Inspection on 22/08/05 for Oak Farm Clinic

This inspection was carried out on 22nd August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Oak Farm Clinic 11/11/08

Oak Farm Clinic 30/11/06

Oak Farm Clinic 12/01/06

Oak Farm Clinic 11/01/05

Oak Farm Clinic 11/11/04

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

CARE HOME ADULTS 18-65 Oak Farm Clinic 276 Fakenham Road Taverham Norwich NR8 6AD Lead Inspector Pearson Clarke Unannounced 22 August 2005 nd The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Oak Farm Clinic I55 s15665 oakfarm v240850 220805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Oak Farm Clinic Address 276 Fakenham Road, Taverham, Norwich, Norfolk, NR8 6AD 01603 868953 01603 865245 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Choicecare 200 limited Mrs Meryl Rushmere Care Home 27 Category(ies) of Physical disability (21) registration, with number of places Oak Farm Clinic I55 s15665 oakfarm v240850 220805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Twenty-seven (27) Younger Adults 18-65 with a physical disability not falling into any other category may be accomodates Date of last inspection 11th January 2005 Brief Description of the Service: Oak Farm clinic offers specialist Neuro rehabilitation and continuing care to people with movement dysfunction and acquired brain injury. The unit was purpose built approximately 15 years ago and is registered to accommodate 21 people under the category of physical disabilities. All accommodation is on ground level in single rooms, some with en-suite facilities, and all areas of the unit can be accessed by people using equipment to assist with their mobility. The unit is located on the outskirts of Norwich and close to some public amenities, with easy access to public transport. Oak Farm Clinic I55 s15665 oakfarm v240850 220805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place as a result of some concerns expressed to the commission by a relative of a resident. This resident is accommodated in the small residential unit Oak Lodge which was previously a separate home, but is now part of the main registration. Given that the last inspection of Oak Lodge resulted in a significant number of requirements and recommendations this inspection was solely focused on this area of the home and has embraced the concerns expressed and outcomes from the previous inspection. During his time in the home the inspector met with management, talked to two members of staff and one resident. In addition to this premises and records were inspected. The atmosphere experienced was relaxed with an easy interaction between residents and staff. What the service does well: What has improved since the last inspection? The home has addressed many of the issues raised in the last inspection and the decision to integrate the small unit into the main registration should allow for more effective management and a more consistent delivery of care. Oak Farm Clinic I55 s15665 oakfarm v240850 220805 stage 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Oak Farm Clinic I55 s15665 oakfarm v240850 220805 stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Oak Farm Clinic I55 s15665 oakfarm v240850 220805 stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 In order to ensure that prospective residents are able to make informed choices , the service needs to update its published information to fully reflect recent changes. EVIDENCE: Although there have been no recent admissions to the residential beds at the service, the fact that they are now part of the wider registration and that the overall registered numbers have increased needs to be reflected in the statement of purpose and service user guide. See Requirement. Oak Farm Clinic I55 s15665 oakfarm v240850 220805 stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,10 EVIDENCE: Previous inspection of Oak Lodge has identified the approach to maintaining confidentiality as an issue. In part this has related to the absence of an office and the resultant difficulties in storing confidential information and the lack of privacy when discussing care related matters. In part the concerns related to the inspector before this inspection were around these areas and these were upheld on the day. Of concern to the inspector was the display of notices giving care instruction and reminders to staff. Such information should not be on public display and should be part of the individual care plan which in turn should be securely stored. This was discussed with the management on the day who accepted this and notices were removed during the inspection. This area of the home still has no office despite previous commitment by the provider to re-develop the unit including proper office provision. Whilst it is understood that there has been some uncertainty about the future usage of the small unit, this issue must be addressed. As such the commission requires Oak Farm Clinic I55 s15665 oakfarm v240850 220805 stage 4.doc Version 1.40 Page 10 that a concrete and timed proposal is submitted which fully addresses this area. See requirement Oak Farm Clinic I55 s15665 oakfarm v240850 220805 stage 4.doc Version 1.40 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 standard(s) 14 The homes management need to ensure that all residents have an adequate programme of structured activity. EVIDENCE: These outcomes were not inspected in any depth, however the needs of one resident were examined in the context of concerns expressed by a relative. Unfortunately the inspector was unable to meet the resident as they were out at day services. Discussion took place with the service management as to the need to provide meaningful activity for this person during the days Monday to Friday. At present they attend day services on two days of the week and the service management acknowledged that this may not be sufficient, particularly as the person concerned has expressed the desire for an expansion of their day programme. However as there is currently a review going on to ascertain whether this persons placement will continue there were reasons not to make immediate change. Whilst this is accepted by the inspector, it is important that this issue is monitored and if the resident is to remain at the home then their day care programme needs re-evaluating to ensure that sufficient activity is provided. In so doing consideration should be given to all areas of the persons Oak Farm Clinic I55 s15665 oakfarm v240850 220805 stage 4.doc Version 1.40 Page 12 needs including their sensory loss and the services of professionals operating in this area as well of those in the field of head injuries need to be looked at. See recommendation Oak Farm Clinic I55 s15665 oakfarm v240850 220805 stage 4.doc Version 1.40 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 standard(s) Standards not inspected EVIDENCE: Oak Farm Clinic I55 s15665 oakfarm v240850 220805 stage 4.doc Version 1.40 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 standard(s) 22 The service management are sensitive to the views and concerns of residents and their representatives and in relation to the focus of this inspection acted in a proactive manner to deal with concerns raised. EVIDENCE: As indicated this inspection was used to look at some specific concerns expressed relating to one person. In relation to this the homes management were keen to address issues in an open way and undertook to address issues raised in a sympathetic and constructive fashion. Oak Farm Clinic I55 s15665 oakfarm v240850 220805 stage 4.doc Version 1.40 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 standard(s) 24,25,30 The future of the unit previously registered as Oak Lodge needs to be resolved by the provider in order to ensure that the unit is fit for purpose and that residents confidentiality is not compromised by the layout. EVIDENCE: The main home was not looked at on this visit, however Oak Lodge was inspected. As indicated elsewhere in this report arrangements for protecting confidentiality in this unit are not good and a requirement has been made. In general terms the home was clean and comfortable. One resident invited the inspector in to their room and it was clear that residents are free to personalise their rooms and generally have the space needed. Oak Farm Clinic I55 s15665 oakfarm v240850 220805 stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 Staffing arrangements found on the day were adequate to meet the needs of the people accommodated in Oak Lodge which was the only area looked at. EVIDENCE: During the inspection the inspector met with the two staff on duty and with one of the residents. The resident concerned liked the staff and felt that his care needs were appropriately met at all times. Both staff members also felt that the home was staffed in a way which allowed them to deliver effective care . Oak Farm Clinic I55 s15665 oakfarm v240850 220805 stage 4.doc Version 1.40 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed. EVIDENCE: Oak Farm Clinic I55 s15665 oakfarm v240850 220805 stage 4.doc Version 1.40 Page 18 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 2 x x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x x 1 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x 2 x x x Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oak Farm Clinic Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x I55 s15665 oakfarm v240850 220805 stage 4.doc Version 1.40 Page 19 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 1 Regulation 6 Requirement That the homes statement of purpose and service user guide be updated to ensure that recent changes to the structure of the home and the registered numbers are fully reflected. That the provider submit concrete proposals to the commission for the future of oak lodge to include the provision of an office That confidential information relating to any individuals care needs is held within their care plan and not displayed in the home. Timescale for action 31st October 2005 2. 10,24 23 31st October 2005 immediate and on going 3. 10 12 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 14 Good Practice Recommendations That the service management ensure that each person accomodated has a programme of activity that meets their needs and aspirations. Oak Farm Clinic I55 s15665 oakfarm v240850 220805 stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 1YF 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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