Inspection on 03/05/06 for Oak House

This inspection was carried out on 3rd May 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

CARE HOME ADULTS 18-65 Oak House 193 Weald Drive Furnace Green Crawley West Sussex RH10 6NZ Lead Inspector Mrs M McCourt Unannounced Inspection 3rd May 2006 11:20 Oak House DS0000066064.V289835.R01.S.doc Version 5.1 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 DS0000066064.V289835.R01.S.doc Version 5.1 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 DS0000066064.V289835.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Oak House Address 193 Weald Drive Furnace Green Crawley West Sussex RH10 6NZ 01293 885469 01293 885469 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) Evesleigh Care Homes Limited Mrs Janet Warburton Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Oak House DS0000066064.V289835.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: A maximum of 4 service users in the categories listed above may be accommodated at any one time. Date of last inspection New registration Brief Description of the Service: Oak House is a care home registered to accommodate up to four Service Users with learning disabilities. The Registered Provider is Evesleigh Care Homes Ltd and the Registered Manager is Ms Janet Warburton. The current scale of monthly charges ranges from £1,092 to £1,909. This information was provided on the pre-inspection questionnaire. Additional charges are made for personal items, such as; toiletries, clothing and so on. The home is a semi-detached property, situated on the outskirts of Crawley town, and therefore has access to all community facilities and is within easy reach of local rail and bus stations. Accommodation is provided over two floors. Each resident has their own bedroom, with a bedroom located on the ground floor, and the remaining three rooms on the first floor. On the ground floor there is a living room, an activity room and a large kitchen that includes a dining area. In addition the home has a garden with lawn and decking to the rear of the property. The Service Users Guide and Statement of Purpose, which incorporates inspection reports, are both located at the home and are accessible to Service Users, staff, relatives and anyone else interested in the service. Oak House DS0000066064.V289835.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection was undertaken by two Inspectors on Wednesday 3rd May 2006 and lasted a total of four and a half hours. Preinspection planning took approximately two days. A full tour of the building took place and included the observation of Health and Safety matters, hygiene issues, decorative order and a general overview of the atmosphere created within the home. Two staff members, three resident(s), and the Registered Manager were spoken to at the time of inspection. Following the site visit the Inspector spoke with a relative of one of the Service Users. Case tracking was carried out by examination of relevant records and information held on the staff and residents spoken with during the course of the inspection. The overall outcome for Service Users was good. What the service does well: Service Users are assisted to access the local community and take part in a wide range of activities. Individual hobbies and interests are encouraged and Service Users are supported to attend college, workshops and specific classes to enhance learning and daily living skills. In addition Service Users have annual holidays and in recent years have visited places like Centreparcs, Butlins and Spain. The home incorporates a good example of reviewing and care planning that is tailored to individual needs and requirements. The accommodation for service users is of a high standard. The home is well decorated and furnished in a comfortable, bright and homely way. Service user’s rooms have been personalised with their own belongings and choice of colour schemes. Staff access a wide range of training from induction through to National Vocational Qualifications level 2 & 3. Specific training in topics relevant to the needs of the service users is offered and staff that mandatory training is regularly updated. Oak House DS0000066064.V289835.R01.S.doc Version 5.1 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 House DS0000066064.V289835.R01.S.doc Version 5.1 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 DS0000066064.V289835.R01.S.doc Version 5.1 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): 2 The outcome for Service Users was found to be good. Service Users are consulted about where they choose to live prior to moving, and are certain that the home will meet their individual needs. EVIDENCE: A Trial Visits Policy is in place at the home that gives guidance on the step-bystep procedure to follow for prospective Service Users. The process for introducing someone to the home includes; tea visits, overnight and weekend stays, followed by reviews to confirm the appropriateness of the placement. West Sussex County Council pre-admissions assessments were contained within individual personal files. Two personal files were examined and found to contain contracts, which had been signed by the Service User. In addition it showed the fee charged, the room number and which authority is funding the placement. The Inspector spoke with one of the residents who said that before she came to live at Oak House she came to visit with her mum. Her room was painted and she was able to put her own personal belongings into the room. Oak House DS0000066064.V289835.R01.S.doc Version 5.1 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 and 9 The outcome for Service Users was found to be good. Service Users needs and personal goals are reflected in their care plans. Service Users are assisted to make decisions about their own lives, which includes taking responsible risks. EVIDENCE: The Inspector examined personal files for Service Users. Each file contained a contract of care, financial information, a personal profile, medical notes, dental records, psychiatric/psychology reports, funeral wishes, behaviour charts, sleep charts, weight charts, and so on. Monthly reports look at all aspects of care and are carried out by allocated keyworkers. Review reports, held recently were comprehensive. The files also Oak House DS0000066064.V289835.R01.S.doc Version 5.1 Page 10 include the Activity Workshop’s own detailed reports, which describe various activities attended by the Service User. Minutes of review meetings show that the meetings are inclusive of health care professionals, relatives/family members, Service Users, staff and Care managers. One Service User spoken with said that she remembers going to her review. Risk assessments are in place for specific and general Health & Safety issues and are reviewed on a regular basis. Discussions with Service Users confirmed that with guidance and support from the staff in some areas they are able to make decisions about their life and to take risks as part of achieving an independent lifestyle. However, it was noted that the home locks certain types of food in a cupboard to ensure that Service Users don’t eat too much of what was described as unhealthy food. The issue was discussed with the Registered Manager and it was explained that the approach used by the home to address the problem is to the detriment of residents. Also it was noted that there is no reference to it in the Service User’s care plan. Oak House DS0000066064.V289835.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 The outcome for Service Users was found to be excellent. Service Users are able to take part in a range of appropriate activities within the local community. Service Users are supported with family relationships and guided to develop personal friendships. Meals are varied and nutritious. EVIDENCE: Personal files show how Service Users are assisted to access the local community and take part in relevant activities. Personal likes and dislikes are recorded and goal planning works towards specific achievements for individuals. Oak House DS0000066064.V289835.R01.S.doc Version 5.1 Page 12 The Registered Manager told the Inspectors that Service Users have annual holidays and in recent years have visited places like Centreparcs, Butlins and Spain. The home is hoping to go abroad again next year. This year’s holidays will be low key in order to plan for next year’s trip abroad. The home does have access to a vehicle, but it was noted that if all of the Service Users wanted to enjoy a trip out together, it was not currently possible due to one of the residents requiring a wheelchair. Activity plans for individual Service Users are on display. These show weekly programmes, including; Art & Crafts, College, music and so on. One Service User spoken with said that she had been at Cookery class earlier that same day. On Monday’s she attends an outreach project where she is supported to learn gardening skills. On Thursdays she goes to the Workshop and learns sewing and picture making. The Inspector was shown the various pictures and paintings that are done at these classes. The service user also said that she likes living at Oak House and is enjoying her new pottery course. Staff were observed interacting with Service Users throughout the day and this included playing board games and assistance with everyday tasks. The Inspector was told that residents help with gardening and recently planted new pots and baskets in the outside garden. Menu sheets were looked at. Meals are varied and balanced. A Service User spoken with said that the food at Oak House is great. Oak House DS0000066064.V289835.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 The outcome for Service Users was found to be good. Service Users receive personal support in an appropriate manner and suited to individual need. The home is able to provide physical and emotional care to individuals. Policies and procedures are in place to ensure the correct administration of medication. EVIDENCE: Personal records show details of healthcare appointments and include the names and addresses of relevant professionals involved in individual care. In addition the files detail funeral wishes, behaviour charts, sleep charts, weight charts, menstruation charts and so on. Staff and Service Users also have access to the Community Team for People with Learning Disabilities to assist with additional support and advice when required. Oak House DS0000066064.V289835.R01.S.doc Version 5.1 Page 14 A medical checklist on personal files shows when the next health appointment is due. However, it has not been filled in since August 2005. The Registered Manager said appointments are being put into a diary instead and this system works better. The Inspector suggested that the home review the document. Reports from various health professionals were seen and were up to date. Monthly reports are carried out and incorporate behaviour, health, medication, dental, chiropody, weight, etc and are have been filled in consistently. Annual reports are in place and cover health, activities, medication, behaviour, communication, finances, personal care and relationships. Goal planning with progress report sheets are up-to-date and include activities such as; attending the gym, cake making, preparing own meals, carrying out laundry duties, cleaning own room, cleaning out pet animals and so on. Service Users care plans were in place and up-to-date. They include all aspects of care and a section called Assessment and Management of Risk lists the various risks identified for the individual concerned. It is very detailed and comprehensive and was last reviewed in December 2005. There is some evidence to suggest that a suitable vehicle is required in order to cater for wheelchairs. It should enable staff to be able to put the wheelchair in and out of the car, ensuring enough room for everyone else to sit comfortably. This is not the case at the moment, therefore restricting the possibility of all four Service Users going out together. Medication is stored appropriately in a locked cupboard. MAR sheets were all signed and up-to-date. A record of signatures shows that staff’s administration of medication is checked by a second member of staff. There seems to be confusion around the company’s policy on this and needs some clarification. The matter was discussed with the Registered Manager who has agreed to address it. A medication review form was out of date. According to the document, medication has not been reviewed since July 2004. Oak House DS0000066064.V289835.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The outcome for Service Users was found to be good Improvements could be made in enabling service users to express their concerns or complaints. Systems are in place to protect Service Users from abuse, neglect and selfharm. EVIDENCE: A missing persons policy is in place, with quick reference information on personal files. The Commission has not received any complaints in respect of this service. The Registered Manager informed the Inspectors that there have been no complaints made to the home. The Complaints record was not available at the time of inspection. There is a complaints policy and procedure in place. Members of staff spoken with confirmed that they felt that service users were able to voice their concerns or members of staff would observe behaviour that indicated they were unhappy. In order to enable service users further to voice concerns or complaints the complaints procedure could be developed into a format that is suitable for the needs of the service users. Other ways for service users to indicate that they wish to make a complaint could be explored and put in place. Oak House DS0000066064.V289835.R01.S.doc Version 5.1 Page 16 Records examined during the inspection demonstrated that all staff had received training in recognising signs of abuse and how to report any concern. Members of staff spoken with confirmed they had received training in dealing with challenging behaviour and this gave them sufficient information and guidance to enable them to work with the service users accommodated. Members of staff confirmed that physical restraint is not required or used in this setting. It was noted that members of staff have access to the Department of Health’s Guidance on Physical Intervention for People with a Learning Difficulty. The Registered Manager explained to the Inspectors the system for managing service users finances. Members of staff support service users with managing their personal allowance only and appropriate records are kept. Each service user has a Bank or Building Society account. There have been some problems with the home’s weekly expenditure allowance. The Registered Manager told the inspector that cheques are not arriving on time and this has happened twice in the past. She said that the problem has been that there was no one available at Head Office to sign cheques. Oak House DS0000066064.V289835.R01.S.doc Version 5.1 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 and 30 The outcome for Service Users was found to be excellent. The home is clean, bright and in good decorative order throughout. Service Users live in a comfortable and safe environment. EVIDENCE: A tour of the premises was undertaken and records in relation to the safety of the property examined. The accommodation for service users is of a high standard. It is well decorated and furnished in a comfortable, bright and homely way. Service user rooms are suitable for each service users’ needs and have been personalised with their own belongings and choice of colour schemes. Two out of the four rooms have en-suite facilities. Service users’ privacy is respected and where able service users lock their bedroom doors and hold the keys. It was noted that there is suitable and sufficient equipment for service users needs. There is a good amount of shared space that includes a lounge, large kitchen with breakfast bar, dining room and conservatory. There is a fairly large garden at the rear of the property that is accessible and safe. The exterior of Oak House DS0000066064.V289835.R01.S.doc Version 5.1 Page 18 the property is well maintained. The staff are able to access a maintenance person for general repair and upkeep of the home. Records examined demonstrated that safety checks on the property and utilities are regularly undertaken and comply with safety legislation. Oak House DS0000066064.V289835.R01.S.doc Version 5.1 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): 32, 34 and 35 The outcome for Service Users was found to be good. A competent and qualified staff team is appropriately trained to meet the individual needs of Service Users. Recruitment policies and procedures are in place to ensure Service Users are protected from harm. EVIDENCE: All staffing records including training records were examined during the inspection. Training records demonstrated that all staff had undertaken a wide range of training from induction through to National Vocational Qualifications level 2 & 3. Training in Health & Safety topics had been undertaken at induction and updated as required. Specific training in topics relevant to the needs of the service users had also been undertaken. Members of staff confirmed that this training had been provided and that updates in Health & Safety topics have commenced. Oak House DS0000066064.V289835.R01.S.doc Version 5.1 Page 20 The records demonstrated that the Registered Manager follows a robust recruitment procedure and all members of staff have had Criminal Record Checks undertaken. Members of staff confirmed that the staffing levels in the home are sufficient to meet the needs of the service users within the home and to take them out to their individual activities. Staffing records demonstrated that the staff team have remained stable for several years and only members of the organisations bank team are used to cover vacant hours. Records demonstrated that all staff have received regular supervision and have had an annual appraisal at the end of last year. Records are kept of regular staff meetings. Members of staff spoken with confirmed that they receive regular supervision and staff meetings are usually held on a monthly basis. Oak House DS0000066064.V289835.R01.S.doc Version 5.1 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, 39 and 42 The outcome for Service Users was found to be good. Service Users benefit from a well run home, and are confident that their views form the basis for self-monitoring and development by the home. Service Users are protected by Health & Safety policies and procedures. EVIDENCE: The Registered Manager is Janet Warburton who has worked as the manager of Oak House for three years. Prior to that she was a senior member of staff. She has over twelve years experience of working with people with learning difficulties and has obtained her NVQ level 4 and the Registered Manager’s Award. Records demonstrated and members of staff spoken with confirmed that training in the Health & Safety topics: Moving & Handling, First Aid, Food Oak House DS0000066064.V289835.R01.S.doc Version 5.1 Page 22 Hygiene, Fire and Health & safety is undertaken as part of their induction programme and then updated as required. Health and safety procedures are on display within the home, including the 1st aid appointed person. Records seen on the day of the inspection indicate that annual safety inspections are undertaken on equipment and utility supplies. Maintenance systems are in place to ensure the safety of residents. Risk assessments had been undertaken in respect of potential risks to staff or service users when using kitchen equipment for example and other hazards within the home. There is a current liability insurance certificate for the home. Policies and procedures have all been reviewed in April 2006. A notice on the policy files states that all policies are now reviewed by a central policy and procedure forum. Home managers must also review the policies and procedures every six months. Oak House DS0000066064.V289835.R01.S.doc Version 5.1 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 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 4 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 4 13 4 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 2 x x 3 x Oak House DS0000066064.V289835.R01.S.doc Version 5.1 Page 24 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Oak House DS0000066064.V289835.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 DS0000066064.V289835.R01.S.doc Version 5.1 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!