Inspection on 06/07/05 for Oak Trees

This inspection was carried out on 6th July 2005.

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 Trees 21/06/07

Oak Trees 24/11/05

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 Roger Andrews Announced 06 July 2005 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 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 Stationary 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 I55 S27491 Oak Trees V229062 060705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Oak Trees Address 26 Norfolk Drive, Attleborough, Norfolk, NR17 1QW Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01953 457360 01953 457360 Flagship Housing Group Ltd Mrs Kerrie Jane Good Care Home 7 Category(ies) of LD Learning disability registration, with number of places OAK TREES I55 S27491 Oak Trees V229062 060705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 To accommodate a maximum of seven (7) adults of either sex with learning disabilities (LD) Date of last inspection 17 March 2005 Brief Description of the Service: Oaktrees is situated in a small estate on the outskirts of the town of Attleborough. There are two adjacent properties, registered as one establishment. The buildings are in keeping with the surrounding houses. The home provides personal care to a total of 7 adults with learning disabilities. One building offers long stay accommodation and support to three tenants, while the other offers short stay respite care to four service users, (guests). In the short stay unit there is one first floor bedroom. All other bedrooms are on the ground floor. Staff within the same management team provide support, to people in their own tenancies within supported living units. As such the service is registered as both a care home and as a domiciliary care agency. OAK TREES I55 S27491 Oak Trees V229062 060705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection of Oaktrees was announced. The inspection involved reading various records, (which show what help people need), talking with tenants, staff and guests as well as discussion with the manager. Other houses where tenants are supported to live more independently were also visited as Flagship is also registered as a domiciliary care agency. The findings from these visits are recorded in a separate report. Survey forms were sent out to guests, tenants and parents/carers. Twenty forms, (six from tenants/guests and fourteen from parents/carers), were returned. The views expressed are included in the report. Guests and staff were also observed undertaking leisure activities during the day. The inspection lasted eight and a half hours. On this occasion not all of the National Minimum Standards were inspected. As the Commission thinks that Oaktrees is a well run service and there is no history of serious complaints only the ‘key standards’ were looked at. These are the standards that the Commission thinks are most important and must be looked at each year. What the service does well: What has improved since the last inspection? The manager has put into place all the things that were suggested in the last inspection report. This includes staff carrying I.D. cards so that tenants can check before they let someone into their house which improves their safety. When someone moves into or comes to stay at Oaktrees any special needs are looked at. This includes looking at their religion or background. OAK TREES I55 S27491 Oak Trees V229062 060705 Stage 4.doc Version 1.30 Page 6 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 TREES I55 S27491 Oak Trees V229062 060705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection OAK TREES I55 S27491 Oak Trees V229062 060705 Stage 4.doc Version 1.30 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 standard(s) 1 & 2 Tenants receive information about the services they are entitled to in a form they can understand and which tells them what level of service they can expect. Proper information is gathered on tenants so that their needs can, as far as possible, be met by the staff. EVIDENCE: Oak Trees has a Statement of Purpose and a Service User Guide. These documents are written in plain English. The Service User Guide has now also been produced in an audio form on a CD, copies of which have been sent out to families. This is commended. There has been no change to the process of assessment of new referrals since the previous inspection. Referrals to the service are made via Social Services who provide admission information. The manager and the acting deputy services manager carry out assessments of potential admissions. This process includes the involvement of parents, social worker and tenants/guests, (including the risk assessment process). The referral and initial assessment process is set out in Flagship’s procedures. However, since the last inspection a form has been added which prompts staff to consider the cultural and/or ethnic requirements of a tenant. OAK TREES I55 S27491 Oak Trees V229062 060705 Stage 4.doc Version 1.30 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 standard(s) 6, 7, 9 & 10 Care plans reflect a good level of detail about the needs of tenants and guests which helps staff deliver a good service. Guests and tenants can participate in daily living activities which have been risk assessed to help protect them. EVIDENCE: Several care plans were viewed. These contained information indicating levels of independence and ability to participate in areas such as personal care, (e.g. bathing, cooking, etc). As would be expected, care plans for guests having short-term stays are not as comprehensive as the permanent tenants, but records give a good picture of activities participated in, general mood and any special care and health needs such as dietary requirements. All care plans contained a photograph of the tenant/guest. In two cases documents did not contain a date showing when they were completed. This can lead to confusion. See recommendation. All of the tenants and guests who replied to the survey indicated that they felt well cared for. They also all felt their privacy was respected. The guests have signs on a hook outside their doors saying ‘do not disturb’ which they can hang OAK TREES I55 S27491 Oak Trees V229062 060705 Stage 4.doc Version 1.30 Page 10 on their doors if they wish. This is commended. All of the parents/carers indicated that they were satisfied with the overall level of care. Each file seen was noted to contain a full risk assessment sheet covering topics such as managing medication, moving and handling and bathing. Reviews of information are also in place and files now contain a separate sheet indicating the date of the next review. One of the guest’s was able to look after her own medication. Where able, tenants/guests can make hot drinks and participate in cooking. Records are stored in the main office in locked cabinets. Confidentiality is included in the induction checklist for all new staff. Two new members of staff were spoken with. They reported that confidentiality was one of the topics covered during their induction process. OAK TREES I55 S27491 Oak Trees V229062 060705 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 15 & 17 Guests and tenants have opportunities to be involved in leisure activities and to be involved in daily living skills that help them to promote independence. Guests and tenants contribute to meal choices and like the food. EVIDENCE: Guests and tenants have opportunities for activities both inside and outside of Oaktrees. The large conservatory provides a large space for in-house pastimes. On the day of the inspection guests were making various cards and items with a variety of paints and paper. One of the tenants had gone with a member of staff to a local town during the morning to do some shopping. This tenant said he goes home every weekend to stay with his parents. He had a computer game in his room and several shelves of videos. The tenants attend various day services during the working week. Written notes in care plans identify the cinema and ten pin bowling as other activities that tenants and guests participate in. One of the guests said that she had been to stay several times before and always enjoyed coming to Oaktrees. She said she looked after her own OAK TREES I55 S27491 Oak Trees V229062 060705 Stage 4.doc Version 1.30 Page 12 medication and looked after her money without help from the staff. She likes knitting and enjoys going out for pub meals and a glass of wine with the staff and other guests. At Oaktrees she said she had a nice room which included a television. Another guest said she had been several times to stay and she liked the staff. The guests are able to help in the preparation of food. Meals include impromptu visits to the pub and take always from time to time. Guests said they liked the food. One guest was on a gluten free diet and was able to have alternatives to the main lunchtime menu. Guests are free to make their own hot drinks in the kitchen. The tenants have their own kitchen where they and staff prepare meals. OAK TREES I55 S27491 Oak Trees V229062 060705 Stage 4.doc Version 1.30 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 standard(s) 20 Medication is managed in a way that helps prevent errors. EVIDENCE: Staff have received external training in managing medications. The medication records viewed were up to date. There are examples of tenants and guests looking after their own medication and this process is risk assessed. Families who use the Oak Trees service have been informed that all medications must come in its proper container clearly labelled by the Pharmacist. OAK TREES I55 S27491 Oak Trees V229062 060705 Stage 4.doc Version 1.30 Page 14 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 standard(s) 22 & 23 Training and policies are in place to help ensure that tenants are protected from accidents and abuse. EVIDENCE: Policies and procedures are in place to deal with complaints and with adult protection issues. All staff have now undertaken abuse awareness training. None of the tenants or their parents/carers have made complaints to the Commission. One of the tenants said he would go to the manager if he had any concerns to be dealt with. The complaints procedure is included in the Service User Guide. Two of the parents/carers indicated in their pre-inspection survey relies that they have made a complaint in the past. In both cases they noted that the complaint was dealt with in a proper manner. The complaints process is included in the Service User Guide which, as noted, is now also produced in audio form. OAK TREES I55 S27491 Oak Trees V229062 060705 Stage 4.doc Version 1.30 Page 15 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 standard(s) The environment is maintained in good condition to help ensure guests and tenants are safe. Tenants can have their own belongings and personalise their rooms to make them feel ‘at home’. EVIDENCE: The building is domestic in style and offers homely communal areas for guests and tenants to use. There is a good sized enclosed garden to the rear where guests and tenants can sit out in warm weather. From observations made during the inspection there were no obvious hazards to health and safety. The building was clean and tidy throughout. Guest allowed access to the bedroom she was using which was pleasantly decorated. A tenant’s room viewed during the visit reflected a high degree of personalisation. OAK TREES I55 S27491 Oak Trees V229062 060705 Stage 4.doc Version 1.30 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 and 36 Staff are recruited in a manner that helps protect tenants from receiving a service from staff who are not suitable. Staff are inducted and trained in a thorough manner that helps staff deliver a more professional service to tenants. Staff are supervised on a formal basis to help ensure issues relating to the care of tenants are discussed and tenants receive a good service. EVIDENCE: Three random staff files were checked. All contained evidence of identity, two written references and an enhanced Criminal Records Bureau check. Two new staff confirmed that they had not been allowed to commence working until these checks had been undertaken. Apart from undertaking mandatory training, staff are also encouraged to undertake NVQ training. One member of staff has completed NVQ 3. Two staff have completed NVQ 2. Nine staff are currently undertaking NVQ 3. Two new staff members described the first month of their employment. Prior to any shift work their first two days involved going through relevant policies and care practices with the manger and a senior staff member. This was followed by OAK TREES I55 S27491 Oak Trees V229062 060705 Stage 4.doc Version 1.30 Page 17 shadowing staff on shift. They were currently in the middle of three days induction training at a separate venue which is arranged on an organisation wide basis. This is in addition to the in-house induction process. Staff are up to date in all areas of mandatory training including health and safety, moving and handling and fire training. The accident record was viewed. No serious occurrences were highlighted. Staff reported that they receive supervision sessions on a regular basis. These are documented and are all staff have an annual appraisal process. The new staff had been made aware that formal supervision sessions will be part of their working timetable. The new staff commented that they found the staff group very supportive and that they had already attended a staff meeting which they found to be professionally run. Tenants are asked if they want to be involved in the recruitment of new staff. In the past some have. On the most recent occasion when new staff were interviewed a tenant was going to help, but then decided not to. OAK TREES I55 S27491 Oak Trees V229062 060705 Stage 4.doc Version 1.30 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 & 42 The views of guests and tenants are sought on a regular basis to help improve the service on offer to them. Records, such as fire and financial, are maintained to help ensure tenants and guests are protected EVIDENCE: There is a quality assurance process and this process has been produced in a report by the manager. This is written in plain English for the tenants. Examples of ways in which quality has been encouraged is by asking tenants as part of an internal survey. It also tells tenants what training staff have undertaken. Guests also receive a feedback form to complete at the end of each stay at Oaktrees. A sample of these were viewed. In general, they express high degrees of satisfaction. Money looked after on behalf of tenants is securely stored and is checked each day to ensure it is correct. A random sample was checked during the OAK TREES I55 S27491 Oak Trees V229062 060705 Stage 4.doc Version 1.30 Page 19 inspection and was correct. Receipts for expenditure are kept. If applicable, tenants have their own savings and bank accounts. Personal monies are not kept in any company accounts. The fire records were checked and were up to date. A tenant was asked what he would do in the event of a fire and he was able to describe how he would leave the building. Tenants have been involved in making procedures such as the fire procedure more understandable. This is commended. OAK TREES I55 S27491 Oak Trees V229062 060705 Stage 4.doc Version 1.30 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 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x x 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 OAK TREES Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x I55 S27491 Oak Trees V229062 060705 Stage 4.doc Version 1.30 Page 21 No 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 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. Refer to Standard 6 Good Practice Recommendations All documents on care plans should have a date of completion included OAK TREES I55 S27491 Oak Trees V229062 060705 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 3rd Floor Cavell House St Crispins Riad Norwich NR3 1YF 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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