Inspection on 09/06/05 for Oakdown House

This inspection was carried out on 9th June 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

Oakdown House 23/01/07

Oakdown House 25/10/05

Oakdown House 18/01/05

Oakdown House 01/09/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Oakdown House Ticehurst Road Burwash Common East Sussex TN19 7JR Lead Inspector Jason Denny Unannounced 9 June 2005 09:30 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. Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Oakdown House Address Ticehurst Road Burwash Common East Sussex TN19 7JR 01435 883492 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) Oakdown Limited Mrs Joyce Chapman Care Home 44 Category(ies) of Learning disability (LD) 44 registration, with number of places Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of residents to be accommodated is forty four 2. The residents will be between the age of eighteen and sixty five years on admission 3. Total accommodation includes twenty six residents in the main house, six residents in the bungalow and twelve in the pavillion 4. To accommodate a maximum of twelve (12) service users with a learning disability and physical disability in the pavillion Date of last inspection 18 January 2005 Brief Description of the Service: Oakdown House provides accommodation for forty-four adults with Learning Disabilities. The main house provides for twenty-six service users on three floors, separated into three ‘flats’, each including a communal lounge/dining area and kitchenette. There are three bungalow flatlets, each for two service users and these provide semi-independent living. Adjoining the main house is a purpose-built special care unit for twelve service users with high dependency needs associated with their learning and physical disabilities. A communal area and assisted bathrooms are provided on each of the two floors, in addition to specialist aids, equipment and adaptations. At ground level there is a well-equipped day resource with an outdoor activity area and a sensory room. On-site workshops for daytime activities include craftwork, painting, drama cooking, music sessions, and a newly built computer suite. A range of workbased, educational and leisure activities are offered off site. The buildings and extensive gardens are set in a rural location with readily accessible village community facilities such as a church, public houses, and a bus route. Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an Unannounced routine inspection [first of two planned before April 1st 2006], which was carried out by two Inspectors and took place between 9.20am and 3.20pm. The Inspection found that of the 27 National Minimum Standards inspected, that 24 of these standards had been met, with 4 exceeded. The overall focus of the inspection was on resident’s involvement in the homes, which included discussions and examination of a range of records including minutes of residents meetings. The Inspectors spoke with 18 residents and observed a number of others in activities. The Inspectors toured all communal areas across the 5 homes which form Oakdown House and looked at bedrooms, kitchens, and activity areas. Discussions with the management team took place around progress since the last inspection. A meal was taken. Care and staff records, along with safety documentation were inspected. The inspectors both interviewed and observed staff. What the service does well: What has improved since the last inspection? Staffing ratios have increased at the busiest time of the day in the Main house. These staffing numbers are also under continuous review with further Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 6 increases planned in line with the changing older person needs of some residents. Only 1 vacancy was found in a staff team of 65 plus therefore resulting in only occasional use of agency staff. Contracts between the Oakdown and the residents contain the necessary detail. The range of activities has improved further such as the introduction of weekly evening social club and pottery classes. The recording of Resident and staff meetings is better. The decoration of the Main house was found to be in progress during the Inspection. A number of shortfalls found in all buildings were found to have been already identified by the Organisation with a plan to attend to this at some future point. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 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 Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 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) 1,2,4 & 5 Although the home provides good information in its guide this is not enough. This information needs to be on display and available to residents and visitors. Assessment information in relation to residents was of a good standard. The home ensures that prospective new residents have a high number of trial visits to ensure they are making an informed choice and to ensure that existing residents have a chance to meet them and pass a view. Residents contracts/agreements are well written, explained, and agreed by all, before a permanent place is offered. The contracts will benefit from showing the input of someone independent of the Organisation to safeguard everyone’s interests. EVIDENCE: The home has a Statement of Purpose. The home has a clear complaints procedure. The format of the Residents Guide was in both normal print and also in large print with photographs and symbols to assist a person with communication needs to follow the information. The guide is also on talking tape. The guide contained a range of information and some photographs but had no views of residents. The Inspector could not find the guide on display in the Main house. A staff member in the lounge at the time indicated that a resident on the top floor had borrowed it. It was explained that everyone should have a copy on requests with a copy of the guide clearly on display to prompt people to access the useful information. Pre-admission assessments are undertaken by the Organisation, with Residents and relatives consulted with. There are social care assessments Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 9 available and discussions with Social Services in every case. This was all clearly recorded for the newest resident. The Inspector found that the newest resident had visited on at least 3 occasions prior to moving in. The resident was found to have settled in well. The inspector observed compatibility of residents within each of the homes all of which have their own distinct purpose. Some residents were found to be in the process of being reassessed due to changes in their needs. For each Resident [service user] there is a Social Services contract, additionally a form of service user agreement has been produced by the home that outlines the rights and responsibilities, terms and conditions, the plan for personal support and the facilities and services to be provided. Contracts seen were found to be signed. Some contracts were signed by a fingerprint where the person lacks the ability to sign. It was recommended that an independent advocate also sign the contracts. The fee level is based on assessed need. One resident was found to be on £422.54 with others with higher needs, on a different fee. The basic fee includes all day services and is fully funded by social services. The detailed breakdown of fees also show the cost of extras should the resident wish to pay for these. Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 10 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) 6,7,8 & 9 Care-Plans were found to contain good information subject to regular review with all relevant people. Care-plans showed evidence of being put into action and were found to be highly relevant to the needs of the individuals concerned. Staff showed a good understanding of guidelines especially in relation to the newest resident. Risk assessments were found to be relevant and thorough. Residents are all supported to be as independent as is practically possible. A wide variety of choice is available to residents, who have an exceptional level of involvement in the running of the Organisation and their individual homes. EVIDENCE: The Inspectors sampled 5 care-plans. The key worker together with the resident carries out care planning. Residents have access to their plans and choose who is to attend their review meetings. The care plan includes an assessment of all aspects of personal and social support and healthcare needs. The Inspectors found a basic level of information helpful for staff in meeting needs. The inspectors found that recent changes for residents had been reflected in amendments to the plans. The plans also contained an individualised daily planner to show staff what assistance is necessary for each resident. The planner also focuses on the development of daily living skills. Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 11 The plans were easy to navigate. Risk assessments also form part of the care planning process and are regularly reviewed such as example of one reviewed on 24.5.05. This includes a moving and handling, environment, and general risk assessment. Another care-plan was found to have detailed health guidelines and an accurate personal profile including catheter care. Minutes of Resident meetings and other records, along with discussions with residents, showed a range of ways in which they are involved in the running of the Organisation. Residents are consulted in relation to the employment of new staff. Residents are encouraged to exercise responsibility and make choices about their day-to-day living. A number of the residents manage their own savings accounts and pocket money expenditure and have keys to their rooms. Those who do not manage their own money sign an agreement to allow the home to do this. This is subject to regular review. The home retains details of an Independent Advocacy Service, should any Resident require this. In practice residents confirmed that they access the independent counsellor who visits twice a week for such a service. The counsellor informed the Inspector that she provides specialist advice and support to residents. Confidentiality is maintained unless this compromises the safety needs of residents. None of the current residents were assessed to require additional independent advocacy. Staff and managers spoken to had an accurate knowledge of the care-planning information and were aware of the key issues involved for each individual. Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 12 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) 12,13,15,16 & 17 Residents are carefully supported to progress to a level of independence that they are comfortable with. Meaningful and exceptionally wide-ranging Activities take place on a regular basis and are available for all residents. The organisation provides an exceptional range of activity facilities. Residents have continuous opportunities to learn new skills and further their education. Full structured routines are in place based on resident’s needs and choices. There is a good range of leisure activity. Residents are encouraged to play a full role in the community by a motivated staff team. Meal arrangements are good and healthy with residents have a choice of a meal. EVIDENCE: A full, weekly programme of activities is available to all Residents with their names recorded on weekly and daily activity sheets according to what preferred activities they wish to attend. All residents spoken too confirmed Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 13 that they were satisfied with the level of activities. This was also confirmed in records, minutes of meetings inspected, and observations. Regular activities organised on site include, woodwork, computer skills, sensory room, music and movement, painting, drama, counselling, gardening, horticulture, physiotherapy, reflexology, and cooking. Discussions, observations, and records indicated regular community activities such as college classes at Ringmer, swimming at Eastbourne along with other leisure activities such as hydrotherapy and pub and shopping trips, in the local community. The inspectors toured the two main activity centres on site. The Pavilion home for people with a more severe physical and learning disabilities has its own purpose built activity centre within the home. All residents were observed to be engaged in varying activities supported by trained staff. The home also has a touch screen computer, its own sensory room, and cycle area. At the large day centre used by other residents, an Art deco painting session was in progress with 6 residents. Other art and crafts activities were taking place. The centre has a range of computers. Woodwork was taking place for others. Some residents were found to be gardening whilst others were shopping. A smaller number of residents were found to be less active, which was partly attributable to age, and motivation and mainly their choice as confirmed in discussions. A number of residents indicated their pleasure with a recent 7 day Holiday to Spain and Somerset respectively. The Inspector saw preparations for a recent play of Robin Hood involving residents in a public performance. Staffing levels were found to be complemented by dedicated activity workers along with volunteers and outside specialists, which visit such as the Reflexologist. A variety of evening and weekend activities are also arranged. One resident indicated that he is supported to go to Church every Sunday except the Sunday before the inspection due to staff sickness. Newer activities such as pottery and a Wednesday night social club have been introduced since the last inspection. Weekend activities were found to be improving in relation to planning. There are 4 vehicles on site with revised plans to ensure that all residents have equal access to these for outings. Links have been established within the community. Residents confirmed that Staff respects their right to privacy; they were observed to be attentive to the needs of residents, whilst at the same time giving encouragement to develop self-help skills and promote independence. A number of residents receive support within their counselling sessions in relation to sexuality and relationship building, as confirmed by the manager and counsellor. Residents were observed to treat the home as their own, freely coming and going, or spending time in the privacy of their own room, as they wish. One resident exercised her wish as she informed the Inspector to have a supported bath at 11am. All residents were found to have written down individualised routines which staff signed to show their understanding. Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 14 Menu plans are agreed in consultation with residents. There is always a choice at mealtimes, a record being kept of any special diets or preferences. The home was found to have a range of fresh ingredients including meats, fruit and vegetables. A meal was sampled by Inspectors. Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 15 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) 18,19 & 20 The home was found to be meeting resident’s health needs and was fully aware of what additional support it required. The inspector judged that resident’s rights were upheld with them receiving support according to their needs and preferences. Medication arrangements were found to be satisfactory. EVIDENCE: A range of individualised protocols was in place with clear guidance on how to support those residents with varying epilepsy conditions. Staff were found to be fully aware of their differing needs with clear written guidance in place along with nurse on call buzzer systems in the home. One resident with a particular medical condition has been supported to move into the more independent bungalows where no routine night checks take place. The home was found to have carefully risk-assessed this and felt that the condition was under control as confirmed in records with the benefits outweighing the risk. Another resident whose health needs had increased was found to have moved from the bungalow back into the main house where more staff support is available. Another resident was found to be receiving regular input from a psychologist following changes in behaviour. Records and discussion indicated that all residents are supported to manage as much of their self-care as possible with this clearly recorded in care-plans. The care-plans clearly indicate what support staff are to give. Those residents spoken with confirmed that they were happy with the way staff support them Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 16 in their health needs. One resident indicated that he had been well supported since returning to the home following a hip operation. He described how his increased need of staff is well met. Staff were observed to skilfully support residents. This was particularly evident in the Pavilion where highly complex needs were being managed and where staff showed a good awareness of the needs and preferences of people with communication needs. The system of storing and administration of medication throughout the homes was inspected and found to be in good order. The actual dispensing of medication was not inspected. A discussion took place around who dispenses medication. The inspectors were informed that only trained senior staff handle Resident’s medication. Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 17 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 Although the home and organisation respond appropriately to complaints especially by residents they need to improve the level of detail and clarity in the complaint file. This process should also show more involvement by residents with their status fully respected by writing to complainants. The rate of Complaints continues to be low relative to the number of residents, with most issues promptly dealt with informally. Staff continue to demonstrate a sound understanding on how to prevent and report abuse and continue to benefit from adult protection training. Staff were found to be aware of the homes complaints recording policy and procedure. All staff follow a consistent approach when dealing with residents distress. EVIDENCE: The inspector found six complaints over the last year brought by residents, usually about other residents. Two of these complaints were found to be substantiated with prompt measures taken by the home. These complaints related to residents being unhappy about their peers invading their privacy. The home fitted alarms to their rooms to alert staff to support those affected. The complaint file did not show what investigations had taken place and the outcome. The record did not confirm the residents view on how the complaint was handled. The Complaints book needed the Manager to explain its contents as the records contained lacked clarity. It was agreed that residents should be treated no differently than other complainants and so should be written to at each stage of the process. Their comments on how the investigation was handled along with the outcome should also be recorded in the complaints log. Key workers are trained to respond to service user’s wishes, suggestions, or concerns. All staff have received training in the protection of vulnerable adults. There is policy guidance for staff to adhere to. This is covered in new staff ‘s induction Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 18 and via periodical training with the last session taking place on 190105 and next scheduled for 220605. The manager was found to be booked on a Social services run Protection of Vulnerable adults course. The home has referred to the POVA list a staff member dismissed from their employment. The home has on behalf of its residents initiated 3 adult protection investigations over the last year. Social services have informed the Commission in between inspections of the homes good practice in this respect. Staff interviewed indicated a sound knowledge of all the issues involved and how to both detect and report potential abuse. Someone claiming to work at Oakdown house communicated one complaint directly to the Commission in July 2004. The complaint related to staffing issues and was found not to be supported by the evidence. The evidence, which did exist, indicated positive outcomes for staff. Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 19 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) 24, 26, & 30. Resident’s benefit from living within homes set within extensive and well maintained grounds. The grounds and garden areas are exceptional, well maintained and safe. Accommodation for residents varies in quality and maintenance. Some residents live within purpose built well maintained and equipped accommodation while other residents especially those with older people needs require some further adaptations to their accommodation and some refurbishment to a one lounge. The accommodation for those who are more independent is in particular need of renewal, redecoration, and more effective cleaning. Resident’s benefit from having their own keys, freedom of access, and safe storage. EVIDENCE: The main building and its 26 rooms were toured as were the Pavilion for 12 people along with the 3 bungalows which house 2 people in each. As far as possible the homes were found to be open and homely. The Pavilion was found to be ideally suited for its purpose. This home was clean, personalised, and well equipped. Improved Wheelchair access to the garden was found to planned. Access is available to the courtyard Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 20 Some of the older people in the Main house were found to use commodes although cleaning arrangements were identified as needing attention along with the need for a sluice. This along with a stair lift was found to be planed for the home although no clear date of when this will take place except that the manager stated that work would commence within the next year. Two of the rooms had slight odours linked to arrangements around toileting. The carpet in the smoking lounge of the Main house was found to need replacing this affects the impression of the home, as this lounge is the usual entrance area. This area was found to have been recently decorated. The carpet is planned to be replaced when a conservatory is created for those residents who smoke. This lounge was found to have been recently decorated. Sufficient number of bathrooms were found in the Main house. However, residents on the top floor described how they prefer to come down a floor to use a shower. On their floor there is two baths one of which was found to be working. The home was advised to explore putting a shower room on the top floor. The main kitchen was found to need a clean especially the fridge and freezer areas. This was addressed during the inspection. All of the three bungalows were found to need redecoration and renewal of several showers. The bathroom areas were found to be in particular need of deep cleaning. All these areas were discussed with the management team who in the main had already identified these shortfalls. A plan of when work will take place was requested. A number of residents were found to have keys to their rooms and their own lockable storage facilities. Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 21 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 & 35 Staffing ratios meet residents assessed needs, have increased since the last inspection, and are under continuous review. Training arrangements for staff were found to be exceptional. EVIDENCE: Rota’s inspected showed that staffing ratios had increased by 1 person since the last inspection in relation to the Main House between the busiest time of 810am. Staff confirmed that this was beneficial to supporting morning routines. It was also found that discussions were taking place to increase this to 8-11am and to have an extra waking night person. The Pavilion was found to be have 7 staff plus a deputy for the 12 residents during the day, and one staff 8-10am for the more independent residents in the bungalows [6 residents]. These level decrease in the evenings according to need. Dedicated day care workers and the availability of deputy managers also boost staffing. The manager assured the Inspectors that staffing levels were sufficient to meet need. The 6 people who live in the bungalow have no staff support on their premises and are aware of calling the Main House if they have a problem. The manager stated that there was a plan to increase staff support at night to the Main house when 2 resident vacancies are filled, which in turn will increase night-time support for the bungalows. The deputy of the Pavilion stated that he is in discussions with Social services to increase 1:1 funding to some residents to increase staffing. Residents and staff interviewed indicated that staffing levels were sufficient but Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 22 were under review due to the older person needs of some people at the Main house. The organisation was found to have 1 vacancy in a staff team of 65 plus. The use of agency has also decreased to an average of 1 shift per week from 4 per week at the previous inspection. Most staff, over 62 , was found to have National Vocational Qualifications. Others were working towards these as confirmed in records and discussions. A TOPSS foundation induction is used for all new staff. An induction book inspected indicated a wide range of induction training, which takes place during the first 6 weeks of employment. Staff also does a core unit of the Learning disability framework before they go on to NVQ. The home is an approved NVQ Assessment centre. Two staff are currently being trained to become NVQ assessors. The first day of induction involves a tour of the home they will work in, followed by emergency procedures. Policies and procedures are taught to staff by a dedicated personal person who supports staff to use a workbook to test their knowledge. Adult protection training is taught within the first few weeks. For a two week period of each month training is delivered for all 5 shift patterns. During the week of Inspection learning disability training was taking place. This was observed during the afternoon of the inspection. A record showed that most staff attended. Dementia and Autism training was found to be planned from the 14th of June. The other two weeks of the month are involved with staff supervision. The organisation continues to have the Investors in People Award. Staff as confirmed in records is requested to bring their NVQ and other work to their six-weekly supervisions where they discuss their personal development needs. Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 23 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) 37,38,39 & 42 Resident’s benefit from a home, which is well managed in their best interests. The management’s team’s input, experience and qualifications, exceed the normal standard and has been essential in delivering positive outcomes for all residents. Residents and staff are supported to be fully involved in the running of the home and are consulted on any changes. Residents and staff have open access to management and have regular opportunities to air their views. Health and Safety maintenance was found to be satisfactory. EVIDENCE: The Registered manager has 40 years of relevant experience in this field of work. She has undertaken periodic training to update her knowledge and skills relevant to the needs of people with learning disabilities both younger and older. The manager is a Registered General Nurse holding a diploma in social work. She has also achieved the Registered Managers Award. One of the three deputy managers has NVQ 4 with the other two deputies working towards NVQ 3. One of these deputies also has a personnel role. The management team Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 24 through discussions displayed their motivation and knowledge of the needs of Residents. Minutes were seen of a range of staff meetings which took place in on 250505 and 040505 and which are monthly. The Inspectors observed staff and Residents having regular and open access to management. Staff spoken too confirmed how well supported they are by the manager. Residents indicated that they are encouraged to participate in the running of the household, wherever possible. Resident’s views are formally sought at their reviews, during their fortnightly house meetings and informally through sessions with their key worker. Minutes of a meeting, which took place on 150505, were seen. An improvement to weekend activities has been implemented. Care plans, policies and procedures are regularly reviewed and updated. A commitment to service user involvement is demonstrated in the planning and delivery of services. Resident’s periodical satisfaction questionnaires were inspected 0.4.05. The inspector also found that a concern about the behaviour of a new resident had been sorted out. The management team were advised to collate the views of residents into periodical report format. The monthly section 26 visits as evidenced in reports are carried out by one of the directors of the organisation. The last report to be sent to the Commission was of a visit occurring on April 24th, which was received on May 23rd. The manager carries out and records risk assessments for safe working practices, including a fire risk assessment. Monthly health and safety checks are carried out and recorded. In-house training and, where necessary, external courses are provided for staff in core skills e.g. first aid, food hygiene, health and safety and Non-abusive Psychological and Physical Intervention. Records showed that all established staff had done these courses including food hygiene and first aid. Radiator guards and water temperature controls are fitted, wherever there may be risks to Residents. The Inspector saw a current liability insurance certificate on display. Health and safety certification was in order. Some electrical appliances were due for retesting 2 weeks before the inspection. The manager confirmed that the contractor was organising this. Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 25 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 4 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 3 x x x 2 Standard No 11 12 13 14 15 16 17 x 4 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x 4 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oakdown House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 4 3 3 x x 3 x H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 26 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. 1. Standard 24 Regulation 23[b],[d], [j],[k]& [n] Requirement That the Registered Person must send the Commission a plan of when work will commence on the following areas: The redecoration, renewal and refurbishment of the Bungalows. Adaptations to the Main house to make it fit for older people, such as a the fitting of a sluice facaility and a stair lift. That a shower room is explored on the top floor to meet the prefered needs of those service users on that floor. That the plan includes the renewal of one of the Main houses lounges. That this plan is sent to the Commission by the date shown 09/09/05. Timescale for action 09/09/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 1 Good Practice Recommendations That the Service user guide must be complete and include all information such as residents views on the home along with emergency social services and health authorities H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 27 Oakdown House 2. 3. 5 22 4. 30 numbers. That information in the guide such as contact names is kept up to date. That the guide is clearly on display in the home and available to service users [Residents] and visitors. That Service user [Resident] contracts are also signed by an independent representative/advocate. That the homes complaint file must contain a clear record of complaints made, in accordance with the standard. That the Complaints file records the investigation and outcome of the complaint. That the file shows evidence of the complainant being written to at each stage, along with the complaints comments about the outome of the investigation. That the homes complaint procedure must include accurate up to date contact names. That cleaning schedules are revised to ensure the regular and effective cleaning of all necessary areas. Oakdown House H59-H10 S21177 Oakdown House V226604 090605 Stage 4.doc Version 1.20 Page 28 Commission for Social Care Inspection 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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