Inspection on 21/06/07 for Oak Trees

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 Excellent. 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 Trees 24/11/05

Oak Trees 06/07/05

Oak Trees 17/03/05

Oak Trees 20/01/05

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Oak Trees 26 Norfolk Drive Attleborough Norfolk NR17 1QW Lead Inspector Debra Allen Unannounced Inspection 21st June 2007 08:15 Oak Trees DS0000027491.V343914.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 Trees DS0000027491.V343914.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 Trees DS0000027491.V343914.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oak Trees Address 26 Norfolk Drive Attleborough Norfolk NR17 1QW 01953 457360 P/F01953 457360 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) Flagship Housing Group Limited Mrs Kerrie Jane Good Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Oak Trees DS0000027491.V343914.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate a maximum of four (4) adults of either sex with learning disabilities (LD) 24th November 2005 Date of last inspection Brief Description of the Service: Oak Trees is situated in a small estate on the outskirts of the town of Attleborough. The service provides short stay respite care for up to four adults with learning disabilities. The building has one first floor bedroom and three ground floor bedrooms. The fees are currently £729.05 per week. Oak Trees DS0000027491.V343914.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care Services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out, by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgements for each outcome group. This inspection was carried out during the course of ten hours and at the same time as Flagship Housing’s Domiciliary Care service. During the inspection the manager, staff and three respite guests were spoken with. Records and files were checked and a tour of the premises was made. One respite guest and two relatives returned questionnaires prior to the inspection, all of which contained very positive comments. There have been no requirements or recommendations made as a result of this inspection. What the service does well: The service user guide is very clearly written, with pictures in some parts to help people understand it better. Before respite guests stay for the first time, each person is sent a copy of a form called ‘Getting to know you before you stay at Oak Trees’. When this form is completed, it contains lots of important information and forms a big part of each guest’s care plan. The care plans, which are put together for each respite guest are very person centred and people are supported to improve themselves, if they want to, particularly in areas such as independent living and daily life skills. The management and staff will do everything they can to make sure respite guests are supported and treated with respect and dignity all the time, even as they get older, become ill or at the time of death. Oak Trees provides a very personal service for respite guests and their families and the complaints procedure is very good. Oak Trees was found to be a very comfortable and homely place to be with a happy and relaxed atmosphere. Oak Trees DS0000027491.V343914.R01.S.doc Version 5.2 Page 6 Quality assurance is very important to the staff and management at Oak Trees and feedback and comments are collected on a regular basis to help Oak Trees become an even better place to stay. 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 Trees DS0000027491.V343914.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 Trees DS0000027491.V343914.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): 1, 2, 3 & 4 Quality in this outcome area is excellent. Respite guests receive comprehensive information, in appropriate formats, to ensure they and their relatives know what support Oaktrees offers and new guests have the opportunity to visit before they stay there. A full needs assessment is carried out for each guest prior to their staying at Oak Trees so they know staff will know what support they need. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All respite guests are given a copy of the Service User Guide, which was seen to be in written and picture format. This guide was also seen to include an individual planning process for prospective respite guests, which shows how referrals are received from Social Services. Oak Trees then send an information sheet and an initial visit for the guest is arranged. If the guest is happy to stay at Oak Trees preparation of their care plan begins. A procedure is also explained in the Service User Guide in respect of emergency admissions, which confirms that staff will access all possible sources of information to make sure appropriate care and support can be provided. Feedback surveys confirmed that Oak Trees meets the needs of families as well as guests. Oak Trees DS0000027491.V343914.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10 Quality in this outcome area is excellent. The assessed needs and risk assessments for all respite guests are shown in individual care plans. All guests are invited and encouraged to be actively involved in all aspects of life in the home and their views are taken into consideration. Respite guests’ information is secure and confidentiality is maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion with the manager and records looked at on the day of inspection confirmed that before respite guests stay for the first time, each person is sent a copy of a form called ‘Getting to know you before you stay at Oak Trees’. This form is divided into sections and, when completed, provides very comprehensive information and forms a big part of each guest’s care plan. Completed forms were also seen to be held on file, reviewed and updated as necessary when a guest has a return visit. Oak Trees DS0000027491.V343914.R01.S.doc Version 5.2 Page 10 Risk assessments were also seen to be in place, which included bathing, manual handling, challenging behaviour and relevant individual assessments. Although guests stay at Oak Trees on a short term basis, it was evident from records seen, observations made and discussions held with guests and staff that they are able to participate, if they choose, in all aspects of life in the home such as meetings, cooking and leisure activities. All personal information, relating to guests, was seen to be stored securely in the office, ensuring confidentiality. Oak Trees DS0000027491.V343914.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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is excellent. Guests have opportunities for personal development if they choose, are part of the local community and engage in appropriate leisure activities. Guests are supported to maintain appropriate personal relationships. Guests are offered a healthy diet and enjoy their meals and mealtimes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans, which are put together for each respite guest were seen to be very person centred and opportunities were noted to be available for personal development if people wanted, particularly in areas such as independent living and daily life skills. Oak Trees have received many compliments relating to their respite care service and one letter looked at thanked the manager and staff for their support for a guest and their family over the years and for helping with the transition to supported living. Oak Trees DS0000027491.V343914.R01.S.doc Version 5.2 Page 12 A range of activities and leisure facilities were observed to be available within Oak Trees such as karaoke, music system, games machine and TV. The conservatory also provides an ideal area for art and craft work. Respite guests were noted as having very varied and active lives and their individuality was seen to be highly respected. A number of people, including respite guests were observed preparing and leaving for work, training or day services on the morning of the inspection. Some of the guests spoken to said they enjoyed staying at Oak Trees, their daily routines and how they also enjoyed other activities such as seeing people or going to the pub. Later in the afternoon, one guest was seen preparing their packed lunch for the following day and another was chatted with whilst relaxing in the lounge after their day at work. Regular meetings take place with all the service users at Oak Trees and it was noted that there is a public committee for all the residents of Norfolk Drive. A number of service users were noted to have attended these meetings on a regular basis and copies of the minutes were seen. The manager confirmed that guests are also welcome and invited to attend these meetings. Mealtimes were noted to be very flexible and, again, person centred as guests change on a regular basis. Evidence was seen by way of records at Oak Trees, service user guide, pre-inspection questionnaire, observations and discussions, that guests choose their menu on a daily basis and they can make themselves drinks or snacks when they want. Oak Trees DS0000027491.V343914.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 & 21 Quality in this outcome area is excellent. Respite guests receive personal support in the way they prefer and their physical and emotional healthcare needs are met whilst staying at Oak Trees. Guests users retain their own medication where possible and they are protected by the home’s medication policies and procedures. The staff and management team provide excellent support for respite guests during ageing, illness and death and they are treated with dignity and respect at all times. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The information contained in the completed ‘Getting to know you before you stay at Oak Trees’ form was seen to provide very comprehensive information, which forms a big part of each guest’s care plan. This helps ensure that respite guests receive personal support in the way they prefer, and that their physical and emotional healthcare needs continue to be met, whilst staying at Oak Trees. These forms, together with the care plans and risk assessments were seen to be kept on file and are reviewed and updated, as necessary, when a guest makes a return visit. Oak Trees DS0000027491.V343914.R01.S.doc Version 5.2 Page 14 All the guests were seen to be encouraged and supported to look after and administer their own medication, but they are also protected by the home’s policies and procedures for dealing with medication. Where necessary a locked cabinet is used to store medication and records looked at on the day of inspection were seen to be up to date. Other records looked at confirmed that staff are very well trained in this area. From discussions with the manager and staff and some of the records looked at, there was very good evidence that guests are supported with total dignity and respect even as they get older, become ill or at the time of death. One particular situation showed how the management and staff had gone over and above the call of duty to ensure a guest was supported and comforted through the time of their illness and eventual death. Oak Trees DS0000027491.V343914.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. Respite guests feel their views are listened to and acted on and they are protected from abuse, neglect and self harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Oak Trees have not had any complaints since the last inspection. The three questionnaires, which were returned prior to the inspection, stated that people knew how to make a complaint if needed. On the day of inspection, the manager was noted going to visit a relative, following a concern that had been raised by them. Although this was not a formal complaint, it was still taken seriously and dealt with professionally and in accordance with Oak Trees’ complaints procedure. Records looked at confirmed that staff are well trained in areas relating to adult abuse and protection. Oak Trees DS0000027491.V343914.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 28 & 30 Quality in this outcome area is excellent. Oak Trees provides a homely, comfortable and safe environment for respite guests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of inspection all the communal areas were seen to be clean and tidy and the whole environment had a very comfortable and homely feel to it. Since the last inspection a number of improvements have been carried out to a very high standard, which include refurbishment of the shower room, redecoration throughout, new carpets and furniture for the lounge, new floors and furniture in the conservatory and a new summer house. Oak Trees DS0000027491.V343914.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 & 36 Quality in this outcome area is excellent. Oak Trees has a robust recruitment procedure and an excellent training programme. Staff are supervised and appraised on a regular basis. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three staff files were looked at and found to contain an application form, evidence of identity, enhanced Criminal Records Bureau (CRB) disclosure and two written references. The manager confirmed that the contracts were held at Oak Trees’ Head Office. The staff files also contained induction checklists, which had been signed and dated by the staff member and their line manager, on completion of each area. An excellent training programme is provided by the organisation, to help ensure the ongoing safety and protection of everyone who uses the service and, at the time of inspection, out of twenty care staff (including the manager and deputy), six have completed NVQ 2, ten have completed NVQ 3 and both the manager and deputy have completed their NVQ4 and hold the Registered Manager’s Award. Oak Trees DS0000027491.V343914.R01.S.doc Version 5.2 Page 18 Discussions with staff, training records and certificates confirmed that staff are also well trained in a number of other areas such as moving and handling, health and safety, COSHH, Medication, first aid, fire safety, food hygiene, person centred planning, abuse awareness, de-escalation of violence and communication. Three staff were spoken to individually on the day of inspection and each one confirmed that they received regular one-to-one support and supervision sessions. This was also confirmed by records seen in their personnel files. All the staff spoken to said that they really enjoyed their work and felt very supported by each other, the management team and the organisation as a whole. Oak Trees DS0000027491.V343914.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42 & 43 Quality in this outcome area is excellent. Oak Trees is a well run service and respite guests benefit from the ethos, leadership and management approach. Respite guests’ views underpin the self-monitoring, review and development of the service. Respite guests’ rights and best interests are safeguarded by the policies, procedures and record keeping at Oak Trees. The health, safety and welfare of respite guests are promoted and protected. This judgement has been made using available evidence including a visit to this service. Oak Trees DS0000027491.V343914.R01.S.doc Version 5.2 Page 20 EVIDENCE: Both the manager and deputy were observed as having very positive, supportive and empowering attitudes towards the staff and guests. A quality assurance report is produced each year, the contents of which are compiled in particular by using feedback and comments received from respite guests, their families and friends. A number of completed ‘Guest Questionnaires’ were looked during the inspection and found to contain some very positive and constructive comments, which confirmed that respite guests’ views underpin the self-monitoring, review and development of the service. Health and safety is promoted at Oak Trees and records looked at confirmed that fire alarm and safety tests are carried out on a regular basis. Cleaning materials/hazardous chemicals were seen to be stored appropriately and staff training in areas relating to health and safety was seen to be up to date. All records looked at were seen to be up to date, including the organisations policies and procedures. Oak Trees DS0000027491.V343914.R01.S.doc Version 5.2 Page 21 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 4 3 3 4 3 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 4 25 X 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 3 LIFESTYLES Standard No Score 11 4 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 4 4 3 4 4 3 3 3 Oak Trees DS0000027491.V343914.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. Refer to Standard Good Practice Recommendations Oak Trees DS0000027491.V343914.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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. 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