Inspection on 11/04/07 for Lower Oldfield Park

This inspection was carried out on 11th April 2007.

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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lower Oldfield Park 24/10/06

Lower Oldfield Park 28/03/06

Lower Oldfield Park 20/11/05

Lower Oldfield Park 30/03/05

Lower Oldfield Park 09/12/04

Lower Oldfield Park 23/03/04

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

CARE HOME ADULTS 18-65 Lower Oldfield Park 82 Lower Oldfield Park Bath Bath & N E Somerset BA2 3HP Lead Inspector Jon Clarke Key Unannounced Inspection 11th April 2007 09:30 Lower Oldfield Park DS0000008168.V335118.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 Lower Oldfield Park DS0000008168.V335118.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. Lower Oldfield Park DS0000008168.V335118.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lower Oldfield Park Address 82 Lower Oldfield Park Bath Bath & N E Somerset BA2 3HP 01225 448396 01225 448396 82lop@btconnect.com 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) Bath Mind Paul Cooper Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (6) Lower Oldfield Park DS0000008168.V335118.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 6 persons with mental disorder aged 20 years and over 24th October 2006 Date of last inspection Brief Description of the Service: 82 Lower Oldfield Park is owned by Places For People and operated by Bath Mind. Bath Mind is an independent voluntary organisation, which is affiliated to National Mind. Bath Mind operates a number of projects in the Bath area, of which 82 Lower Oldfield Park is one, for people experiencing mental ill health problems and their carers. 82 Lower Oldfield Park is a care home, providing care and support for up to six people with long-term mental health needs. The manager, a senior care officer and a team of care officers support the residents 24 hours a day. The Home is a three-storey building conveniently placed close to a bus route into the centre of Bath and is close to local amenities, and the shops on Moorland Road. There are six bedrooms, two communal lounges, a kitchen/diner, four bathrooms and five toilets on all three levels. There is also a sleep-in bedroom for staff members on the first floor. Bath Mind’s aim is to provide encouragement, support and assistance to residents to increase and improve their quality of life, freedom and independence to move on to supported housing when appropriate. The fee charged to stay at the Home is £ 716 week. Lower Oldfield Park DS0000008168.V335118.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over one day. The manager was present throughout this inspection. As part of this inspection a number of records were looked at including care plans, medication, health and safety and those relating to staff recruitment and training. There was also an opportunity to talk with three of the residents about their experience of living in the home. What the service does well: What has improved since the last inspection? The previous inspection did not identify any areas for improvement. However the home has now increase and diversified the ways individuals who live in the home take an active part and participate in the running of the home. This entails each individual having “chores” of a housekeeping nature that they have to undertake. This reflects how living in the home means you have to take part in the daily routines and is part of a move towards independent living. When asked about this individuals spoke positively of the tasks they undertake. Lower Oldfield Park DS0000008168.V335118.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Lower Oldfield Park DS0000008168.V335118.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 Lower Oldfield Park DS0000008168.V335118.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good arrangements and practice in place in the needs assessment of perspective residents of the home so that an informed decision can be made of the ability of the home to meet identified needs and that it is an appropriate and safe place for the individual. EVIDENCE: A number of assessments were looked and showed that comprehensive information is obtained about the social, physical and mental health needs. Referrals are made through the local authority mental health team with involvement of Community Psyiatric nurse and social worker. Information was also recorded about the individual likes and dislikes and their views of their care needs. Lower Oldfield Park DS0000008168.V335118.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans reflect the personal needs and goals of the individual and people who live in the home are able to make decisions about their lives and supported in taking risks so that they can lead independent lives taking into account their mental health and well-being. EVIDENCE: A number of care plans were looked at and showed that their needs and aspirations are identified. Included in care plans are needs around personal care, social interaction, medication and health. Evidence was seen of individual’s involvement in their care plans and reviewing on a six monthly basis. Reviews are held involving the individual and other parties where necessary such as CPN/Social Workers. Care plans had been signed by the individual. Risk assessments are completed in one instance where the care plan had identified the wish of the individual to take up cycling. Care plans and risk Lower Oldfield Park DS0000008168.V335118.R01.S.doc Version 5.2 Page 10 assessments also recorded actions to be taken by staff in response to behaviours and where the individual’s mental health was poor and variable. In talking with staff about one individual they were able to set out how they approached this individual change in mood as result of her mental health. In talking with staff they spoke of how they had with an individual identified how they wished to undertake activities such as art and staff were actively looking at opportunities that were available in the community. One individual I spoke too said how he had made suggestions about activities and these had been arranged: “if I speak to staff they will always help me”. Regular house meetings are held and minutes which were looked at showed that individuals had used the opportunity to talk about the daily life of the home, the new arrangements for doing “chores”, and make suggestions about trips and activities. When I asked individuals about these meeting they said they were “good” “we can say what we want”. Lower Oldfield Park DS0000008168.V335118.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The practice and culture of the home helps to make sure that those that live in the home have access and opportunities to take part in appropriate activities and maintain and have links in the local community. People who use the service are supported in having personal relationships and their rights are respected. There are good arrangements in the home to make sure that individuals have a healthy diet and meals meet their dietary needs and there is choice available. EVIDENCE: In talking with staff, individuals and looking at records there was evidence that opportunities are available for people who live in the home to take part in community resources: attending social centre, undertaking community classes. Where necessary staff will accompany individuals however there is a clear understanding from staff that individuals can chose how they spend their day Lower Oldfield Park DS0000008168.V335118.R01.S.doc Version 5.2 Page 12 and their ability to undertake activities or go out can be dependant on their mental health. This was confirmed by two people I spoke too who said how they can “do as we want really” “its up to us”. There are no real restrictions on individuals having visitors into the home or their own accommodation and staff recognised the right to privacy. Activities are arranged in the home such as art, one person said he never “gets bored”. One individual spoke very positively of the trips out which are arranged by the home. A menu of the week’s meals was displayed in the kitchen and this was varied offering balanced choices and individual’s own choice. Staff will accompany individuals to the local shops to buy food and either cook the meals on their own or with staff support. Individuals said how they “enjoyed” the food available and how it was “always good”. There is a range of snacks available. The manager spoke of looking at changing the meal arrangements so that they were more flexible in terms of time and also involving people who live in the home much more in the preparation of meals particularly lunch to include trying to offer greater choice. Lower Oldfield Park DS0000008168.V335118.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. 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. There are good arrangements in place so that the personal, physical, emotional and health support provided meets the choices and needs of people who live in the home. The home administers medication and the practice, policy and procedures make sure that individual’s health is protected. EVIDENCE: Individual care records include history and record of health appointments such as optician, dental and GP. Individuals also receive support of community psychiatric nurse or social worker where this is necessary. One person in the home has recently returned from hospital following a hip operation and the home had had contact with physiotherapy and was following their advice regarding rehabilitation. As part of care plan reviewing individuals goals are identified and ways to support them in achieving these goals are identified and recorded. Individuals are also involved through their reviews in identifying preferred daily routines and likes and dislikes. Lower Oldfield Park DS0000008168.V335118.R01.S.doc Version 5.2 Page 14 The previous inspection identified that medication arrangements are satisfactory with medication being stored securely and stock checks being carried out. Administering records were looked at on this inspection and all recording was satisfactory with signatures of dispensing member of staff. People who live in the home are able to manager their own medication and risk assessments are undertaken and reviewed so that this practice is as safe as possible and the individual is not placing themselves at risk. In discussing medication practice with the manager it was raised how one individual requests medication and this is given in that they were able to recognise when this medication is needed. Whilst record is made of administering on medication charts it was agreed with the manager that recording also be made in individuals daily care record as to the circumstances which required medication to be given. This would safeguard the individual and staff in providing a full record and frequency of medication given. Lower Oldfield Park DS0000008168.V335118.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. 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 has clear procedures in place and this enables individuals to make a complaint and voice their views about the service they receive and to know that they will be listened to and actions taken where necessary. The home makes sure that as far as possible residents are protected from harm by having policy and procedure about the Protection of Vulnerable Adults and providing training to all staff in this area. EVIDENCE: No complaints had been made since the previous inspection. The last inspection noted that the home has the required complaints procedure in place and each person who lives in the home is given a copy. I spoke to one individual about what they would do if unhappy about anything their response was “tell staff”, they also said how “staff would always do something if I wasn’t ok about something”. Minutes of residents meeting that were looked at showed that individuals had used these meeting to voice their views. The home has a protection of vulnerable adults procedure in place, which sets actions to take in event of any allegation, and is linked to the local authority adult protection guidance and procedure. Staff have undertaken the required Adult Protection training and the manager has completed Investigator’s training. Lower Oldfield Park DS0000008168.V335118.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a safe and hygienic environment for the people that live there and staff. However some improvements could be made to the décor of the home to raise the quality of decoration. EVIDENCE: A person who lives in the home showed me around whilst generally the home is homely with good facilities there were areas such as lounge and bathroom which were looking tired and dated. I discussed with the manager how this gave the home a rather tired look and how it would benefit from decoration. I was shown the individual’s accommodation which had been personalised and the previous inspector had also been shown individual accommodation and again these had all been personalised with pictures, television and other personal items. Lower Oldfield Park DS0000008168.V335118.R01.S.doc Version 5.2 Page 17 The home was clean and tidy however the manager said how they had been experiencing some difficulties with maintainence which is not the responsibility of MIND. He has now hopefully resolved the difficulties and it is hoped areas requiring maintainence will now be addressed by the leaseholder. Lower Oldfield Park DS0000008168.V335118.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing arrangements in the home are satisfactory so that the needs of residents can be met in an efficient way with care being provided by skilled and competent staff. The recruitment and selection of staff is undertaken to make sure that as far as possible the health and welfare of resident is protected. However making sure there is full employment history obtained from perspective employees would further protect the welfare of individuals. Staff in the home receive regular supervision so that their practice and performance can be reviewed and any areas of development or concern addressed formally through this process. EVIDENCE: Training records were looked at and showed that all staff had completed mandatory areas of training including Adult Protection, Food Hygiene, First Aid and fire safety. Staff also undertake more specialised training around mental health awareness. Two members of staff have completed NVQ 3 with further 3 having started this qualification. The manager has NVQ 4 Registered Manager Award. Lower Oldfield Park DS0000008168.V335118.R01.S.doc Version 5.2 Page 19 There are currently eight members of staff and shifts are generally covered by existing staff rather then using agency, bank staff are also available to cover leave and other vacancies. There are two staff on duty during the night with one staff on at night who “sleeps in” and is therefore on call for any emergency. Recruitment record for one member of staff was looked who has been recruited since the previous inspection. Their application form was looked at there were significant gaps in their employment history with no record of why this was and the manager was also not aware of the reason for these periods of “unemployment”. Two references had been obtained as required and health declaration had been made. Their CRB was also not available for inspection. Supervision records were looked at for 3 members of staff and showed that they all had received supervision on a 3 monthly basis. Staff meeting are also held regularly providing further opportunity to inform staff about practices and changes in the home. These meeting provide a forum for their views to be sought as to day to day running of the home and developments such as the changes in working arrangements which have been introduced through the “chores” which are now undertaken by people that live in the home. Lower Oldfield Park DS0000008168.V335118.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home benefit from a well run home and are given every opportunity to express their views about the quality of care they receive so that the culture and ethos of the home is centred on the needs of the people that live there. The practices of the home help to make sure that the health and welfare of the people that live and work there are protected. EVIDENCE: Mr Cooper has been the manager of the home since 2006 having previously worked in a care home run by the RNID and has extensive experience of working with individual who have mental health needs. Individuals and staff I spoke too were very positive about his management of the home. Lower Oldfield Park DS0000008168.V335118.R01.S.doc Version 5.2 Page 21 As part of individual care reviews quality monitoring questionnaires are completed and these are discussed as part of the review. There is no record or report made as to the conclusions of these questionnaires or of any actions taken as a result of comments or suggestions made. This was discussed with the manager at the time of this inspection. The views of professionals and others who have contact with the home should also be sought to contribute to the quality monitoring undertaken. Health and Safety records were looked at and showed that fire alarms are tested weekly, emergency lighting monthly. There is environment fire risk assessment in place. Gas Safety certificate issued 07/08/06. Annual service of fire equipment last being 25/07/06. Environmental Health inspection 23/02/06 which was satisfactory. COSHH training is undertaken by staff and potential hazardous chemicals or products used in the home have COSHH Data information. Staff and people who live in the home undertake fire evacuation practice regularly the last being 25/03/06. I also discussed with the manager fire evacuation practice for nightime period. Lower Oldfield Park DS0000008168.V335118.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 3 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 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 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 Lower Oldfield Park DS0000008168.V335118.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA34 Regulation 12 (1) (a) Requirement Ensure that full employment history is obtained and any gaps in employment are explored and reasons for these gaps to be recorded. Timescale for action 11/04/07 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 YA20 Good Practice Recommendations Record in individual care records circumstances in which medication is given when such medication is not taken on a regular basis by the person. Lower Oldfield Park DS0000008168.V335118.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Lower Oldfield Park DS0000008168.V335118.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. 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