Inspection on 22/04/05 for Oak House Residential Care Home

This inspection was carried out on 22nd April 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Oak House Residential Care Home 21/10/09

Oak House Residential Care Home 03/05/07

Oak House Residential Care Home 16/08/06

Oak House Residential Care Home 27/09/05

Oak House Residential Care Home 22/11/04

Oak House Residential Care Home 05/05/04

Oak House Residential Care Home 23/07/02

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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 56 Surrenden Road Brighton East Sussex BN1 6PS Lead Inspector Jane Jewell Announced 22 April 2005 12:00 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 House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Oak House Address 56 Surrenden Road Brighton East Sussex BN1 6PS 01273 500785 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) Mr Anthony David Sargent Janice Ford Care Home 14 Category(ies) of Learning Disability (LD) 14 registration, with number of places Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of service users to be accommodated is fourteen (14). 2. Service users must be aged between eighteen (18) and sixty-five (65) years on admission. 3. Service users with a learning disability only to be accommodated. 4. That one named service user may be over sixty-five (65) years on admission. Date of last inspection 22 November 2004 Brief Description of the Service: Oak House is a privately owned Victorian semi detached house providing residential care for up to fifteen adults who have mild to moderate learning disabilities. The providers have owned the home for 25 years. The home is located in a residential area on the outskirts of Brighton, close to Preston park, local amenities and bus routes into Brighton. Placements are generally long term, with many residents having lived at the home for many years. The home works closely with the Grace Eyre Foundation and accesses many of the services offered by them including day care provision. The home is presented over three floors, ground, first and second floor. Resident accommodation consists of ten single and two shared bedrooms. Communal facilities include a sitting room, lounge diner and rear garden. Stairs and other access arrangements would make it unsuitable for residents with significantly restricted mobility. The homes literature states that one of its aims is to provide residents with a comfortable and happy home suited to residents own special requirements. Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced routine inspection, which took place between 12pm and 5.30pm. On the day of the inspection there were thirteen residents living at the home. The inspection involved a tour of the premises, examination of the homes records, discussion with management, consultation with four staff and ten residents. The inspector received fourteen feedback cards from residents and relatives on their views of the home. The focus of the inspection was on the quality of life for people who live at the home. In order that a balanced and thorough view of the home is obtained, this inspection report should to be read in conjunction with the previous inspection reports. The Inspector would like to thank the residents, staff and management for their hospitality and assistance during the inspection. What the service does well: What has improved since the last inspection? Many of the areas of concern noted during previous inspections have been addressed. Action is in place to ensure that those areas not yet fully met are done so in the near future. Standards of care planning continues to improve to enable staff to be aware of the care and support needs of each resident. Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 Page 6 Improvements made to the recruitment practices ensure that residents are protected from unsuitable staff being employed. Increased resident participation in the day to day decisions about life at the home and in making personal choices supports residents individuality and control over aspects of their life. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 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 House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 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) 1,2,3 and 5 The home provides both prospective and existing residents, with a good level of information about services at the home. This supports prospective residents and their representatives to make informed decisions about the home. Residents are only accommodated if the home is satisfied that they can meet their needs. The home is meeting the needs of most residents. EVIDENCE: There is a range of well documented information about the home and the services it provides, this includes a statement of purpose and service user guide. This has been provided to prospective residents, social services and partnership agencies. There have been no new admissions to the home since the last inspection. However, in line with previous requirements the homes needs assessment documentation has been adapted to include more information on the needs of prospective residents to enable the manager to make a more informed decision as to whether needs can be met at the home. An important part of the admission criteria is the compatibility with current residents. Applications may be turned down if it were felt that that needs could not be met, or that the impact of the new individual on the established resident group would compromise the needs and welfare of all. Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 Page 9 Residents accommodated have mild to moderate learning disabilities. Placements are long term, and it has evolved that the age of the established resident group is, in the main, above 40 years and female. This includes some who are over 65 years old. The home has geared its services accordingly. Residents appeared settled and were relaxed about approaching staff for help or to engage in conversation. There was appropriate evidence available to confirm that the home meets the assessed needs of residents. This is evidenced through regularly reviews, care planning documentation, and working closely with health care professionals to support each placement. One resident has an advocate with many other residents waiting to be assigned one. Four residents have recently joined a local speak out group. Contracts are agreed between the home and the placing agency with each contract being specific to both the agency and the resident’s particular needs. Alongside this formal contract there is a separate statement of terms and conditions of residency. This is used with residents and their families to make explicit the placement arrangements, and to clarify mutual expectations around rights and responsibilities. Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 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 standard(s) 6,7,8,9 and 10 Care plans were generally found to be relevant and comprehensive, providing staff with a framework for a good standard of care. Not all risks faced by residents are identified. Integral to the ethos of the home is ensuring and respecting resident’s rights to make decisions and that generally there are no specific limits. Services are generally designed to provide appropriate care and support in ways, which maximise independence and choice for residents. EVIDENCE: Comprehensive care planning documentation has been implemented. This has been developed in conjunction with the home by a management consultancy. Information is gathered about residents and recorded in various documents, which make up the care plan. Four care plans were sampled and these generally provided a good framework to guide staff in their work with residents. Guidance on managing challenging behaviour and personal care needs were particularly noted by the inspector as providing a very good standard of information for staff. Care plans are reviewed by the manager every two months, and changes in needs, noted by the inspector, had been identified in the care plans sampled. Notwithstanding this it was discussed that care plans should be reviewed more Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 Page 11 regularly to ensure that changes in needs and preferences are promptly identified. No resident consulted was aware of his or her care plan, despite the vast majority of care plans being signed by the individual. Some residents stated that they were not interested in being involved in their care plan where others wanted to know what was written about them. The manager was aware that the next step of implementing the new care planning documentation is for residents to be more actively involved in the review of their care plans. In line with previous recommendations the system for daily recording has been reviewed to ensure that accurate, relevant, none judgmental information is only recorded. Staff were observed to encouraged residents to make informed decisions and choices, according to their abilities and understanding. Residents are involved in some day to day decisions about life in the home. This included what activities were being undertaken and aspects of communal living. The home tries to balance the rights of residents, who may at times present risk to themselves and others. Core risk assessments are undertaken which cover areas of potential risk, which include: hot water, challenging behaviour and the environment. Guidance is provided on how identified risks should be managed. Risk assessments sampled had not all been regularly reviewed and updated and this resulted in the changes in needs of a resident now independently bathing not being assessed. This placed them at potential risk, as hot water was delivered in excess of a safe temperature. Risks faced by one residents self administering medication had also not been identified. Staff demonstrated a good understanding of their responsibilities towards maintaining resident’s confidentiality. Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 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 standard(s) 11,12,13,14,15,16 and 17 Residents are provided with opportunities to maintain and develop skills, within the constraints of their individual needs, likes and dislikes. Resident’s preferences in regard to food, going to bed, rising and bathing are taken into account. Residents have been enabled to develop individually and in accordance with their personalities. EVIDENCE: None of the residents are in formal education or employment. However, the majority attend local day centres, which specialise in the needs of older people and where they are offered a range of opportunities for informal education and occupation. Where residents have made a choice not to attend day services this has been respected by the home and alternative arrangements made for personal development and occupation. All residents consulted felt suitably occupied during the day. Staff continue to show an understanding of the needs of older residents to have appropriate relaxation time, and age appropriate activities and occupation. Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 Page 13 There are strong links with day centres and residents attend a range of social clubs within the local community. Residents spoke of how important these clubs were to meeting their friends and having fun. Outings are usually undertaken at the weekend when the staffing levels enable these trips to occur. This involves small groups going shopping for personal items. Residents spoke of taking it in turns to go on these trips, which they felt was every other weekend and that this was sufficient when combined with the other activities they undertook. During the week, leisure activities are mainly based at the home with residents saying these include watching television, board games, karaoke, craft and music for health and beauty sessions. The home has its own transport, which is used mainly for medical appointments with taxis and public transport mainly used for outings. Three residents spoke of how important it was to see their friends and family regularly and staff spoke of how they have helped residents to maintain these links through supporting them to visit their family, regular phone calls and visitors to the home. One resident has recently had a friend for tea. The manager is sensitive to the potential vulnerability of residents when entering into intimate relationships, and mindful of issues around informed consent and adult protection. Some residents have set routines, which have been determined by themselves and is important to their well being. For others daily routines are flexible with residents stating that they determine when they go to bed and get up. Others stated that they have a regular bath time but can request a different time if they wanted. During the inspection residents were observed to move around the home freely, choosing which rooms to be in and what level of company they wanted to enjoy. All meals are cooked and prepared by care staff as part of their duties. The day’s menu is now displayed in pictures to promote choice and orientation. Records indicated that a fairly traditional menu is provided with residents stating that they always liked the food provided. Some residents are involved in clearing and setting tables. The Kitchen was well-equipped and provided suitable facilities for catering, it was seen to be clean and well organised. In line with previous requirements the kitchen has been risk assessed to determine the safety measure necessary to limit access to the kitchen while meals are being cooked. Residents are instructed not to enter the kitchen during the preparation of meals and this was observed by the inspector to be followed by residents. Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 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 standard(s) 18,19 and 20 Sensitive and flexible support is provided to residents to ensure that their personal and medical needs are met. Residents are assisted to choose their own clothes, hairstyles and to ensure this reflects their individual personalities. The system for the administration of medication are generally good with clear and comprehensive arrangement being in place to ensure residents medication needs are met. EVIDENCE: The majority of residents do not require direct personal care. Instead, staff prompt and encourage residents to maintain their personal appearance. Staff were knowledgeable about the support needs and preferences of residents. Residents consulted felt that the support provided was appropriate and which respected their privacy and dignity. Residents spoke of buying clothes that they chose and felt were fashionable. A keyworker system is still being developed in order to support the continuity of care provided. In line with previous requirements guidance on the keyworking role has been developed and discussed with staff. However, not all residents consulted knew the name of their keyworker or what this role involved for them. Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 Page 15 Residents care plans include details of their health needs and the steps to be taken to manage them. The home works closely with health care professionals including GP’s, District Nurses, chiropodists, opticians and dentists to ensure residents receive the necessary health care intervention. Residents stated that when they have felt unwell and wanted to see a Doctor then this has been organised by the staff promptly. Support is given to attend appointments and staff accompany residents into the consultations only upon the invitation of the resident. Written guidance is available on the safe handling and storage of medication. Actions in relation to medicines movement such as orders, receipts, administration and disposal are recorded. Clear guidelines have been established on the administration of PRN medication, which make clear the individual requirements for when these medications are prescribed. Staff who administer medication are in the process of undergone medication training. The home has an established relationship with the pharmacy used and is able to obtain advice and support when needed. The supplying pharmacist also undertakes a quarterly monitoring visit to the home to audit their medication practices. One example was noted whereby a risk assessment had not been undertaken to determine and manage any risks faced by a resident who self administers a medicine. Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 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 standard(s) 22 and 23 The home has a good system for dealing with complaints and concerns raised. There are procedures and practices in place that supports the protection of vulnerable adults. EVIDENCE: The home has an accessible complaints procedure for residents, their representative and staff to follow should they be unhappy with any aspect of the service. There have been no recorded complaints received by the home or the CSCI since the last inspection. In addition to the formal complaints procedure residents have raised concerns regarding aspects of communal living during residents meetings. Clear records were maintained of how these concerns had been addressed promptly and sensitively. Residents stated that they felt able to tell the manager or staff directly if they were unhappy with anything. There are policies on adult protection and whistle blowing which make clear the vulnerability of people in residential care, and the duty of staff to report any concerns they may have to a responsible authority for investigation. In addition, a staff handbook provides guidance on types of abuse and what to do if abuse is suspected. Staff have recently undertaken training in adult protection and showed an understanding of adult protection issues. The manager reported that they are due to also undertake this training in the near future. Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 Page 17 There are also policies and procedures on the management of aggression towards staff, staff receiving gifts and the management of personal allowances. Records and accounts are maintained of all expenditure made on behalf of residents. Various arrangements are in place for the distribution of personal allowances depending upon individual needs with clear records and receipts maintained of any expenditure. Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 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 standard(s) 24,25,26,27,28, 29 and 30 The premises are comfortable, clean and well maintained with appropriate domestic style furnishing, fixtures and fittings. The overall decor and furnishings were particularly noted to be of good quality, and reflective of the age and gender of residents. EVIDENCE: Since the previous inspection the home has undergone further upgrade and redecoration to ensure that the environmental standards remain high. This includes redecoration of some communal areas, bedrooms and the external building. In addition standards of maintenance are high and where maintenance issues are identified these are addressed promptly by the provider. The home originally had three shared bedrooms, but following a recent placement relocation one shared bedroom has now been made into a single bedroom. Those currently sharing have made a positive choice to share and have done so for some time. During the inspection every bedroom was visited, which were noted to be personalised with resident’s personal effects. Bedrooms are provided with Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 Page 19 domestic style furniture and fittings, together with bedding carpeting, curtains and decorated to a high standard. The home provides a good range of communal areas. The lounge and dinning room have recently been redecorated to a high standard with all resident’s saying how nice these rooms are. There is a rear garden which has a paved patio with seating and barbeque area along with a lawned area and flower beds, making this an attractive space for all residents to use. There are sufficient number of communal bathrooms/showers and toilets located around the home to meet the needs of residents. One toilet did not have hand-washing facilities and did not have an impermeable wall covering to enable it to be cleaned effectively. The home is not designed to offer a service to people with physical disabilities and the access arrangements within the home would make it unsuitable for residents with significantly permanent restricted mobility. Some technical aids have been fitted to enable those with minor mobility restrictions to shower safely. Bed rooms have a call point fitted to enable assistance to be summoned if needed. Call points checked were in working order. The home was found to be clean and free from offensive odours. Staff ensure a good standard of hygiene and cleanliness and there are procedures in place to ensure that these standards are maintained. Suitable laundering facilities are provided along with good infection control practices including the availability of protective clothing and equipment. Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 Page 20 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) 31,32,22,34,35 and 36 Staffing levels were appropriate to meet the needs of residents. Staff demonstrated very positive attachment to residents. The staff group includes a core group who have worked at the home for many years and showed a good level of competence and make a positive contribution to the quality of life of residents. Training opportunities for staff have increased with staff feeling supported to carry out their roles. EVIDENCE: Job descriptions are used and staff demonstrated some understanding of their individual roles and how these contributed to the home achieving its stated purpose and function. It is recommended that the job description for senior staff/ persons in charge in the absence of the manager be reviewed to clearly state their roles and responsibilities. Staff felt able to seek advice and support from the manager or provider if they were unsure how to manage a situation or residents needs. One member of staff has completed an NVQ training with a further three currently undertaking various NVQ qualifications. Staff are gradually undertaking all core training and the manager reported that additional specialist training in Makaton and learning disabilities is planned to be undertaken in the coming year. To support staff in the interim the manager has developed an information folder on aspects of learning disabilities. Staff Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 Page 21 stated that they are encouraged to access any additional training provided by the local council. Staff spoke of undertaking a comprehensive induction programme, using TOPSS workbooks and attending training days. A record of training undertaken by each staff is completed but does not indicate what training is needed by the individual in order to fulfil their responsibilities and assist the manager in planning training needs. The manager was previously required to undertake this by introducing a training and development plan, which is linked to the homes statement of purpose, service aims and residents needs. This had not been done at the point of inspection. The weekday core shift pattern is organised for two care assistants to be on duty thorough the waking day, this is in addition to the manager. During the night there is one “awake” member of staff and the manager/providers provide “on call” cover off site. At the weekend three care assistants are employed during the am shift to facilitate outings and activities to be undertaken. The evening meal is cooked by one of the two care staff on duty. The manager stated that cover is provided by them during this time, as this is a particularly busy time with residents returning from their days activities and requiring assistance with bathing and needing staff engagement. The Inspector continues to be assured that during this early afternoon period either the manager or providers are around to provide this needed additional cover. Following a period of staff turnover there is now a more stable team with residents stating either how “nice” “helpful” or “Kind” staff are. No staff have been recruited since the last inspection, when poor standards of recruitment practices were noted. Following this inspection the manager has tightened up the recruitment process to ensure that residents are protected and legal requirements are met. Residents are currently not formally involved in the recruitment of staff, but it was reported do take a keen interest in the induction of new staff. Regular formal supervision of staff has been initiated along with annual appraisals. This system is gradually being introduced for all staff. The manager also undertakes informal supervision in the form of generally overseeing staff within the work place. Staff stated that they could approach the manager with any concerns or queries and felt supported in their roles. Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 Page 22 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) 37,39,40,41 and42 The home continues to be managed affectively with a strong sense of leadership and direction provided. The homes records were well organised and supportive to the effective and efficient running of the home. Health and safety practices were generally noted to be good with the exception being to improve systems to monitor hot water temperatures and window restrictors. EVIDENCE: The registered manager has been in post for nearly two years. She has many years experience in management of care facilities and was open and helpful in their discussion with the Inspector. She is a Registered General Nurse and is currently undertaking a Registered Managers Award. In addition they are planning to undertake additional specialist training to keep up to date with good care practices in the care of adults with learning disabilities. In addition they have undertaken training in person centred care planning. Staff and residents spoke positively about the manager with particular reference to her approachability and relaxed nature. It was evident that there Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 Page 23 is good communication between the manager and staff. There are clear lines of accountability between the home and the providers. Following the registration of the manager the provider’s role has changed and they were previously required to undertake an unannounced recorded monthly visited to the home, this has not yet been introduced. Some quality assurance mechanisms are in place, these include six weekly monitoring visits by a Grace Eyre Foundation representative and formal yearly reviews with social services for some residents. In addition questionnaires have been developed to obtain feedback on the services provided and the performance of the home from health care professionals and relatives. Those seen were positive about the care provided and the management of the home. A comprehensive manual of policies and procedures is available. These are designed to inform and guide staff in their work with residents and reflect changes in legislation and development in practices. Staff are provided with copies of core policies and procedures in a staff handbook. Records about residents were securely stored, with entries that were relevant largely up to date and used non judgmental and respectful language. Residents are able to access information held about them, but to date no residents has requested access. There are extensive policies and procedures relating to health and safety. A record of accidents is kept and was seen to be up to date with no specific patterns identified. The manager was advised to obtain accident records, which comply with the Health and Safety Executive and Data Protection Act. The manager was previously recommended to undertake regular hot water checks to ensure that residents are safeguarded from the risk of accidental scolding. There was no evidence to confirm that this was being undertaken and therefore this has now been made a requirement. Good systems are in place to support fire safety, this includes: regular fire alarm and emergency lighting checks, maintenance of fire equipment, fire safety training and fire drills. In line with previous requirements a fire risk assessment has recently been undertaken. This has been completed by a fire safety expert and records the actions to be taken to ensure adequate fire safety precautions in the home. Two window restrictors had been adjusted by workmen, this posed potential risk from falls and security and the manager was immediately required to check all windows to ensure that restrictors had not been tampered with. Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 Page 24 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 2 2 2 3 3 3 Standard No 11 12 13 14 15 Oak House 3 3 3 2 3 Standard No 31 32 33 34 35 36 Score 3 2 3 3 2 2 Version 1.20 Page 25 H59-H10 S14215 Oak House V213335 210405 Stage 3.doc 16 17 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 3 2 x Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 Page 26 YES 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 6 Regulation 15(2)(c) Requirement That unless it is unpractical to do so residents are consulted regarding the development and review of their care plan and are notified of any revision to the plan. That individual risk assessments are undertaken on risks faced by residents and that these are reviewed frequently and recorded as having been reviewed. That hand washing facilities are available in all communal toilets and that walls have an impermeable wall covering. That a training and development plan be developed which is linked to the homes statement of purpose, service aims and service users needs and individual plans. (Outstanding from inspection of 13/11/03) That records of visits by the Responsible Individual are in accordance with the National Minimum Standards. (Outstanding from inspection of 22/11/04) That a record is made of hot water temperature checks Timescale for action 30-6-05 2. 9 13(4)(c) Immediate 3. 27 23(2)(j) & 13(4)(c) 18(1)(c) (i) 30-7-05 4. 35 30-6-05 5. 37 26 30-5-05 6. 42 13(4)(c) Immediate Page 27 Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 (Previously a recommendation) 7. 42 13(4)(c) That all windows which pose a risk from falls or security are checked to ensure that restrictors have not been tampered with. Immediate 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 31 Good Practice Recommendations That the job description for senior cares be reviewed to include their role and responsibilities. Oak House H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 Page 28 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 H59-H10 S14215 Oak House V213335 210405 Stage 3.doc Version 1.20 Page 29 - 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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