Inspection on 21/06/06 for Oak House

This inspection was carried out on 21st June 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oak House 21/11/06

Oak House 20/03/06

Oak House 08/11/05

Oak House 13/02/05

Oak House 03/08/04

Oak House 01/03/04

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 House Newland Nr Coleford Glos GL16 8NJ Lead Inspector Mr Paul Chapman Key Unannounced Inspection 21st June 2006 10:00 Oak House DS0000016516.V303741.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 House DS0000016516.V303741.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 House DS0000016516.V303741.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oak House Address Newland Nr Coleford Glos GL16 8NJ 01594 832218 01594 810374 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) Oak House Trust Limited Mr Stephen Horne Care Home 16 Category(ies) of Learning disability (16), Learning disability over registration, with number 65 years of age (3), Sensory Impairment over of places 65 years of age (1) Oak House DS0000016516.V303741.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th March 2006 Brief Description of the Service: Oak House is a large detached property in the village of Newland, near Coleford. The home is registered to provide accommodation for up to 16 adults with learning disabilities; currently there are 12 male residents. The home has extensive grounds with grassed areas, vegetable plots and outbuildings. The service users are extensively involved in the up keep of the garden and growing vegetables. In addition to this they also make birdhouses and other similar items in the workshops. The home is staffed at all times. There are domestic and care staff. The manager and his family live in flats in the property and provide the majority of the care. The registered manager was present throughout the inspection. One of the registered manager’s sons is the deputy manager. Oak House DS0000016516.V303741.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The two inspectors arrived at the property unannounced at 1000hrs and completed the site visit over a period of 4.5 hours. During this time inspectors spoke with the management team and the majority of the service users. A tour of the premises and grounds was completed with the registered manager. All of the key standards were inspected as well as assessing the home’s progress towards meeting the requirements and recommendations of the previous inspection. What the service does well: What has improved since the last inspection? The management team have implemented a new assessment and care plan document that will allow comprehensive assessment of peoples’ needs leading to detailed care plans in the future. New risk assessments for one service user have been completed. Service users meet regularly as a group to discuss what activities and trips they would like to do. Oak House DS0000016516.V303741.R01.S.doc Version 5.2 Page 6 Inspectors saw evidence that the service users were able to access snacks and drinks as they wished. The home’s management team continue to work with the CSCI to improve the service provided by the home. Staff have completed a number of mandatory training courses that aim to minimise the risk to service users and enhance the service provided. Five of the service users’ bedrooms now have door locks that give them the option for increased privacy. The management team have developed self–completion questionnaires for service users and their relatives that ask them for their opinion about the quality of the service. 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 House DS0000016516.V303741.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 House DS0000016516.V303741.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 The home’s management team has produced a Service User’s Guide that meets the criteria of these regulations and each person living at the home has been issued with a copy of the document. EVIDENCE: The manager explained that no new service users have been admitted to the home since the previous inspection. The process completed for any future admissions will be examined by the inspectors. The manager stated, and service users confirmed that since the previous inspection a Service User’s Guide has been issued to each person and a copy of the Guide is kept in the home’s office. Oak House DS0000016516.V303741.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, 9 The care planning system proposed by the management team is comprehensive and based on the principle of service user involvement at each stage. This system must now be implemented for each person. Risk assessments must be completed for all of the service users that empower them to complete tasks while ensuring that risks to their safety are minimised. EVIDENCE: A requirement of the previous inspection related to Standard 6 and care plans for the service users. The home’s management team were required complete the following: 1. Care plans must describe in detail how each service user’s needs are to be met in respect of health and welfare. 2. Include consideration of each person’s activity programme as part of care planning. Oak House DS0000016516.V303741.R01.S.doc Version 5.2 Page 10 3. Include also details of any specialist communication needs and any methods of communication that may be appropriate to the person and details of support required from staff. 4. It was agreed that 50 of these care plans will be completed by the timescale for action. Before the inspection was completed the registered manager contacted the CSCI and asked for an extension to this timescale to the 30/06/06. The CSCI agreed to this. At this inspection the inspectors discussed the management teams progress towards meeting this target. Evidence was seen that progress had been made, although the target date of 30/06/06 not being met. It was agreed with the CSCI that care plans for the 2 service users with the most needs would be completed by 30/06/06 and that through July, August and September care plans will be completed for all of the other service users. Inspectors examined the one care plan that had been completed in the new format. The home hope to implement this format for all of the service users. Inspectors spoke to the management team about this format and the possibility of encompassing elements from another care plan package. The inspectors agreed with this. The service user plan examined by an inspector showed that the management team had assessed the service user’s daily living needs including religious observance, personal safety, personal care and well being, communication, meals and diet, daily living and social activities. These areas are completed by staff with the service users and staff explained that they sat with the service user and let them explain/answer the questions. The document allows for relevant historical information to be recorded if required. The care file examined by the inspector showed that a care management review had been completed in May 2005. The home has been using an advocacy service for a number of months now. At the previous inspection service users had explained the advocates input, and were able to give further examples on this occasion. The CSCI feel that this has been a really positive step by the management team and has allowed the service users to discuss issues confidentially with people outside the home. All of the requirements for standard 6 of the previous inspection report will be carried over as part of this inspection report. The previous inspection report made a number of requirements against standard 7. The management team were required to: Oak House DS0000016516.V303741.R01.S.doc Version 5.2 Page 11 1.Identify the support, which individuals may require with managing their own money. 2.The support, and any agreed limitations with regards to accessing personal money by service users must be documented in care plans. 3.Develop written guidance on what contributions can be sought from the service users. 4.This guidance must recognise that the service users may not be able to make a truly informed choice about paying for other people’s presents. 5.The practice of service users buying presents for staff must be reviewed by the registered providers. Inspectors examined the home’s policy on protection of service users, which highlights safeguards against financial abuse. It identifies that “the home believes that service users keeping their own money and spending it on whatever they want is an important element of maintaining human dignity”. Conversations with service users confirmed that they were able to spend their money on what they wished. At the next inspection the inspectors will examine the home’s progress on meeting the requirements highlighted above. The previous inspection report made a requirement for the management team to review risk assessments to ensure that the strategies minimise risks while still empowering service users, and ensure that all risk assessments are up-todate. The care file examined by the inspector contained risk assessments that met this criteria. Inspectors will assess risk assessments further at the next inspection when the management team have completed all of the service users new assessments and care plans. The management team are reminded to ensure that all of the assessments they complete are signed and dated by the author. Oak House DS0000016516.V303741.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): 12, 13, 15, 16, 17 Statements made by the service users were positive about the activities they are involved in and evidence shows that the staff are actively trying to give service users more control in planning activities. The home continues to make efforts to find other activities available locally and this should provide service users with more choice and opportunities. The service users benefit from wholesome and nutritious diets but opinions were conflicting about whether they have a choice. Service users’ are able to make choices as to whether they have keys for their bedroom doors. EVIDENCE: Service users meet regularly as a group without the staff present to discuss the activities that they wish to complete, and inspectors saw a copy of these Oak House DS0000016516.V303741.R01.S.doc Version 5.2 Page 13 minutes. Inspectors suggested that staff could develop a collection of photos to help the service user choose places that they would like to visit. Outings that the service users wished to be planned included attending; The Monmouth show, skittles, Cribbs causeway shopping centre, Midland Safari Park, Bristol Zoo, Gloucester docks, cinema, Cotswold Farm Park and Longleat. Service users spoke to inspectors about what they had been doing over recent weeks, this included visits to garden Centres (at the time of the inspection service users were just returning from a garden centre with seeds and plants), they had been ten pin bowling, out for meals and the Cinema. One service user attends the local day service and when talking to the inspector he expressed how much he was still enjoying this. At the time of this inspection the football world cup was taking place and the service users spoke about how much they were enjoying it. Service users had a chart up on the wall in the games room which they were completing. The service users were able to watch any game they wished and meals and other activities were delayed or re-arranged to fit around them watching the football. Several of the service users stated that they were going to buy England shirts. The inspectors believe that due to the fact that the majority of service users have lived at the home for many years that they are part of the community. Service users stated that they use the local facilities to do their shopping. The deputy manager stated that they have been trying to find activities locally for service users to be involved in and this must be continued. Inspectors saw evidence of the service users having contact with their families where possible. This ranged form regular contact via the phone/letter to going out for a day with them. Since the previous inspection the home have made significant progress in ensuring that all of the service users have the opportunity to lock their bedroom doors. This was a requirement of the previous inspection (see standards 24 to 30 for a summary of the progress). An ongoing issue for inspectors over recent inspections has been the service users access to snacks and drinks throughout the day. Service users stated that they were able to have snacks when they wished and showed the inspectors the snack cupboard that they have access to. Whilst an inspector was examining a service user’s file they noted that there was a consent form permitting the storage of their clothing in the home’s laundry. This is now in need of review as service users keep their clothes in their bedrooms. Service users choose their meals weekly and meals are chosen depending what is available in the home’s freezer, or store. The manager gave examples of the Oak House DS0000016516.V303741.R01.S.doc Version 5.2 Page 14 service users making individual choices as to what they eat and when they wish to eat it. An example of this was when the service users wished to watch the world cup on television. When the inspectors spoke to the service users about the food provided they said that it was nice and that they have three cooked meals a day. When the inspectors asked service users about the home’s menu they stated that they usually don’t know what is on the menu and one of the other service users lets them know what is for lunch and dinner. This has been an ongoing issue identified by the inspectors at a previous inspection. The manager must make the process of choosing meals more transparent, in addition the inspectors suggest the use of a picture menu displayed in the dining room. Oak House DS0000016516.V303741.R01.S.doc Version 5.2 Page 15 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 home’s medication administration is well managed which minimises the potential risks to the service users of a medication error. Health action plans are being developed currently and will provide other professionals with the necessary information about each of the service users to enable them to provide the appropriate support when necessary. EVIDENCE: The previous inspection report made a requirement that the manager must maintain a record of any seizures, and guidelines must be developed for staff to follow when managing a service user’s seizures. This has been completed and the inspectors were able to see positive comments by a Community Nurse involved with the service users at the home. Records showed that service users have attended recent appointments with Dentists, Chiropodists and GPs. At present all of the service users’ needs are being assessed by the local Community Learning Disability Team. Oak House DS0000016516.V303741.R01.S.doc Version 5.2 Page 16 The previous inspection report made a requirement for the manager to ensure that any accident is recorded correctly. Examination of records since the previous inspection showed that this is being done now. The home has moved to using blister pack medication since the previous inspection. Examination of the medication administration showed that is was managed correctly. The manager stated that it is the intention that the staff team will complete medication training in the coming months. Inspectors saw evidence that in the service user’s file that they had been asked to consent to receiving their medication. The inspectors will expect to see this in other service users’ files when they have been completed. Oak House DS0000016516.V303741.R01.S.doc Version 5.2 Page 17 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 complaints procedure is in need of updating to provide the service users with accurate information if they wished to make a complaint. Completion of adult protection training will raise the staffs’ awareness of these issues and minimise risks to the service users. The continuing use of an independent advocate to support the service users should enable them to voice their views and concerns. EVIDENCE: The home has a complaints procedure. Examination of the complaints procedure showed that it was in need of review. The reference to the NCSC should be changed to the CSCI and the contact details should be that of the person who would investigate the complaint in the home. Service users explained that they felt that they could make a complaint if they were unhappy about anything. No complaints have been made since the previous inspection and the home continue to make use of an independent advocate to support the service users to make choices where it is required. The manager explained that they are organising adult protection training for the staff team. This training will be completed with the Gloucestershire Adult Protection team and the manager is awaiting a date to complete this. The inspectors have advised the manager to obtain a copy of the “Alerter’s Guide”. Oak House DS0000016516.V303741.R01.S.doc Version 5.2 Page 18 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, 30 The home is clean, hygienic and maintained to a high standard throughout minimising risks to service users. The management team continue to make adaptations to the environment that will enhance peoples’ privacy, choice and independence. EVIDENCE: The home was cleaned to a high standard throughout. The building is maintained to a high standard throughout and provides the service users with ample communal space. On the ground floor there is a large lounge with a television, DVD player, stereo and games computer. There is a separate dining room sited near the kitchen. There is a games room that service users were using to complete different activities. On the first floor there is another lounge with a television. The furniture provided in the communal areas is of good quality and in a good state of repair. One of the inspectors completed a tour of the building and grounds with the registered manager. The home is sited in extensive grounds and the inspector was shown different areas that have been created by the service users. This included a raised bed area created for a service user who wished to do some Oak House DS0000016516.V303741.R01.S.doc Version 5.2 Page 19 gardening but was unable to due to their mobility. Another service user has created a wild garden at the front of the property and they spoke to the inspectors about how much they enjoyed this. Since the previous inspection new iron railings have been fitted in the rear garden and up and down the steps. The inspector noted that one step leading down from the service user’s raised flowerbed is in need of replacing; the manager stated that this would be addressed. The home grows a lot of vegetables and fruit and the manager explained that a lot of the soft fruit and currants are made into jams and drinks by the staff and service users. The service user make use of workshops across the site where they make bird boxes, etc. Inspectors have commented previously about the lighting in these areas and since the previous inspection additional lighting has been fitted. Whilst completing the tour of the building the manager pointed out a number of improvements since the previous inspection. This included a new sluice in the laundry and five of the service users bedroom doors now being fitted with locks. The inspector spoke to the manager about the door locks. They explained that each of the service users has been offered keys, but as yet none of them have wanted keys. Two service users who are having locks on their bedrooms in the near future have stated that they wish to have keys. The door locks are very good in that when a service user closes their door other people are unable to open the door from the outside. Service users are able to get out of the room by just turning the handle, no keys are required. The inspectors feel this is good and promotes privacy for the service users although they might not be able to, or want a key. Where service users share bedrooms they are provided with privacy screens to use at their discretion. Inspectors spoke to one service user who used to share a bedroom. He stated that he “really likes having his own bedroom”. A previous inspection report has made a requirement for a bedroom without a window to be fitted with a skylight. The manager explained that the local planning department would have made a decision about this by August and a skylight will hopefully be fitted after this. The inspector visited all of the service users bedrooms. The registered manager was seen to be respectful to the service users asking them if we could enter the bedrooms and knocking on each door. Since an inspection completed in November 2005 all of the bedrooms appear a lot more personalised with pictures, personal possessions and colour schemes. An issue raised as a result of the inspection completed in November 2005 related to the limited number of clothes that the service users were keeping in their bedrooms. The home has now addressed this with service users keeping the Oak House DS0000016516.V303741.R01.S.doc Version 5.2 Page 20 majority of their clothes in their bedrooms. The manager stated that some clothes are still kept in the laundry, but this will be addressed. All of the bedrooms have been fitted with additional electrical sockets since the previous inspection. All of the occupied service users bedrooms that used to have clear glass in the window frames of the dividing walls have now got frosted/ or painted glass to provide more privacy. The manager has stated that when any new service user moves they will be given the choice as to what they would like. Either frosted/painted glass or the windows removed. As identified in previous inspection reports the manager must provide the CSCI with a timescale for when all of the windows between the bedrooms will be removed. Oak House DS0000016516.V303741.R01.S.doc Version 5.2 Page 21 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): 32, 34, 35 The staff team have completed a number of training courses covering the mandatory topics required by these standards, which in turn will improve the service provided at the home. EVIDENCE: No new staff have been employed by the home since the previous inspection. Since the previous inspection staff have completed a number of training courses. These include courses in risk assessment, manual handling, first aid, fire safety, ageing, best interest and consent and a member of the management team recently attended training in employment law. In conversation with the management team inspectors were informed that the deputy manager intends to start their registered manager’s award in Cheltenham in Gloucester. Other staff members are currently completing their NVQ’s. One NVQ level 2 was being verified at the time of this inspection, whilst two other staff were in the process of completing their NVQ’s at level 2. Oak House DS0000016516.V303741.R01.S.doc Version 5.2 Page 22 The inspectors were informed that training with a specialised consultant is planned which will be based on induction/foundation/TOPSS and LDAF. The inspectors require clarification as to the nature of these plans with the timescales for their implementation. Oak House DS0000016516.V303741.R01.S.doc Version 5.2 Page 23 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, 39, 42 The management team are committed to improving their practices and the quality of life for the service users. The management team are surveying both the service users and their relatives to ascertain more information about the service they provide with the aim of identifying areas weakness in which they need to improve. Also enabling them to identify what they do well. The management team minimises the risk to service users whilst they are in the home by completing various audits. EVIDENCE: As highlighted previously in this report the home is maintained to a high standard throughout. The inspectors believe that it is important to recognise that although at present this home does not meet all of the minimum standards the CSCI recognise the amount of work completed by the management and staff team to improve the standard of care provided by the Oak House DS0000016516.V303741.R01.S.doc Version 5.2 Page 24 home. Therefore the way in which the home is run has improved since November 2005. The improvement highlighted above involves using other professionals and organisations when completing assessments of service users needs and providing training across a wide range of topics. The home use a set of specialised manuals provided by a professional care organisation. They send the home regular updates explaining any changes to the law and approaches that are relevant to the care industry. The inspector informed the deputy manager that the home’s policies are in need of review and a number of them are “too generic” and in need of personalising for the home. The previous inspection report made a requirement to ensure that a robust risk assessment was developed to ensure that service user remain safe during power failures. At this inspection inspectors were able to examine a policy that meets this criteria. Since the previous inspection the management team have conducted a self completion survey of the relatives of the service users. At the time of this inspection the management team were awaiting their results. As part of this inspection process the CSCI sent questionnaires to relatives and other professionals involved with the service users at the home. All of the questionnaires received from service users relatives were really positive and included comments like “extremely well cared for” and “happy there”. The inspectors will examine the responses to the questionnaires received by the home at the next inspection. The management team has also developed questionnaires for the service users to complete. The inspectors suggested that the use of pictures/photos might make the document more user friendly. The inspectors examined the testing/checking of the home’s fire equipment. All equipment was seen to be checked as required by the regulations. In addition to this a fire risk assessment has been completed which is reviewed annually. A health and safety audit has been completed. Oak House DS0000016516.V303741.R01.S.doc Version 5.2 Page 25 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 X 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 2 23 2 ENVIRONMENT Standard No Score 24 3 25 2 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 1 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 2 14 X 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X X X 3 X X 3 X Oak House DS0000016516.V303741.R01.S.doc Version 5.2 Page 26 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 YA6 Regulation 12, 15, 16 and 17 Requirement Care plans must describe in detail how each service user’s needs are to be met in respect of health and welfare. Include consideration of each person’s activity programme as part of care planning. Include also details of any specialist communication needs and any methods of communication that may be appropriate to the person and details of support required from staff. The manager must ensure that as agreed with the CSCI that care plans for the 2 service users with the most needs will be completed by 30/06/06 and that through July, August and September, etc care plans will be completed for all of the other service users. 2. YA7 12 and 15 Identify the support which individuals may require with DS0000016516.V303741.R01.S.doc Timescale for action 29/09/06 29/09/06 Oak House Version 5.2 Page 27 managing their own money. This support and any agreed limitations with regards to accessing personal money by service users must be documented in care plans. 3. YA7 13(6) Develop written guidance on what contributions can be sought from the service users. This guidance must recognise that the service users may not be able to make a truly informed choice about paying for other people’s presents. 29/09/06 4. YA7 13(6) The practice of service users buying presents for staff must be reviewed by the registered providers. 29/09/06 5. YA9 13(4)(b)(c) Risk assessments must be revised to ensure that the strategies minimise risks while still empowering service users and that all risk assessments are up-to-date. 29/09/06 6. YA13 16(2)(m, n) 7. YA18 15 8. YA24 23(2)(b) The manager and his team must continue to identify activities within the local community that can be offered to the service users. The manager must ensure that each service user has a care plan to address their personal care requirements. The manager must ensure that DS0000016516.V303741.R01.S.doc 29/09/06 29/09/06 18/08/06 Page 28 Oak House Version 5.2 9. YA25 23(2) (p) the step in the garden that is identified in the report is replaced so it does not pose a health and safety risk. Provide a skylight window in the bedroom which has no external windows. Provide an action plan with timescales for when the home intends to block internal window openings in bedrooms. The manager must review the home’s procedures to ensure that they are up to date and accurate. 29/09/06 10. YA26 12 01/09/06 11. YA39 24 29/09/06 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. Refer to Standard YA17 YA35 YA17 Good Practice Recommendations A referral should be made to the speech and language therapist to assess the person’s eating and drinking in view of perceived concerns about choking. The manager should inform the CSCI of the induction training to be completed with the staff by the home’s care consultant. A picture menu should be displayed in the dining room. The manager should make the way in which service users choose their meals more transparent. The service users should be enabled to manage their own finances. The possibility of people having savings accounts should be explored. The manager should review the home’s complaints procedure. The manager should obtain a copy of the “Alerter’s guide” from the Gloucestershire Adult Protection Team. DS0000016516.V303741.R01.S.doc Version 5.2 Page 29 4. YA7 5. 6. YA22 YA23 Oak House Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Oak House DS0000016516.V303741.R01.S.doc Version 5.2 Page 30 - 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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