will be able to meet service users’ needs. Some service users surveys commented that they were enabled to make choice of where they wished to live. There is no vacancy at present. The manager is aware of the need to ensure that an assessment of care need is completed prior to any prospective service user viewing the home. Little Oaks Residential Home DS0000066384.V304501.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, 8, 9, 10 The quality in this outcome group is good. The home is currently developing an appropriate care plan for each service user. Service users are encouraged to exercise choice and participate in all aspects of life within the home. Service users are supported in taking risks. Records relating to service users are stored securely and appropriately maintained. EVIDENCE: Care plans are maintained for each service user. Two care plans were examined in detail. Care plans included a photograph of the service user, and provided information regarding service users needs. A new updated care plan including social assessment, personal care, dietary needs, behaviour, emotional, social, health, personal contact and life skills have been written. The manager is currently completing updated individual risk assessments for each service user. Little Oaks Residential Home DS0000066384.V304501.R01.S.doc Version 5.2 Page 10 The manager plans to further develop care plans at the home. Service users are encouraged to exercise choice, and independence is promoted. Service users spoken with stated that they enjoyed participating in tasks within the home, and that they are consulted regarding the meals and activities provided. The home operates a Key worker system to ensure that the home continues to meet the needs of each service user. Staff will support service users in managing their finances where required. Financial records were examined for two service users. All entries were supported by receipts with one staff signature. It is recommended that the manager set up a new file in order to provide a clearer and more accessible finance system. The manager is advised that two staff signatures on records is good practice for an improved audit trail. The inspector discussed with the manager about a notice board displaying who is working that day. Whilst respecting the wishes of service users living at the home who do not want to see photographic staff rota displayed, one or two may wish to have this information provided either in a communication folder or in their own bedroom. All records relating to service users are stored securely, and may be accessed by service users at their request. Little Oaks Residential Home DS0000066384.V304501.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): 11, 12, 13, 14, 15, 16, 17 The quality in this outcome group is good. The home offers service users opportunities to engage with peers, access appropriate leisure activities, and exercise choice. Service users rights and responsibilities are respected. Service users are offered a choice of menu, and stated that they enjoyed the meals provided. EVIDENCE: Service users are supported in developing and maintaining daily living skills. Staff from the home will assist service users in continuing to access social, and educational resources. Service users are encouraged and supported to undertake role of employments. On the day of the inspection, one service user was spoken with before he went to work. Three service users were at home. One service user went for a walk with a staff member and one service user participated in a meeting with health care professionals. Little Oaks Residential Home DS0000066384.V304501.R01.S.doc Version 5.2 Page 12 Service users spoken with and the activity plan confirmed that service users access local facilities including shops, parks, supermarkets, and pubs. Service users confirmed that they are supported in accessing the cinemas and ten pin bowling. Key workers reports illustrate discussion with service users about making plans to visit the seaside. The home has regular contact with most service users family members. Care plans provide details of service users personal and family relationships. Service users rights and views are respected. One care plan seen included a service user agreement, outlining their rights and wishes. Some service users accessing the service have a befriender and another is considering an advocate. The home has a menu that provides a balanced and nutritious diet. The menu is attractively presented with colour photographs of the meals planned for the week. Service users and the manager confirmed that they are able to choose alternative meals if they wished. On the day of the inspection, breakfast time was relaxed and unhurried. Service users were supported with their choices and timing. Little Oaks Residential Home DS0000066384.V304501.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, 21 The quality in this outcome group is adequate. Service users are provided with appropriate assistance to meet their personal care needs. The home supports service users in accessing healthcare services. The home has a medication policy. Medication Administration Records had not been fully maintained. EVIDENCE: Service users are provided with support to undertake personal care tasks as required. A new care plan has been written to detail the service users’ personal care. Staff support service users in accessing healthcare services and ensure that specialist advice is sought as necessary. Staff are provided with medication training. Currently medication is stored securely within the home and one service user is encouraged to self medicate independently. The inspector sampled the Medication Administration Record. This was checked and found to be reasonably well maintained. The Medication Little Oaks Residential Home DS0000066384.V304501.R01.S.doc Version 5.2 Page 14 Administration Record file had medical footnote and photograph ID. Advice was given to the deputy manager regarding a service user who self medicates. The medication record would need to demonstrate that two staff supervised the preparation of the weekly medicine and state that the risk assessment is found in the care plan. The home have policies in place regarding death and dying which forms pat of the staff induction. Liquid medications were found stored in medication cabinet without opening dates or date of disposal. This is advised as good practice. The deputy was given a copy of expiry date guidance sheet. One service user is currently receiving eardrops, which had no Medication Administration Record in place for the current month. This has been identified and raised with the deputy manager. Little Oaks Residential Home DS0000066384.V304501.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 The quality in this outcome group is good. The home has a complaints procedure and policy relating to the Protection of Vulnerable Adults. EVIDENCE: The home has appropriate policies relating to the Protection of Vulnerable Adults, Whistle Blowing, Complaints policy, and Grievance policy. The inspector met with staff members and asked about their understanding of Safeguarding Adult procedures. One new staff member was unaware of the processes. Staff training should be introduced to ensure all staff are familiar with protection issues and reporting procedures. It is recommended that a copy of Local Authority Safeguarding Vulnerable Adult in Somerset (Multi Agency policy) be sourced. The deputy manager has recently obtained a copy of Department of Health ‘No Secrets’ policy. Staff recruitment files were seen to be robust and contained records required in Schedule 2, Care Homes Regulations. The home should develop a ‘Concerns, Complaint and Compliment’ log. Little Oaks Residential Home DS0000066384.V304501.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, 25, 26, 27, 28, 30 The quality in this outcome group is good. The home has been decorated and furnished to a good standard. The home has sufficient communal areas and bathrooms to meet service users’ needs. The home was found to have a good standard of cleanliness. EVIDENCE: Little Oaks is a small, domestic style, detached property situated in the town. Service user accommodation is provided over two floors. Communal space comprises of a lounge, dining room and kitchen. There is an enclosed garden at the rear of the property that provides a patio area with picnic table and bench. Service user have been actively involved with gardening and growing vegetables. Service user rooms are single occupancy. One room has an en-suite wash sink. Service users rooms have been decorated to a good standard and further work is currently being carried out to improve two rooms. Service users rooms are personalised with their own belongings and decorative posters. There are one bathroom and additional toilets close to communal areas. Little Oaks Residential Home DS0000066384.V304501.R01.S.doc Version 5.2 Page 17 The laundry area was clean and well organised. Appropriate hand washing facilities had been provided for staff throughout the home. It is recommended that paper towels are provided as part of infection control strategy. The home had been maintained to a high standard of cleanliness. Upon inspecting the kitchen, it was identified that Control of Substances Hazardous to Health (COSHH) were not fully adhered to. Dishwasher tablets and cleaning products will need to be risk assessed and stored appropriately. The inspector discussed with the deputy how meal times were managed in the home. The deputy advised the inspector that the service users prepare their meals at differing times and demand of the kitchen were phased. Little Oaks Residential Home DS0000066384.V304501.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): 31, 32, 33, 34, 35, 36 The quality in this outcome group is adequate. Staff are experienced and provide a good standard of care. Staffing levels are appropriate to meet service users’ needs. Staff will require further training updates. Staff receive appropriate support and supervision. EVIDENCE: Duty rotas are maintained appropriately. The manager advised that they plan to complete a staff training needs analysis, and develop a plan to meet these needs. Mandatory training will need to be provided for all new staff member. Three staff recruitment file was examined which included evidence of a POVA First check and enhanced CRB disclosure being obtained. The home has recently recruited staff and provided appropriate induction training. Staff spoken with confirmed that they had received appropriate support and regular supervision. Staff file evidenced that appraisals and supervision are being provided. Staff meeting are being provided regularly. Little Oaks Residential Home DS0000066384.V304501.R01.S.doc Version 5.2 Page 19 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, 38, 39, 40, 41, 42, 43 The quality in this outcome group is good. The home is well run. There is a relaxed and open atmosphere within the home. Appropriate actions have been taken to promote the health and safety of staff and service users. EVIDENCE: Pam Degun is registered manager for Little Oaks. Jan Bird has recently been appointed as the deputy manager at Little Oaks. Jan Bird is currently applying to CSCI for registration. It is anticipated that Jan will undertake the role of registered manager whilst Pam would take on the role of responsible individual. Pam teaches children with autistic spectrum disorder. Jan has worked in the care field for many years and has experience of working in children services. Little Oaks Residential Home DS0000066384.V304501.R01.S.doc Version 5.2 Page 20 The manager and deputy has spent time reviewing practice, and plans to focus on the development of care plans, and staff training at the home. Staff and service users spoken with stated that the manager was approachable, and that they felt listened to. The home has appropriate policies and procedures in place to safeguard vulnerable service users. All records relating to service users are stored securely in accordance with the Data Protection Act 1998. The home has a current Employers Liability insurance. Fire safety records were examined. Fire equipment is serviced and tested as required. All staff members had been provided with updated fire safety training. Equipment servicing records had been appropriately maintained. On the day of the inspection, water temperatures were not being maintained. The deputy has been advised to set up a weekly log to record temperature readings. It is required to implement up to date environmental risk assessment and if necessary install radiator covers where necessary in the home in order to minimise risk of burns. It is also recommended that the home arrange for an external agency to carry out test for Legionella as part of preventative strategy. The home will also need to set up a risk assessment for newly recruited 17year old staff in new file to state clearly no lone working and no personal care until 18 years of age. Little Oaks Residential Home DS0000066384.V304501.R01.S.doc Version 5.2 Page 21 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 X 30 2 STAFFING Standard No Score 31 2 32 2 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 3 3 3 3 3 2 1 3 Little Oaks Residential Home DS0000066384.V304501.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Not applicable 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 YA20 Regulation 13 (2) Requirement Timescale for action 18/08/06 2. YA42 13 (4c) 3. 4. YA42 YA24 13 (4a) 13 (4a) The registered manager will need to make arrangement for Medication Administration Record to be maintained for one service user’s short term medication The registered manager will 18/08/06 need to ensure water temperature readings are recorded weekly for all hot water outlets The registered manager will 18/08/06 need to ensure all chemicals (COSHH) are locked securely The registered manager will 30/09/06 need to ensure that a comprehensive environmental risk assessment is completed for radiators throughout the home. Little Oaks Residential Home DS0000066384.V304501.R01.S.doc Version 5.2 Page 23 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. 2. 3. 4. 5. Refer to Standard YA20 YA30 YA34 YA30 YA43 Good Practice Recommendations To record additional detail on Medication Administration Record for service user who self medicates To arrange for external agency to check all water outlet and central heating annually as part of prevention of Legionella To implement a risk assessment for newly recruited 17year old staff in new file to state clearly no lone working and no personal care until 18 years of age To ensure provision of paper towels as an effective infection control strategy To implement a stronger finance audit trail with two staff signature on all transactions Little Oaks Residential Home DS0000066384.V304501.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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. 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