Inspection on 03/08/06 for Oak Bungalow

This inspection was carried out on 3rd August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oak Bungalow 24/06/08

Oak Bungalow 31/01/06

Oak Bungalow 09/08/05

Oak Bungalow 14/03/05

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 Oak Bungalow Six Acres Close Roman Road Taunton Somerset TA1 2BD Lead Inspector Judith McGregor-Harper Key Unannounced Inspection 3rd August 2006 09:10 Oak Bungalow DS0000036637.V306437.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 Oak Bungalow DS0000036637.V306437.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. Oak Bungalow DS0000036637.V306437.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oak Bungalow Address Six Acres Close Roman Road Taunton Somerset TA1 2BD 01823 327715 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) Somerset County Council (LD Services) Mrs Wendy Jones Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Oak Bungalow DS0000036637.V306437.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users may be admitted who also have a concurrent physical disability. Service Users will be admitted for a maximum of 3 months between each admission and discharge 31st January 2006 Date of last inspection Brief Description of the Service: Oak Bungalow provides respite care. Service user accommodation is provided in four units. Oak Bungalow and Meadow View each have four bedrooms. There are also two flats, which each provide accommodation for one person. The home is situated within walking distance of Taunton town centre. Oak Bungalow is registered with the Commission for Social Care Inspection to provide care for up to 10 service users aged between 18-65 years who have a learning disability. Service users who have a concurrent physical disability may also be admitted to the home. The home is run by Somerset Social Services. The Registered Manager is Wendy Jones, and the Responsible Individual is David Dick. Oak Bungalow DS0000036637.V306437.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 carried out by one inspector and took place over one day between the hours of 09.10 am – 12.50 pm. Nine residents were in receipt of respite services at the two units (Oak Bungalow and Meadow View) on the day of the inspection. There was therefore one vacancy. There was a mix of male and female residents. All residents were aged between 18 – 64 years. The inspector was able to see and interact with most residents; some were out at pre-arranged usual classes/activities etc. There was one professional visitor to Meadow View during the inspection visit. The inspector received a detailed pre-inspection questionnaire about the service completed by the registered home manager. Staff on duty were able to give time to speak with the inspector. The registered manager Mrs. Jones and duty staff were available for comment during the inspection. The inspector would like to thank Mrs. Jones and the staff for their time and hospitality shown to the inspector during her visit. The atmosphere at the home was friendly and active. Staff carried out their duties in an attentive and supportive manner. The aim of this inspection visit was to inspect key National Minimum Standards as part of the Commission’s ‘Inspecting for Better Lives’ strategy. Inspectors focus on outcomes for service users and measure the quality of the service under four general headings. These are - excellent, good, adequate and poor. The judgement descriptors for the seven chapter outcome groups are given in this report. What the service does well: Oak Bungalow and Meadow View provide respite care to service users who have a range of abilities and needs. Staff follow a person-centred approach to ensure that the care provided meets service users’ individual needs. There is a relaxed and friendly atmosphere within the home. The Registered Manager provides a clear direction for staff, who report feeling supervised and supported. Service users are aided in developing and maintaining living skills, and independence is promoted. Service users are able to participate in a range of activities and are supported in accessing the local community. Staff are skilled to manage a wide range of individual service user needs. Oak Bungalow DS0000036637.V306437.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. Oak Bungalow DS0000036637.V306437.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 Oak Bungalow DS0000036637.V306437.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. The overall outcome for these assessed Standards is adequate. Service users and their families are provided with comprehensive information regarding the home. However, the units are in breach of the condition of registration that the maximum stay at the units is three months. Appropriate assessments are completed to ensure that the home will be able to meet service users’ needs but strategies for length of stay need developing. EVIDENCE: The home has a Statement of Purpose and Service User Guide that provide details of the services and facilities provided at Oak Bungalow and Meadow View. The Statement of Purpose clearly asserts that the units are registered for respite care, for a maximum of three months. This is currently not being complied with as three people have exceeded this length of stay. The homes must not breach this condition of registration and must not give a false statement of actual service provided in literature provided to prospective residents. The Service User Guide is provided in a format that is accessible to service users. Oak Bungalow DS0000036637.V306437.R01.S.doc Version 5.2 Page 9 The home has an admissions procedure. The Registered Manager ensures that an assessment of need is completed prior to any service user being admitted to the home. In light of problems with exceeding maximum lengths of stay imposed by the Commission, the admission assessment should include a strategy on admission length. Service users are encouraged to visit the home for short periods and tea visits before staying overnight. Due to the nature of the service, the home sometimes has emergency admissions. Oak Bungalow DS0000036637.V306437.R01.S.doc Version 5.2 Page 10 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 overall outcome for these assessed Standards is good. The home has appropriate care plans for service users. 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 appropriately maintained and stored securely. EVIDENCE: Care plans are maintained for each service user. These follow the standard model used by Somerset Social Services. Three care plans were examined in detail. Care plans included a photograph of the service user, and provided information regarding service users needs, daily routines and preferences. Risk assessments had been completed where required. Care plans had been regularly reviewed and updated appropriately. Service users are encouraged to exercise choice, and independence is promoted. There is a notice board displaying who will be on duty each day. Oak Bungalow DS0000036637.V306437.R01.S.doc Version 5.2 Page 11 The home has established a protocol for one service user to spend short periods of time accessing the community independently. Staff will support service users in managing their finances where required. Records are maintained of all transactions involving service users finances. These are supported by receipts and two staff signatures, and are audited on a weekly basis. All records relating to service users are stored securely, and may be accessed by service users at their request Oak Bungalow DS0000036637.V306437.R01.S.doc Version 5.2 Page 12 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 overall outcome for these assessed Standards is good. Service users are provided with a range of opportunities, and are supported in accessing the local community. Service users rights and responsibilities are respected. Service users are fully involved in food preparation and menu planning and stated that they enjoy 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 that they would normally attend, during periods of respite care. Service users are able to participate in a range of activities. Those currently provided include: arts and crafts, games, puzzles, music, cooking, gardening Oak Bungalow DS0000036637.V306437.R01.S.doc Version 5.2 Page 13 and walks. Service users also attend discos, drop in at Six Acres, and enjoy pub lunches and shopping. Visitors are welcomed at the home. The home has regular contact with family members. Service users are supported in developing the weekly menu, food shopping and meal preparation, as is appropriate to their individual abilities and needs. The weekly menu is displayed, and includes the name of the person who has chosen that days meal. Service users spoken with enjoyed the increased opportunity for ‘home cooking’, and the meals provided. Kitchens in both Oak Bungalow and Meadow View have benefited from recent upgrade and refurbishment. Oak Bungalow DS0000036637.V306437.R01.S.doc Version 5.2 Page 14 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. The overall outcome for these assessed Standards is good. Service users are provided with appropriate assistance to meet their personal care needs, including emotional, physical or psychiatric support. The home supports service users in accessing healthcare services. Medication is managed well but an amendment to the home’s medication policy is recommended to protect staff administering medications brought by service users from their homes into the units. EVIDENCE: Service users are provided with support to undertake personal care tasks as required. Personal care is provided in private. Staff support service users in accessing healthcare services and ensure that specialist advice is sought as necessary. Feedback from two community health care professionals associated with the service about the management of healthcare needs and personal support to service users by Oak Bungalow and Meadow View staff and managers was positive. Oak Bungalow DS0000036637.V306437.R01.S.doc Version 5.2 Page 15 Staff are provided with medications training. Due to the nature of the service provided, there are a number of admissions and discharges. Staff ensure that clear records are maintained of all medications entering and leaving the home. Medication Administration Records were examined. These included a photograph of the service user. A signature had been received for all medications given. The medication policy for the home was examined. This is a well written document but it is recommended that there be an amendment to the current policy adding what protocols staff must follow should unlabelled medicines be supplied to the unit from a service user. This will then support staff administering medicines in ensuring that prescribed medicines are identified. Oak Bungalow DS0000036637.V306437.R01.S.doc Version 5.2 Page 16 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 overall outcome for these assessed Standards is good. The home has a comprehensive complaints procedure and appropriate policies relating to the Protection of Vulnerable Adults. Complaints are thoroughly investigated and feedback from the complainant is sought in order that the complainant is satisfied with the manner in which the complaint has been handled. EVIDENCE: The home has a complaints procedure displayed, which includes the photographs of people that may be contacted, including the Inspector from Commission. Somerset Social Services Department has also produced a video and DVD providing details of how to make a complaint. A copy of the Somerset Social Services document entitled ‘Our Promise to You’ is also displayed. Since the last inspection, the home has received one verbal complaint. The Registered Manager responded promptly and ensured that appropriate actions were taken, complaint investigation recorded and outcome for complainant documented. The home has appropriate policies relating the Protection of Vulnerable Adults and whistleblowing. Oak Bungalow DS0000036637.V306437.R01.S.doc Version 5.2 Page 17 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, 29, 30. The overall outcome for these assessed Standards is adequate. The units have generally been decorated and furnished to a good standard. Some corridors and communal areas in Meadow View would benefit from redecoration in order to enhance the environment. Appropriate adaptations have been provided to meet physical handling needs for service users. The home has sufficient communal areas and bathrooms to meet service users’ needs. The units were found to be socially clean but infection control is compromised by inadequate equipment. EVIDENCE: Service user accommodation is provided in four units. Oak Bungalow and Meadow View each have four bedrooms. There are also two flats, which each provide accommodation for one person. Communal areas and bathing facilities are provided within each unit. Service users are able to bring personal possessions with them into the homes. A photograph of the service user is displayed on the door of the room they are Oak Bungalow DS0000036637.V306437.R01.S.doc Version 5.2 Page 18 staying in. All service user rooms are single occupancy. Two bedrooms at Oak Bungalow, one bedroom at Meadow View and both of the flats have en suite facilities. There is an on-going program of maintenance within the home. Since the last inspection there have been facility upgrades in the shower room at Oak Bungalow and a new bath for Meadow View. Oak Bungalow has also benefited from some routine redecoration to communal areas. The laundry was tidy and well organised. The washing machines at both Oak Bungalow and Meadow View do not have sluicing facilities and staff are hand sluicing soiled linen. This compromises cross infection measures at the units and advice should be obtained from the local Health Protection Unit for appropriate clothes washing machines for the homes. The laundry at Oak Bungalow also does not have hand washing facilities and this is required to manage infection control to a satisfactory standard. Other equipment for the management of cross infection such as personal protective equipment for staff, hand basins in bathrooms with liquid soap, paper towels and pedal bins are supplied. Staff were observed using suitable personal protective equipment when attending to personal care needs of service users. Oak Bungalow DS0000036637.V306437.R01.S.doc Version 5.2 Page 19 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, 33, 34, 35, 36. The overall outcome for these assessed Standards is good. Staff are competent and provide a high standard of care. Staffing levels are appropriate to meet service users’ needs. Staff are provided with regular opportunities to attend training. Staff receive appropriate support and supervision. EVIDENCE: Duty rotas are maintained. Copies for current four week staffing rosters were supplied to the Commission on request. There are generally four care staff on duty during the day, and two sleep-in or one waking and one sleep-in members of staff throughout the night, depending upon service users needs. The registered manager reported flexibility in staffing to enable additional staffing for service users with known higher need of staff support. Newly appointed staff receive Induction training. There have been no new staff employed for over 12 months. The staffing team is stable. There has been one recent internal promotion within the staff team and additional training has been provided for this staff member in order to fulfil their role competently. Staff are encouraged to study for NVQ qualifications and attend further training courses. Currently 50 of care staff hold an NVQ care Oak Bungalow DS0000036637.V306437.R01.S.doc Version 5.2 Page 20 qualification to a minimum level 2. Individual staff training records are maintained. Recent training has included equality and diversity, the administration of rectal diazepam, moving and handling, managing pressure and stress, fire awareness, epilepsy and first aid. Staff meetings are held. Staff spoken with confirmed that they receive appropriate support and regular supervision. Oak Bungalow DS0000036637.V306437.R01.S.doc Version 5.2 Page 21 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, 41, 42. The overall outcome for these assessed Standards is good. The Registered Manager provides effective leadership to the staff team. 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: The Registered Manager is Mrs Wendy Jones. She is an experienced manager and has provided strong leadership to the staff team at the home. Mrs. Jones holds the City and Guilds Certificate in Advanced Management and is studying toward the NVQ level 4 award in Care. Service users and staff stated that she was approachable and that their views were listened to. Oak Bungalow DS0000036637.V306437.R01.S.doc Version 5.2 Page 22 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. Fire safety records were examined. Fire equipment is serviced and tested as required. There are notices displayed in each room in Somerset Total Communication that provide details of the actions to be taken in the event of a fire. Staff are provided with regular fire safety training. Health and safety records had been appropriately maintained. Hazardous substances had been stored securely and were not accessible to service users. Staff are scheduled to receive a training update in the Control of Substances Hazardous to Health (COSHH) later this year. All accidents are recorded and reported as required. Oak Bungalow DS0000036637.V306437.R01.S.doc Version 5.2 Page 23 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 1 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 1 STAFFING Standard No Score 31 3 32 X 33 3 34 3 35 3 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 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 3 X 3 3 X Oak Bungalow DS0000036637.V306437.R01.S.doc Version 5.2 Page 24 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 YA1 Regulation 4 (3) (b) Requirement Timescale for action 29/09/06 2. YA30 13 (3) The registered manager must ensure that the conditions of registrations are complied with. The Commission requires an action plan (with timescales) detailing how residents who have been at the units in excess of three months will be supported to find suitable alternative accommodation. 1/ The hand sluicing of soiled 01/12/06 linen in the home must cease in order to ensure the risk of cross infection in the home is minimised. Suitable mechanical equipment for sluicing soiled linen must be supplied. 2/ A hand washing sink is required in Oak Bungalow laundry/sluice. Oak Bungalow DS0000036637.V306437.R01.S.doc Version 5.2 Page 25 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 It is recommended that the home’s medication policy be amended. If the home receives unlabelled medications, it is advisable to state in the medication policy what further necessary steps must then be followed by staff to ensure the identification of prescribed medications. Oak Bungalow DS0000036637.V306437.R01.S.doc Version 5.2 Page 26 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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