Inspection on 04/10/05 for Oak Lodge

This inspection was carried out on 4th October 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 but made no statutory requirements on the home.

Other inspections for this house

Oak Lodge 14/04/09

Oak Lodge 15/10/08

Oak Lodge 04/12/06

Oak Lodge 31/01/06

Oak Lodge 17/01/05

Oak Lodge 23/08/04

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

CARE HOME ADULTS 18-65 Oak Lodge 213a Eastbourne Road Polegate East Sussex BN26 5DU Lead Inspector Lucy Green Unannounced Inspection 4th October 2005 10:00 Oak Lodge DS0000046902.V256566.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 DS0000046902.V256566.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 DS0000046902.V256566.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Oak Lodge Address 213a Eastbourne Road Polegate East Sussex BN26 5DU 01323 488616 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) The Regard Partnership Limited Mr Garry Lee Norwood Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Oak Lodge DS0000046902.V256566.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated will be six (6). Only service users diagnosed with a learning disablity to be accommodated. Service users will be aged between eighteen (18) and sixty-five (65) years on admission. 17th January 2005 Date of last inspection Brief Description of the Service: Oak Lodge is a purpose built bungalow, situated just off the main A22 Polegate/Eastbourne Road. The home shares the same site as Hillview, another service owned by this organisation. Local shops and public transport links are a short walk away. Resident accommodation provides six single bedrooms and a communal lounge. The bathrooms are fitted with the necessary adaptations. The site provides a large garden and ample parking. The home is registered to accommodate six younger adults with learning disabilities. The Regard Partnership is the Registered Provider of this service. This organisation owns a large number of homes across England and Wales. Oak Lodge DS0000046902.V256566.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at Oak Lodge are referred to as ‘residents’. This unannounced inspection took place over five hours on 04 October 2005. This is the first statutory inspection of this year. The purpose of this inspection was to meet with residents and staff and to generally monitor care practices at the home. A tour of the premises took place, rotas and care records were inspected. The Inspector joined four residents for their lunchtime meal and spoke with two residents individually. Two staff on duty and the Manager were spoken with throughout the inspection process. What the service does well: Oak Lodge provides a good standard of service to the people it supports. The home delivers care in a way that focuses on the individual and respects dignity and choice. Meals are varied, balanced and well presented offering both choice and variety. Residents informed the Inspector that they regularly have the opportunity to go out for meals and indeed on the day of this visit, two residents enjoyed lunch out to celebrate one of their birthdays. Residents access a range of activities, both inside and outside the home. Residents spoken with confirmed that they enjoyed their trips out town, hydrotherapy and weekly music sessions. The staff and Manager invested time and effort into planning meaningful holidays this year, with three residents being supported to visit Euro Disney for five days. Oak Lodge DS0000046902.V256566.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Oak Lodge DS0000046902.V256566.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 DS0000046902.V256566.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&5 Residents benefit from having accessible information which outlines the rights and responsibilities regarding their placement at Oak Lodge. EVIDENCE: The home has a comprehensive Statement of Purpose and Service User Guide in place. Both documents have recently been reviewed and updated. The Service User Guide has been produced in a pictorial format to make it as accessible as possible to the residents living at Oak Lodge. In line with a requirement at the last inspection, there is now a written contract outlining the terms and conditions attached to a placement at Oak Lodge. This document has been produced in plain English and made as easy as possible to understand. Copies of the Service User Guide and contract were found in residents’ care plans. Oak Lodge DS0000046902.V256566.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, 8 & 9 Residents benefit from a detailed plan of care which outlines their needs and how they should be met. Further protection would be afforded if the home ensured that all sections of the care plan were updated to reflect changing needs and care practices. EVIDENCE: The Inspector viewed the care plans for two residents, both were found to contain detailed information about how care should be delivered. There was evidence that residents had been consulted about how they receive support and individual likes and dislikes were recorded. Care plans had been regularly reviewed and minutes of formal reviews were in situ. Review notes identified that one resident’s needs had significantly changed over recent months and therefore the way care was being delivered had altered. Whilst a short-term care plan had been introduced, the main care plan and guidelines had not been updated to reflect this change. It is therefore required that this matter be addressed and that the home ensure that any future changes to residents’ care is accurately reflected in the documentation in place to support them Oak Lodge DS0000046902.V256566.R01.S.doc Version 5.0 Page 10 The home has undertaken a range of risk assessments in respect of the residents, specific behaviours and their environment. There was documentary evidence that Oak Lodge seeks to include residents in the running of the home. One resident informed the Inspector that he helps with domestic tasks in the home including, laundry, cooking and maintaining responsibility for tidying his bedroom. Key-worker meetings are held on a monthly basis. This provides residents with the opportunity to discuss issues about their life at the home on a one-toone basis with their allocated worker. Throughout the inspection process, it was obvious that residents had established ownership of their home and were able to influence the running of the service through a variety of ways. Oak Lodge DS0000046902.V256566.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, 14, 15 & 17 Residents are encouraged and supported to lead healthy and fulfilling lives. Residents benefit from a range of balanced and nutritious meals. EVIDENCE: The activity plans in the two care plans examined provided documentary evidence that residents participate in a range of appropriate activities. The Inspector spoke with one resident about how he spent his time and he talked with enthusiasm about the activities he undertakes. On the day of inspection, it was one of the resident’s birthday and two residents and two staff had gone out for lunch to celebrate this occasion. A birthday party at the home was also being arranged. Residents access a range of community facilities, including regular trips into town, meals and drinks out, hydrotherapy and cinema visits. The home also links in with another local service for music sessions on a weekly basis. Two residents access college courses one day each week and another resident attends a day centre three days per week. Oak Lodge DS0000046902.V256566.R01.S.doc Version 5.0 Page 12 This year, three residents have been on holiday to Euro Disney which was reported to have been a huge success. The residents stayed in a hotel for five days and were supported by three members of staff. The other three residents are due to go to Bognor Regis for a week in October and stay in a cottage. On the day of the inspection, it was observed that the routines of the home were reflective of the individual needs of the residents. It was evident that residents are enabled to choose where to spend their time and make informed choices about their daily lives. Oak Lodge has a positive approach to enabling residents to maintain contact and relationships with families and friends. There was evidence in the care plans that several of the residents have regular family contact and staff support service users to meet with and visit their families. One resident told the Inspector that a member of staff was supporting him to visit his mother that afternoon. The Inspector joined four of the residents for their lunchtime meal. Three residents ate ham and cheese sandwiches with crisps and one resident had macaroni cheese. The food was appetising and well presented. Residents took their meal together, although staff explained that some residents sometimes choose to eat alone. It was observed that those residents who require assistance at mealtimes were supported with sensitivity and respect. Meals are generally prepared according to a six-week rotating menu. The menu shown appeared varied and balanced. Staff on duty confirmed that the menu was however flexible and that if residents wished to eat out, have a takeaway or have something different, then this would be accommodated. Oak Lodge DS0000046902.V256566.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): 18, 19 & 20 Staff have the knowledge, information and experience to ensure health and personal care needs are fully met. Residents and staff would be better protected if medication was managed appropriately. EVIDENCE: It was observed during the inspection that personal care is provided with dignity and respect. The two care plans viewed contained detailed support plans to guide staff in the delivery of care. Staff support residents to ensure their health needs are met. The Inspector was particularly impressed with the way the service has responded to the changing needs of one resident. The staff on duty demonstrated they were knowledgeable about this resident and had been able to advocate on her behalf to ensure she received the appropriate health care and most effective pain relief. Care plans contain a record of any visits or contact with professionals external to the home. There was evidence of current involvement from General Practitioners, Dentists, Chiropodists, Optician and the local Community Learning Disability Team. Oak Lodge DS0000046902.V256566.R01.S.doc Version 5.0 Page 14 The home must however, ensure that they regularly weigh residents and maintain a record of this. A number of issues were raised in respect of the way medication is managed at Oak Lodge. Firstly, the home is required to review the way controlled medication is stored, dispensed and administered. The Manager and Senior staff confirmed that only staff who had received relevant training and supervision were permitted to manage medication. It was however identified that there are currently only a few staff have received this training and it is therefore recommended that additional staff undertake this training to alleviate the pressure from a few key staff. The internal procedure at Oak Lodge is that medication is undertaken by two people. Through discussion with staff, it transpired, that on occasion, the trained member of staff would dispense the medication and pass to the witness to administer to the resident. The person dispensing the medication would then sign the MAR sheet. It was explained to both staff and the Manager that the person signing the MAR sheet is responsible for the whole process and that therefore remains accountable for the administration of the medication, despite delegating to another person. This practice must therefore cease. An Immediate Requirement form was therefore left in respect of medication. Oak Lodge DS0000046902.V256566.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): 23 Adequate systems are in place to protect residents from abuse. EVIDENCE: Various systems are in place to protect clients from abuse. The two recruitment files inspected showed that new staff are employed subject to the required checks by the Criminal Records Bureau and receipt of two written references. It is however, required that the adult protection policy is updated to include details of the Protection of Vulnerable Adults register which was introduced on 26 July 2004. Employment and disciplinary policies should also be updated to reflect the correct procedures to be followed in the event of an adult protection allegation being made against a staff member. Oak Lodge DS0000046902.V256566.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 & 30 Residents benefit from a clean, comfortable and well maintained home. The physical adaptations enable service users to move safely and independently around their home. Residents would benefit from improved access to the garden. EVIDENCE: Oak Lodge is a large purpose built bungalow which is situated just off the main A22 Polegate/Eastbourne Road. The home is well maintained and provides residents with sufficient private and communal space to meet their needs. Level access is provided inside the home, although it is required that access to the garden be improved. At the time of the inspection, the home was found to be clean and tidy throughout. Resident accommodation is provided in six single bedrooms which have been decorated and furnished to reflect the individual. Communal space comprises of a large lounge and a kitchen / dining area. Bathroom facilities are appropriately adapted. Oak Lodge DS0000046902.V256566.R01.S.doc Version 5.0 Page 17 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): 33, 34 & 35 Residents benefit from a dedicated and competent team of staff. Staff have the skills and support to perform their roles effectively. EVIDENCE: At the time of the inspection, the Manager stated that the home was in the process of recruiting one full-time and one part-time post. Vacancies have been covered through overtime and the use of relief staff. The rota indicated that staffing levels were flexible and respondent to the number of residents at home and activities going on. The Manager reported that minimum staffing levels provide four staff in the morning and three staff in the afternoon/evening. At night there is one waking and one sleep-in person on duty. The atmosphere in the home was observed to be calm and relaxed on the day of the inspection and there were sufficient staff on duty to meet the needs of the residents. Staff training is ongoing at Oak Lodge with staff having completed or working towards National Vocational Qualifications. New staff at Oak Lodge undertake appropriate induction training, including the Learning Disability Award Framework (LDAF) course, where staff are new to supporting people with learning disabilities. It is required that the home also introduce an appropriately accredited foundation course to follow-on from the induction. Oak Lodge DS0000046902.V256566.R01.S.doc Version 5.0 Page 18 The recruitment files for two new staff were viewed and whilst the majority of the required information was found to be in place, it was identified that not all staff had supplied a full employment history, containing a written statement to account for any gaps. Oak Lodge DS0000046902.V256566.R01.S.doc Version 5.0 Page 19 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 & 42 Residents benefit from a well managed and safely run home. EVIDENCE: Since the last inspection, the Manager at Oak Lodge has been registered with the Commission for Social Care Inspection. He has worked in a management capacity within residential services for the last eight years and has completed a host of relevant training. The Manager has confirmed that he is due to commence the Registered Managers’ Award in the near future. Various systems are in place to ensure the Health and Safety of the home are maintained. Several safety audits were viewed and found to be accurately maintained. Oak Lodge DS0000046902.V256566.R01.S.doc Version 5.0 Page 20 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 X X X 3 Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X 3 2 2 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oak Lodge Score 3 2 2 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 3 X DS0000046902.V256566.R01.S.doc Version 5.0 Page 21 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)(b) Requirement Care plans to be updated to accurately reflect the current needs and support required for all service users. Home to maintain a record of service user weights. The Registered Person to make arrangements for the recording, handling, safekeeping and safe administration of all medication. Policies and Procedures to reflect current guidance on the Protection of Vulnerable Adults. (Previous timescale of 01 December 2003 and 01 March 2004 not met) Action be taken to provide level access to the garden. The Registered Person ensure correct recruitment procedures are followed, including obtaining a full employment history., as detailed in Schedule 2 as amended. All new staff undertake foundation training which is in line with Skills for Care specification. Timescale for action 01/12/05 2 3 19 20 17(1)(a) 13(2) 01/12/05 04/10/05 4 23 13(6) 01/12/05 5 6 24 34 23(1)(a) 19 01/04/06 01/12/05 7 35 18(1)(c) 01/12/05 Oak Lodge DS0000046902.V256566.R01.S.doc Version 5.0 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Oak Lodge DS0000046902.V256566.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection East Sussex Area Office 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. 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