Inspection on 11/07/05 for Oakcroft

This inspection was carried out on 11th 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

Oakcroft 10/10/08

Oakcroft 16/10/07

Oakcroft 26/02/07

Oakcroft 29/12/05

Oakcroft 18/10/04

Oakcroft 27/04/04

Oakcroft 02/03/04

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

CARE HOME ADULTS 18-65 Oakcroft 8 Winston Rise Four Marks Alton GU34 5HW Lead Inspector Pat Hibberd Unannounced 11.07.05 09:00 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. Oakcroft H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Oakcroft Address 8 Winston Rise Four Marks Alton GU34 5HW 01420 563442 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) Iliace Limited Mr Michael Roberts CRH 4 Category(ies) of LD Learning Disabilities 18 years - 30 years registration, with number of places Oakcroft H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Service Users can be admitted between the age of 18 and 30 years. Date of last inspection 8.10.04 Brief Description of the Service: Oakcroft is owned by Iliace Ltd a private organisation . The Responsible Individual is Richard Roynane and the Registered Manager Michael Roberts. The home is one of a number owned by the Organisation. The property has four bedrooms and is situated in a rural location within a ten minute drive from the town of Alton which has a range of leisure, recreational, shopping, educational and employment facilities. The service provides for four service users between the ages of 18 and 30 years who fall within the learning disability service user group. Oakcroft H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over four hours and was the first of the 2005/2006 inspection programme. Fifteen of the forty-three standards relating to younger adults were assessed. There was one issue identified on this occasion, details of which can be found in the main body of the report. One concern was highlighted at the last inspection relating to the need for all staff to undertake training in the protection of vulnerable adults has been addressed. The inspection included a tour of the home and garden. Discussions were held with three service users, two staff members on duty and the home’s manager. Prior to the inspection the Home was sent a self-assessment questionnaire relating to care provision, staffing, the environment and health and safety in the home. This was completed and returned to the Commission prior to the inspection and contributed to the findings as detailed in this report. Two comment cards were received from relatives. Both praised the service in terms of communication with the staff team and the overall care provided. However, both considered that the home needs to ensure there are more staff on duty that can drive, particularly at weekends, as they reported that activities are sometimes cancelled due to lack of drivers. This was discussed with the manager. Further details can be found in the main body of the report. A further four comment cards were received from service users. Service users advised that they liked living in the home, felt involved in decisions reached about their home and, that they considered the staff treat them well. One service user indicated that they would like to do more at weekends. One service user file and one staff file was viewed which further contributed to the findings of the inspection. What the service does well: What was evident throughout the inspection was the commitment to ensuring service users are central to all care provided and lead a full and positive life style. The home has a Communication Co-ordinator who is responsible for ensuring the methods of communication in the home are appropriate for each individual. Oakcroft H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 Page 6 The staff team were seen to communicate appropriately with service users using various communication methods. The home is keen to ensure service users’ interests are identified and a range of both in house and community activities are provided. The Organisation has their own “activities (DAP) team” who, alongside the management and staff, assess and provide individual programmes for all service users. There is a range of training provided and staff confirmed that they receive regular supervision and daily support from the manager, which they find beneficial to their daily practice. 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. Oakcroft H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 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 Oakcroft H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 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) 2 There is a comprehensive assessment process ensuring service users needs are identified by the home prior to admission. EVIDENCE: There have been no new admissions to the Home since the last inspection. The home has an extremely comprehensive process of assessment, which includes four areas of need. The first is a personal profile of the individual, the second skills maintenance, the third work placements and finally behavioural guidelines. The manager confirmed that there are systems in place to ensure any prospective service users’ needs are assessed by a suitably experienced and competent person. Oakcroft H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 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 and 9. The arrangements for care planning are consistent for all service users, ensuring their care needs are met within a risk management framework. Service users are supported to make decisions as to their chosen lifestyle. EVIDENCE: One service user file was viewed, and the care was discussed with staff and the individual service user. Observations were also made about how the care was delivered. The care plan had a range of information relating to the individual and the support required to ensure their needs are being met including risk assessments which are constantly monitored and reviewed on a two monthly basis or sooner if required. Service user views as to care provided had been captured through a continuous process of monitoring /observation by the staff team. Details were recorded in reviews held in files and daily records completed by staff. Time was spent with one service user who was going on holiday on the day of the inspection. They were able to indicate that they had been fully involved in Oakcroft H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 Page 10 preparing for the holiday and had made choices as to how they were hoping to spend their time. Staff indicated they had been given clear guidance on how to support service users while they were on holiday. From discussions held with staff it was evident that they were aware of service user’s needs, and care plans and risk assessments would be implemented as appropriate. The manager confirmed that care management assessments had been provided for a number of service users and that Social Services and Community Health Teams were involved with individuals as necessary. Daily records are completed for all service users with shift “handovers” taking place with a view to ensuring continuity of care. Oakcroft H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 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) 13,14 and 17 Links with the local community are good with service users having opportunities for appropriate activities based on their interests. Menus are well-balanced, creative and offering choice ensuring the dietary needs of service users are met. EVIDENCE: The Organisation has an ‘activities ‘ team and together with the home staff they endeavour to ensure service users have a community presence by devising programmes of activities for each service user. These include swimming, cooking, bike rides, shopping, horticulture, music and movement. One service user has a voluntary job and is supported by staff. One file viewed confirmed that the service users interests are being pursued through planned programmes. Oakcroft H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 Page 12 The Home has a Communication Co-ordinator who explained that their role is to ensure all documentation is up to date. They are further responsible for developing in house programmes in pictorial formats to ensure service users can identify how they are to spend their day. Two service users were able to indicate activities they enjoy and pursue and who supported them. Discussions were held with the manager and staff with regards to three feedback forms received by the Commission, which indicated that there were not always sufficient weekend staff on duty who could drive, resulting in activities being cancelled. Both the manager and staff confirmed that there was a vacancy on one shift for a driver. Candidates were being interviewed and it was hoped that all shifts would soon have a driver on duty. In the interim, staff are providing in house activities and utilizing public transport. Service users weekly programmes were viewed which indicated that they were actively involved in a range of activities including weekends. Rotas confirmed there are sufficient staff on duty during the evening and weekends to support the activities identified. The home has one unmarked vehicle available for service users. The manager advised that there are currently no service users accommodated who would understand the concept of voting. The manager confirmed that this would be pursued if appropriate for an individual. Menus were well balanced, following consultation with a dietician to ensure their nutritional value. Menus are in a pictorial format with service users actively involved in the planning/shopping and preparation. An alternative meal choice is always available. Oakcroft H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 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) 18 and 19. The health needs of service users are well met with evidence of good multidisciplinary working taking place on a regular basis. Personal support is offered in such a way as to promote and protect service users’ privacy and dignity. EVIDENCE: All service users have access to a GP. One care plan viewed confirmed that the service user has access to health professionals as required including the local community learning disability health team. Details of preferred personal support needs for the service user were available in the file viewed. The information was detailed and had been regularly reviewed by the manager and staff team to ensure they had read and understood the guidance documented. Health action plans had also been completed and shared with staff. Staff were observed supporting Service Users with their personal care in a dignified and respectful manner. Oakcroft H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 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 and 23 The complaints policy and procedure is available to all service users and relatives, ensuring their concerns are addressed. Arrangements for protecting service users are satisfactory. EVIDENCE: The home has a complaints policy and procedure in a pictorial format of which all service users have a copy. The manager confirmed that parents and representatives are also provided with a copy, as not all service users would have an understanding or concept of how to make a formal complaint. Two staff members spoken to indicated that they felt confident that service users would express dissatisfaction with service provision using their individual means of communication or, through a change in behaviour. There have been no complaints since the last inspection. The manager demonstrated that he is aware of the Hampshire Adult Protection policy and procedure and his role in the event of an allegation of abuse. Staff spoken to were also aware of their role and responsibilities and had undertaken adult protection training. Due to there being one Service User accommodated who can exhibit challenging behaviour SCIP (Strategies in crisis for prevention and intervention) training is undertaken by all staff. Details of approaches to be taken were detailed in one service user file viewed. Oakcroft H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 Page 15 All staff are required to undertake a Criminal Record Bureau check before commencing work in the home to ensure the continuing protection of service users. Oakcroft H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 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 standard(s) 30 The home has good practices ensuring that service users live in a clean and hygienic environment. EVIDENCE: The home was clean, bright and hygienic with policies and procedures and systems in place including infection control /control of substances hazardous to health (COSHH), food hygiene and moving and handling training for the majority of staff. Staff spoken to confirmed that they were aware of their responsibilities in relation to hygiene in the home, were provided with gloves and aprons as required and had received infection control training. Access to the laundry area is through the kitchen, and staff confirmed their awareness of adherence to an appropriate policy and procedure. Hand washing facilities were available throughout the home. A contract is in place for the disposal of clinical waste. Oakcroft H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 Page 17 Oakcroft H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34 and 35 The home’s recruitment practices are satisfactory, ensuring service users are protected. Service users are supported by sufficient trained staff although some staff would benefit from additional training to ensure they have the appropriate skills. EVIDENCE: The home’s manager is on duty in the home Monday to Friday between the hours of 9am and 5pm. He indicated that he would undertake additional hours if necessary to cover staff sickness within the Organisation. Rotas viewed confirmed that there are two staff on duty between 7.30am and 9.30pm. The waking night member of staff commences their duty at 9.00pm providing time for the two afternoon shift members an opportunity to discuss the day, and any issues that may have arisen for service users. From discussions held with regard to service users’ needs, it was evident that there are sufficient staff on duty to meet their current needs. Staff meetings are held two monthly with two staff indicating that they considered the meetings to be helpful and a forum to discuss service users’ needs as a staff team. Oakcroft H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 Page 19 One staff file viewed contained all information as required including a Criminal Record Bureau check, completion of an application form, two written references and employment history. The home has a staff development and training programme with the manager and the Organisation’s training officer having responsibility for the budget and training programmes. All new staff receive a thorough induction with the Learning Disability Award Framework (LDAF) being integral to the process. All staff are currently completing the six induction packs based on the LDAF. Staff have undertaken a range of training which including autism, moving and handling, first aid, fire safety, food hygiene, medication administration, COSHH, infection control, epilepsy, Person Centred Planning, SKIP, Makaton, Adult Protection, health and safety and continence. Two staff have not undertaken moving and handling training and three staff need to undertake food hygiene training. The manager further advised that only one of the seven staff employed in the home has achieved an NVQ (National Vocational qualification). He is in discussion with the Organisations Training Manager to ensure that the home can meet the requirement of 50 of the staff team achieving the qualification by the end of the year. Oakcroft H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 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 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) No Standards were assessed on this occasion. EVIDENCE: Oakcroft H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 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 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x 3 Standard No 11 12 13 14 15 16 17 x x 3 3 x x 3 Standard No 31 32 33 34 35 36 Score x x 3 3 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oakcroft Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 Page 22 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 35 Regulation 18 Requirement The Registered Provider must ensure all staff have received moving and handling and food hygiene training. Timescale for action 11/9/2005 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 Good Practice Recommendations Oakcroft H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 Page 23 Commission for Social Care Inspection 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Oakcroft H54 S34443 Oakcroft V234398 11.07.05.doc Version 1.40 Page 24 - 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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