Inspection on 21/06/07 for Oak Lodge

This inspection was carried out on 21st June 2007.

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

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

Other inspections for this house

Oak Lodge 12/06/06

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 Simon Smith Unannounced Inspection 21st June 2007 12:30 Oak Lodge DS0000010215.V346085.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.V346085.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.V346085.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.V346085.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25 January 2007 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 on a main road in the West Hill area of Wandsworth. It is located near local shops, transport and community facilities. Information about the home is provided to residents in a written guide. The current fee is £620 per week. Oak Lodge DS0000010215.V346085.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector used evidence from a range of sources when making judgements about the home. These included a visit to the home (12.30-17.00) and discussion with residents and staff. A sample of records was examined, including residents’ files. Surveys were available to residents, relatives, staff and professionals who visit the home. One resident and one member of staff returned surveys to the CSCI. There were 11 residents at the time of inspection. Two residents had moved on in the week before inspection. The home met all the National Minimum Standards assessed at this visit. The service offers residents a structured, time-limited programme of psychodynamic group work. Residents commit to living as part of the therapeutic community, which is based on a system of peer support. The service aims to involve residents in decisions that affect them, although residents agree to accept any restrictions placed upon them by the programme’s rules. One resident said, “You need the structure, but it’s a subtle structure, its not strict”, whilst another commented, “The house is well structured and we have both time to work and time to reflect”. Residents are expected to play a full role in the routines of the home and hold regular business meetings, at which the nominated supervisor allocates jobs. Residents perform the supervisor role on a rota basis. A rota is posted on the residents’ noticeboard to identify which residents are responsible for which jobs. Residents meet at 8am every morning and begin their morning jobs at 8.50. In the second half of their placements, residents look at options for moving on from Oak Lodge. Cranstoun Drug Services has four other residential services that work with residents who have completed the primary course. Staff also make referrals to other organisations where appropriate. Some residents are referred to day services that provide ongoing support whilst others explore opportunities at college or in voluntary work. What the service does well: Provides clear information about the service for residents when they move in. Provides a structured programme of therapeutic group work. Encourages openness and provides regular opportunities for residents to discuss their feelings. Residents benefit from a stable and experienced staff and management team. Oak Lodge DS0000010215.V346085.R01.S.doc Version 5.2 Page 6 Residents gave positive feedback about staff and said that they provide good support. Staff said that they have good access to training and good support from the service manager. 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. The summary of this inspection report can be made available in other formats on request. Oak Lodge DS0000010215.V346085.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Oak Lodge DS0000010215.V346085.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 2, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clear information about the home is available to residents. Prospective residents’ needs are effectively assessed prior to admission. Residents have a written contract that sets out their terms and conditions. EVIDENCE: Each resident receives a Residents’ Handbook when they move into the home. This gives details of house rules, disciplinary and complaints procedures and provides an outline of the home’s programme. Staff advised that all referrals to the service and residents’ assessments are managed centrally by the organisation and not through the home. Staff said that the assessment process comprises a thorough interview and an opportunity for prospective residents to visit the home. All the residents’ files checked contained evidence of assessment. Oak Lodge DS0000010215.V346085.R01.S.doc Version 5.2 Page 9 Residents are tenants of the Metropolitan Support Trust and have a signed licence agreement that sets out the terms and conditions of residency. Oak Lodge DS0000010215.V346085.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive good support from staff to identify and monitor individual goals. Residents receive good support to make choices about their lives. The home carries out risk assessments where necessary. The home shares information with other agencies appropriately. EVIDENCE: Each service user has an individual care plan drawn up within a month of moving in. This care plan forms the basis of their individual programme and treatment. The standard care plan format addresses ten domains: drug use, Oak Lodge DS0000010215.V346085.R01.S.doc Version 5.2 Page 11 health, legal, housing, education/training/employment, relationships, childcare issues, personal development, dietary, spiritual and cultural issues and moving on. The residents’ care plans checked all contained evidence of regular review and evaluation. Staff said that residents’ care managers visit them during their time at the home, usually after around two months. Residents also meet regularly with their keyworker, who provides support in identifying and monitoring individual goals. Staff demonstrated a good knowledge of residents’ needs and a commitment to supporting residents in making informed decisions about their lives. The home carries out risk assessments where necessary, usually in response to individual issues identified at the time of assessment. All residents who take regular medication are risk assessed regarding their ability to self-medicate. Due to the nature of the service, staff may have to provide information about residents to other agencies or professional bodies, such as the probation service, or provide reports for court. Residents sign consent forms to allow the home to share information about them with other professionals where appropriate. Oak Lodge DS0000010215.V346085.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 – 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have opportunities for regular outings and exercise. Residents are supported to pursue individual interests where possible. Any rules and restrictions that affect residents are clearly outlined by the home. Residents contribute to the home’s menu and are involved in preparing meals. EVIDENCE: The home arranges an outing every six weeks. Residents said that the last outing was to Thorpe Park and that other trips have included visits to the Oak Lodge DS0000010215.V346085.R01.S.doc Version 5.2 Page 13 cinema or bowling. The home is close to shops and residents are involved in the local community. Residents have good opportunities for physical exercise. The home has a small gym and an exercise trainer visits each week. Residents can also attend a local gym each week. The home enables residents to pursue individual interests where possible. For example two residents expressed an interest in maintaining the home’s garden and this is being supported. There are some rules and restrictions that residents must observe. These are explained when residents move to the home and are outlined in the Residents’ Handbook. For example, residents must be in their bedrooms by 11pm during the week and by 1am at weekends. In addition, all residents have to agree to random urine tests. Residents are not usually able to leave the home during their first two weeks at the home and must be accompanied by a senior resident when going out from weeks three to five. Overnight visits can only be requested when residents have completed their midway assessment. Residents’ requests to leave the home are discussed by staff and residents’ peers before being approved. If a resident infringes any of the house rules, they must complete a 21 day assessment. Staff said that residents also receive additional support and monitoring during the assessment. At the end of this period the resident presents their assessment to staff and peers for feedback. Residents’ comments indicated that they acknowledge the value of assessments and generally support One resident said, “No-one wants to be on them [assessments], but people realise they’re good in the long run”. Residents are expected to cook at least once a week and a menu planner and assistant are identified on the residents’ rota. Residents cooked both meals served during the inspection. These were of good quality and were enjoyed by residents, the majority of whom ate together in the home’s dining room. Staff said that the home aims to promote healthy eating and that there are plans to introduce a Nutrition group. Staff also gave examples of how the home had catered for residents’ individual dietary needs, such as obtaining Halal meat for one resident. Oak Lodge DS0000010215.V346085.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ healthcare needs are met during their time at the home. Staff support residents to obtain treatment where necessary. Facilities for the storage of medication should be improved. EVIDENCE: Residents are encouraged to register with a local doctor but can maintain registration with their existing general practitioner if they prefer and this arrangement is manageable by the home. Residents are expected to arrange medical appointments in their free time where possible but are able to attend appointments in structured time if necessary. Healthcare forms one of residents’ care plan domains and the care plans checked provided evidence that residents’ healthcare needs are met during Oak Lodge DS0000010215.V346085.R01.S.doc Version 5.2 Page 15 their time at the home. Staff support residents in obtaining treatment where necessary, chase up referrals and appointments and liaise with healthcare professionals about residents’ care. Staff gave examples of supporting residents with their healthcare needs, such as arranging physiotherapy sessions for one resident. Medication is stored in a cabinet in the ground floor office. However the cabinet is not designed for this purpose and is not used solely for medication storage. The last inspection report recommended that the home obtain “an appropriate secure cupboard….for the sole purpose of storing items of medication”. This has not been actioned and the recommendation is reinstated. As stated earlier in this report, all residents who take regular medication are risk assessed regarding their ability to self-medicate. There is a lockable medication cabinet in each resident’s bedroom. Medication administration records for three residents were checked and found to be accurate. Oak Lodge DS0000010215.V346085.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate procedures are in place for the management of complaints. Residents feel confident about raising concerns with staff. Guidance is provided for staff in the recognition, prevention and reporting of abuse. EVIDENCE: Residents spoken to during the inspection were aware of the home’s Complaints procedure. None of those spoken to had needed to make a complaint but they were confident that complaints would be properly dealt with by the home. The home provides guidance for staff in the recognition and reporting of abuse. The home works within the framework of the local authority‘s policy on the Protection of Vulnerable Adults. This policy ensures that staff have a clear understanding of their role and responsibility in reporting any concerns. Oak Lodge DS0000010215.V346085.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 25, 27, 28 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is comfortable, safe and well maintained. The home is clean and hygienic. EVIDENCE: Some further improvements are planned, including new blinds for the lounge and some residents’ bedrooms. Oak Lodge DS0000010215.V346085.R01.S.doc Version 5.2 Page 18 The communal rooms include a large lounge and separate dining room. The home has a large garden, which was well used by residents during the inspection. All bedrooms are shared. Bedrooms are equipped with basins and many have built-in wardrobes. Residents can bring personal effects with them when they move in, although bedding is provided. All areas of the home were clean and hygienic at the time of inspection. Oak Lodge DS0000010215.V346085.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 33, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a stable and experienced staff team. Staff have access to appropriate training and support. Residents gave positive feedback about staff. EVIDENCE: Staffing at the home is provided 24 hours a day. The staff team comprises a manager and four project worker posts, one of which was vacant at the time of inspection. Staff said that the home regular bank staff to cover vacant shifts and does not use agency staff. Feedback from residents was positive regarding the staff working at the home. Staff interacted positively with residents during the inspection and demonstrated a good knowledge of their needs. Oak Lodge DS0000010215.V346085.R01.S.doc Version 5.2 Page 20 Staff said that team meetings are held weekly and that they have opportunities to contribute to the agenda. Staff also have a monthly session with an external facilitator, which is used to examine practice issues. Staff said that they have access to individual supervision, although one member of staff said they would value more frequent supervision sessions. Staff confirmed that the home carries out appropriate pre-employment checks, including referees and Criminal Records Bureau disclosures. However these documents are held at the organisation’s head office and were not available for inspection. Staff said that they have access to regular training through the organisation’s training department, which issues two training brochures each year. Staff said that those working towards NVQ qualifications had not had regular access to an assessor but that another NVQ Provider had recently been appointed. Oak Lodge DS0000010215.V346085.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an experienced manager. The quality of the service is reviewed by the organisation each year. The health and safety of residents and staff is maintained. EVIDENCE: The manager has worked at the home for many years and has achieved registration with the CSCI. Staff said that the manager is “really supportive” and that he “knows the client group very well”. Oak Lodge DS0000010215.V346085.R01.S.doc Version 5.2 Page 22 Staff said that a service review was to take place in the near future. Staff advised that this is an annual process which involves evaluation from team members and input from a senior manager or external consultant. Staff provided evidence of satisfactory health and safety checks, including a five-year electrical check. Fridge and freezer temperatures are recorded daily. Staff check the home’s food three times each week. Standards of food hygiene at the time of inspection were good. The Certificate of Employers Liability Insurance displayed in the home expired in June 2006. The home must ensure that the new certificate is displayed as soon as appropriate. The home’s fire risk assessment was reviewed in June 2006. Staff said that some signage relating to fire safety was awaited at the time of inspection. The Fire Book provided evidence that fire points are tested weekly. Fire drills are held regularly and the last drill on file took place in June 2006. An engineer checked the home’s fire fighting equipment in June 2007. Oak Lodge DS0000010215.V346085.R01.S.doc Version 5.2 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 3 2 3 3 X 4 3 5 3 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 3 25 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 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 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Oak Lodge DS0000010215.V346085.R01.S.doc Version 5.2 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. 1 2 Refer to Standard YA20 YA42 Good Practice Recommendations Obtain an appropriate cabinet for solely for the storage of medication. Ensure that a valid Certificate of Employers Liability Insurance is displayed in the home at all times. Oak Lodge DS0000010215.V346085.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V346085.R01.S.doc Version 5.2 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. 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