Inspection on 12/06/06 for Oak Lodge

This inspection was carried out on 12th 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oak Lodge 21/06/07

Oak Lodge 30/09/05

Oak Lodge 29/04/05

Oak Lodge 06/01/05

Oak Lodge 25/08/04

Oak Lodge 25/02/04

Oak Lodge 14/01/04

Similar services:

Agar Grove & St Augustine`s Alcohol Treatment & Rehab

Herbert Street

Haven (The)

Charis

Hartley House

Brook Drive, 124

Rugby House Project

City Roads Crisis Intervention

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

CARE HOME ADULTS 18-65 Oak Lodge 136 West Hill Putney London SW15 2UF Lead Inspector Jon Fry Unannounced Inspection 12th June 2006 11:00 Oak Lodge DS0000010215.V299792.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 Lodge DS0000010215.V299792.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 Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oak Lodge Address 136 West Hill Putney London SW15 2UF 020 8788 1648 020 8780 0286 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) www.cranstoun.org. Cranstoun Drug Services Mr David Hoy Care Home 14 Category(ies) of Past or present alcohol dependence (7), Past or registration, with number present drug dependence (7) of places Oak Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th September 2005. Brief Description of the Service: Oak Lodge provides care for up to 14 clients on a short-term programme for the treatment and rehabilitation of drug and alcohol problems. The home is a large detached house situated on a busy main road in the West Hill area of Wandsworth. It is located near to local shops, transport and community facilities. Information about the home is provided to residents in a written guide. The current fee is £546.00 per week. Oak Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by a regulation inspector on the 12th June 2006. The inspection took place over four hours. The inspector spoke individually with three clients, the manager and one member of staff. A number of records were examined, as well as a tour of the communal areas of the home. Completed surveys were additionally received from two members of staff. What the service does well: 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 Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 6 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 Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 7 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 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clients are provided with information about the home to help them to make a decision about moving in. The needs of prospective clients are assessed prior to admission to make sure that the home will be able to meet these. EVIDENCE: There is a satisfactory assessment procedure to make sure that staff understand the individual needs of a client before they move into the home. Assessments were seen for two clients whose care files were examined. The Residents Handbook (Service Users Guide) provides good information for new clients regarding the house rules and rehabilitation programme. Three clients spoken to said that they were given this information before entering the home. Only four clients were living at the home at the time of the inspection visit. The manager stated that the service was ‘under threat of closure’ due to the lack of placements in recent months. Staff at the home have been working to attract more referrals and a number of admissions were lined up for the Oak Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 8 coming weeks. The lack of clients was clearly having an impact on the service in terms of staff motivation and keeping to established routines. Oak Lodge DS0000010215.V299792.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, 8 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans must fully address the individual needs of clients and be kept under regular review. Staff must carry out risk assessments to ensure the health and welfare of individual clients. Clients are encouraged to take responsibility for all aspects of life in the home with support from staff as necessary. EVIDENCE: The clients spoken to were very positive about the support provided at the home. Comments included ‘brilliant’ and ‘caring’. Care plans were in place for all four clients. These differed as to how well they were completed and how often they were evaluated. To be effective working documents, care plans must be regularly reviewed and updated. This was not being consistently done at the time of this inspection visit. Oak Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 10 An ‘initial’ assessment of risk was in place within one of the files examined. This gave an area of potential risk to be followed up following admission but a full written assessment was not still available for this client. The responsible key worker stated that they had followed this up but had not documented this within an assessment. There were no risk assessments available in the files for the three other clients. This is unacceptable and practice must be improved in this area to fully protect the health and welfare of those living and working at the service. Clients are encouraged to take responsibility for all aspects of daily living. Household tasks are completed on a rota basis although this was proving more difficult than usual due to the low numbers of clients at the time of the inspection visit. Oak Lodge DS0000010215.V299792.R01.S.doc Version 5.2 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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff offer clients appropriate support to arrange social activities, maintain relationships and find educational or employment opportunities. Clients are responsible for the menu choices and the meals served. Better systems need to be in place to monitor the diet of residents. EVIDENCE: Clients organise their own leisure and social arrangements with support from staff as needed. Clients spoken to said that they had received a gym pass from the home. There had been a recent trip out to the Science museum and another was planned to Brighton within the next week. Due to the low numbers of clients, the weekly groups for literacy, life skills and sports were not being held. The manager reported that these would be started again once client numbers had increased. Oak Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 12 Clients are responsible for the preparation of meals each day on a rota basis. Meal planners are displayed in the communal areas that are completed by the clients on a weekly basis. One client received money on the day of inspection to buy Halal meat. Comments from clients included ‘I have the food I like’, ‘fine’ and ‘we rely too much on the free food from Marks and Spencer’. The menus were discussed with the manager and one member of staff. A Requirement has been made for the home to monitor these more closely to make sure that individual diets are varied, balanced and nutritious. Oak Lodge DS0000010215.V299792.R01.S.doc Version 5.2 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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The health care needs of clients are being met. Improvements to care planning are however required to fully document this. Good medication systems are in place for the protection of clients. EVIDENCE: Support with physical health is provided by the local GP who clients can register with when they move to the home. Individuals are able to stay with their own GP if this can be satisfactorily managed. Individual health needs are addressed within the care plans. As stated previously, it is essential that staff at the home fully document any issues and make sure that the evaluation process is ongoing. Staff were not administering any prescribed medication to any clients at the time of this inspection. The record for homely remedies had improved and stated the time of administration for each time they were given. Oak Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 14 The filing cabinet used for the storage of medication is secured to the wall and is used for the storage of other records. It is recommended that a cabinet used only for the storage of medication be provided in line with Royal Pharmaceutical Society guidelines. Oak Lodge DS0000010215.V299792.R01.S.doc Version 5.2 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A satisfactory complaints procedure is in place that is given to new clients on admission. Satisfactory procedures are in place about the protection of vulnerable adults. EVIDENCE: No complaints have been received by the home or the CSCI since the last inspection took place in September 2005. The clients spoken to say that they were given the home’s information pack before entering the home. This includes the complaints procedure for the service. The home safeguards clients from abuse by making sure that all staff are aware of the relevant procedures. These procedures ensure that staff have a clear understanding of their role and responsibility in reporting any concerns to the appropriate persons. Oak Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 16 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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are provided with an adequate environment, which is fairly comfortable and homely. Some areas are in need of updating and redecoration. EVIDENCE: The communal areas of the home are homely in appearance – the lounge provides a very pleasant area for clients to use. Clients comments about the environment included ‘ok’ and ‘fine’. The premises were seen to be kept clean but many areas are starting to present as requiring update in the short term. Priority must be given to the carpeting in communal areas and the bathrooms. A number of the fridges and freezers in use also now require replacement as many of the interior fittings are missing and the lights do not work. Oak Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 17 Requirements have been made within this report about the following issues: communal stairwells / hallways / office – the carpets need replacing kitchen – some units require repair or replacement kitchen – the fridges and feezers need to be replaced second floor bathroom and toilet – the flooring requires replacement second floor toilet – the missing wall tiles need replacing stairwells and hallways – two light fittings need shades. It is strongly recommended that the bathrooms in the home are updated to provide more pleasant areas for client’s use. Oak Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 18 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, 33, 34, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is working towards having a competently trained staff team to make sure they can meet the all the needs of the clients. EVIDENCE: Feedback from clients was positive regarding the staff working at the home. These included ‘good’, ‘polite’ and ‘considerate’. Two clients said that they felt they had benefited from the current low numbers of clients as the home was ‘quiet’ and they could not ‘hide’ behind other clients issues. One client said they were ‘surprised’ at the lack of structure or routine at the home. An organisational training programme is in place. The training records do not satisfactorily document that basic training has been given to all staff in areas such as medication, first aid and food hygiene. One member of staff reported that they had completed risk assessment and management training. Another member of staff is undertaking a therapy qualification. The manager and a member of staff spoke about the NVQ Level Three training that the organisation is planning to make available. It is essential that this training be rolled out for staff working at the home. Oak Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 19 One member of staff spoken to said that they received regular 1-1 supervision with the manager of the home. A staff ‘consultancy’ group session is held every three weeks with an external person leading. This provides for additional support for staff working at the home. Oak Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 20 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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Clients benefit from the ethos and management approach at the home. Quality assurance practices need to be improved to make sure that the service meets both sector specific and national minimum standards. Risk assessments and other Health and Safety practices require improvement to fully ensure clients health and welfare. EVIDENCE: The manager has nearly completed the NVQ Level Four managers award. Feedback from clients and staff was very positive regarding the manager with comments such as ‘brilliant’ and ‘he provides lots of support’. The manager stated that unannounced visits to the home by the organisation are occurring but not on a regular monthly basis. The reports of these visits Oak Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 21 are still not being supplied to the CSCI on a monthly basis as required by the Regulations. Fridge and freezer temperature records are being better kept but the actual equipment needs replacement as they are in a poor state of repair. A Fire Officer visited the home in February 2006 and asked for two issues to be addressed. These had not been actioned at the time of this inspection and Requirements have been made within this report to make sure they are fully addressed. Records to confirm that electrical installation checks and yearly equipment checks had been carried out were also not available to the inspector at the time of this visit. Quality assurance practices need to be improved and must include regular audits of care planning and risk assessment practices within the home. It is recommended that an organisational audit be carried out against Quality in Drug and Alcohol Services (QuADS) Standards as the previous one took place in 2003. Oak Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 22 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 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 X 2 X X 2 X Oak Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 23 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 YA6 Regulation 15 (2) Requirement The Registered Persons must ensure that all individual care plans are subject to an ongoing process of evaluation and review. (Previous timescale of 01.11.05 not fully met). 2. YA9 13 (4) The Registered Persons must ensure that full individual risk assessment documentation is put in place with regard to any identified risks. Documentation in place must fully evidence the assessment process and be personalised to the individual. (Previous timescale of 01.12.05 not fully met). 3. YA17 16 (2) (i) The Registered persons must ensure that the menus are monitored closely. This is to ensure that clients are provided with a healthy diet Oak Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 24 Timescale for action 01/07/06 01/07/06 01/07/06 whilst at the home. 4. YA24 23 (2) (b) (d) The Registered Persons must ensure that the carpeting in the communal stairwells and hallways throughout the home is replaced. (Previous timescale of 01.01.06 not fully met). 5. YA24 23 (2) (b) (d) The Registered Persons must ensure that: kitchen units are repaired or replaced as required the fridges and freezers are replaced the office carpet is replaced the flooring in the second floor bathroom and toilet is replaced the missing tiles in the second floor toilet are replaced light fittings have suitable shades provided. 6. YA32 18 (1) The Registered Persons must ensure that all care staff receive training in First Aid, Medication, Food Hygiene, Fire Safety and Health & Safety. (Previous timescale of 01.01.06 not fully met). 7. YA39 26 The Registered Persons must ensure that written reports of monthly unannounced visits by the registered provider are held at the home and that these are supplied to the CSCI. (Previous timescale of Oak Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 25 01/10/06 01/10/06 01/09/06 01/07/06 01.11.05 not fully met). 8. YA42 13 (4) The Registered Persons must 01/08/06 ensure that a five yearly electrical installation check is carried out by a suitably qualified person. Annual electrical appliance safety checks must also take place. Written confirmation must be supplied to the CSCI that these checks have been completed within the timescale specified. (Previous timescale of 01.12.05 not fully met). 9. YA42 13 (4) The Registered Persons must ensure that: A fire risk assessment is completed for the home The back door fire exit has a lock fitted which does not require the use of a key. 01/07/06 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. Refer to Standard YA20 Good Practice Recommendations It is recommended that an appropriate secure cupboard be provided for the sole purpose of storing items of medication. It is strongly recommended that the bathrooms are updated and an additional shower facility be provided for clients use. 2. YA24 Oak Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 26 3. 4. YA32 YA39 It is strongly recommended that all staff have access to an NVQ level three training programme. It is recommended that an organisational audit be carried out against the QuADS Standards. Oak Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Lodge DS0000010215.V299792.R01.S.doc Version 5.2 Page 28 - 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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