Inspection on 30/09/05 for Oak Lodge

This inspection was carried out on 30th September 2005.

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 12/06/06

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 30th September 2005 11:30 Oak Lodge DS0000010215.V254928.R01.S.doc Version 5.0 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.V254928.R01.S.doc Version 5.0 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.V254928.R01.S.doc Version 5.0 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.V254928.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th April 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 well situated for local shops, transport and community facilities. Oak Lodge DS0000010215.V254928.R01.S.doc Version 5.0 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 30 September 2005. The inspection took place over five hours. The inspector spoke individually with five 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. What the service does well: What has improved since the last inspection? What they could do better: Six Requirements not fully met since the last inspection in April 2005 must be addressed promptly by the home. The environment could be further improved by new carpeting in communal areas, further work to the kitchen and bathrooms and the addition of a second shower. Risk assessments must be fully completed to ensure the health and welfare of clients. Oak Lodge DS0000010215.V254928.R01.S.doc Version 5.0 Page 6 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.V254928.R01.S.doc Version 5.0 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.V254928.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 4. Clients benefit from their needs being appropriately assessed before admission. Clients are provided with good information about the home. EVIDENCE: There is an appropriate 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. Four clients spoken to confirmed that they were given this information before entering the home. The admissions procedure sets out the process for referrals and includes information about suitable clients for the service. Oak Lodge DS0000010215.V254928.R01.S.doc Version 5.0 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, 9 and 10. The individual needs of clients are well documented within care plans, however, staff must make sure that all care plan documentation is kept up to date. Staff must carry out full risk assessments to ensure the health and welfare of individual clients. EVIDENCE: All clients spoken to were extremely positive about the support provided at the home. One client said that their key worker was “fantastic” and another person stated that their key worker had “built trust”. A full and up to date care plan was in place for one client whose documentation was examined. The care plan seen for another client had not been updated to show the individual’s progress since admission. To be effective working documents, care plans must be regularly reviewed and updated. An ‘initial’ assessment of risk was in place within one of the files examined. This document flags areas of potential risk but does not state how risks are to Oak Lodge DS0000010215.V254928.R01.S.doc Version 5.0 Page 10 be reduced. An assessment was not available for another client at the time of inspection. Client confidentiality is suitably protected by the organisational policy and secure storage of individual files. The policy sets out the rules for the sharing of information. Oak Lodge DS0000010215.V254928.R01.S.doc Version 5.0 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, 16 and 17. 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. EVIDENCE: Clients organise their own leisure and social arrangements with support from staff as needed. In addition to this, a sports group meets weekly with arranged activities such as bowling, swimming and jogging. Two clients also spoke very positively about the weekly relaxation group held at the home. Three individuals were attending a gym at the time of inspection. Two clients at the home stated that they went on a group holiday to Wales in September 2005. One client said that this had been “brilliant”. Clients were seen to cook their own lunch on the day of inspection. Two clients are responsible for the preparation of meals each day on a rota basis. Meal planners are displayed in the communal areas as completed by the clients themselves. Oak Lodge DS0000010215.V254928.R01.S.doc Version 5.0 Page 12 One client said that “there is always plenty to eat” and another person reported that the food was ‘lovely’. One individual felt that the rota system “worked well” whilst another client stated that preparing the meals all day was “too much”. Oak Lodge DS0000010215.V254928.R01.S.doc Version 5.0 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): 19 and 20. The health care needs of clients are met. Good medication systems are in place for the protection of clients, however further work is needed on keeping accurate records. EVIDENCE: Clients are registered with a local GP on admission 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. Medication records for two clients were examined. Risk assessments for selfmedication are completed for each client as needed. Administration records are generally well maintained but the home must make sure that a valid reason is recorded where medication has not been given. The record for homely remedies given must also state the time of administration. The filing cabinet used for the storage of medication is secured to the wall and is also 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.V254928.R01.S.doc Version 5.0 Page 14 In order to fully ensure the health and safety of residents, it is recommended that arrangements be made for all staff administering medication to receive training from a creditable source. This training has not been given to all staff currently working at the home. Oak Lodge DS0000010215.V254928.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. 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: The complaints procedure states that complaints can be made at any time to the CSCI. This document includes the local address and telephone number of the Commission. No complaints had been received by the home since the last inspection. 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.V254928.R01.S.doc Version 5.0 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, 25, 27, 28 and 30. Residents are provided with a fairly comfortable and homely environment. The toilet and bathroom facilities should be updated and another shower provided to fully meet the needs of clients. EVIDENCE: The communal areas of the home are homely in appearance – the lounge provides a very pleasant area for clients to use. Four out of five clients individually reported that they were satisfied with their individual bedroom accommodation. Comments included “comfortable”, “best room in the house” and “alright”. One client felt their room was “too small” to be used as a double. Another person reported that they shared their room that “took some getting used to” but was now “ok”. All five clients spoken to commented on the lack of shower facilities. They all felt that the current single shower was not enough and that another shower should be provided on the second floor. Oak Lodge DS0000010215.V254928.R01.S.doc Version 5.0 Page 17 Some issues from the inspection that took place in May 2005 have been addressed by the service. These include the re-decoration of the kitchen and meeting room. Requirements have been made within this report about the following issues: communal stairwells / hallways / office – carpets need replacing kitchen – units require repair or replacement second floor toilet – missing tiles need replacing. second floor stairwell – light fitting needs replacement. Two clients commented on the outdated look of the bathrooms on both upper floors of the home. A recommendation has been made for the home to consider updating these bathrooms. Oak Lodge DS0000010215.V254928.R01.S.doc Version 5.0 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 and 35. An effective staff team meets clients individual needs. Further training must be provided to staff in order to fully ensure the health and welfare of clients. EVIDENCE: Feedback was extremely positive regarding the staff working at the home. Comments included “blinding”, “they’ve really helped” and “really good people”. One client said that their key worker was “really helpful” and another individual stated “fantastic”. One senior post has been lost since the last inspection took place in April 2005. The manager reported that this was due to changes within the organisation and a need for financial cutbacks. One staff member and the manager both stated that this reduction was having an impact on the staff team and that individual stress levels were now higher due to the increased workload. The training records for two members of staff did not satisfactorily document that basic training had been given in areas such as medication, first aid and food hygiene. The registered manager said that an organisational training programme was not currently in place. Oak Lodge DS0000010215.V254928.R01.S.doc Version 5.0 Page 19 Oak Lodge DS0000010215.V254928.R01.S.doc Version 5.0 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. Clients benefit from a well run home. Risk assessments and other Health and Safety practices require improvement to fully ensure clients health and welfare. EVIDENCE: The manager is studying for the NVQ Level Four managers award. Feedback from clients and staff was very positive regarding the manager of the home. One individual said “very good” and another person stated that he was “supportive”. Unannounced visits to the home by the organisation are occurring. The reports of these visits are still not being supplied to the CSCI on a monthly basis as required by the applicable Regulations. Oak Lodge DS0000010215.V254928.R01.S.doc Version 5.0 Page 21 Records for fire safety are kept satisfactorily. Fridge and freezer temperature records are maintained but do not show consistent safe operating temperatures are being kept to. Records to confirm that a five yearly electrical installation check has been carried out were still not available to the inspector. The Requirement has been re-stated from the previous report. Oak Lodge DS0000010215.V254928.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 X 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 2 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 X 2 3 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X X 2 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oak Lodge Score X 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 X 2 X X 2 X DS0000010215.V254928.R01.S.doc Version 5.0 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. 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 01.07.05 not fully met). 3 YA20 13 (2) The Registered Persons must ensure that the nonadministration of medication is recorded accurately on the administration records. The records must clearly state: a valid reason for the nonadministration of medication 01/11/05 Timescale for action 01/11/05 2 YA9 13 (4) 01/12/05 Oak Lodge DS0000010215.V254928.R01.S.doc Version 5.0 Page 24 a time of administration for homely remedies. 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 01.07.05 not fully met). 5 YA24 23 (2) (b) (d) The Registered Persons must ensure that: the kitchen units are repaired or replaced the office carpet is replaced the missing tiles in the second floor toilet are replaced the light fitting on the second floor stairwell is repaired or replaced. 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 01.08.05 not fully met). The Registered Persons must ensure that written reports of monthly unannounced visits by the registered provider be supplied to the CSCI. (Previous timescale of 01.06.05 not fully met). The Registered Persons must ensure that a five yearly electrical installation check is DS0000010215.V254928.R01.S.doc 01/01/06 01/01/06 01/01/06 7 YA39 26 01/11/05 8 YA42 13 (4) 01/12/05 Oak Lodge Version 5.0 Page 25 carried out by a suitably qualified person. Written confirmation must be supplied to the CSCI that this check has been completed within the timescale specified. (Previous timescale of 01.07.05 not fully met). The Registered Persons must ensure that refrigerators are maintained at specified safe temperatures for food storage. Full witten records must be kept to evidence action taken by the home to ensure this. (Previous timescale of 01.05.05 not fully met). 9 YA42 13 (4) 01/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA20 YA24 YA27 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 an additional shower facility be provided for clients use. It is recommended that the flooring in the two communal bathrooms is replaced. Further consideration should be given to updating both bathrooms. Oak Lodge DS0000010215.V254928.R01.S.doc Version 5.0 Page 26 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.V254928.R01.S.doc Version 5.0 Page 27 - 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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