Inspection on 12/05/05 for Oakfield

This inspection was carried out on 12th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Oakfield 26/09/08

Oakfield 30/04/08

Oakfield 14/08/07

Oakfield 18/12/06

Oakfield 26/10/05

Oakfield 08/11/04

Oakfield 07/06/04

Oakfield 04/09/03

Oakfield 19/06/03

Oakfield 30/07/02

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

CARE HOME ADULTS 18-65 Oakfield Easton Maudit Wellingborough Northants NN29 7NR Lead Inspector Helen Wilson Unannounced 12th May 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. Oakfield C51.C08.S12876.Oakfield.V225819.12.05.05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Oakfield Address Easton Maudit Wellingborough Northants NN29 7NR 01933 664222 01933 664333 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) Oakfield (Easton Maudit) Limited Vacant Care Home 18 Category(ies) of Learning Disability (LD) 18 registration, with number Mental Disorder (MD) 8 of places Oakfield C51.C08.S12876.Oakfield.V225819.12.05.05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 18 Service users category LD to include 8 service users under the category of MD Date of last inspection 8.11.04 Brief Description of the Service: Oakfield is situated on the outskirts of the village of Easton Maudit. The home is registered to provide care for 18 service users with a learning disability. The home has substantial grounds, which are used to keep various animals. All accommodation is in single bedrooms spread over two floors. The home has a minibus, a people carrier and a car at its disposal. People living at the home can attend day care services provided in the same building. The home is owned by a charity of the same name and a Board of Trustee Directors provide oversight of its operation. A recent change within the Board membership has resulted in a new Chairman, Mr Roy. Oakfield C51.C08.S12876.Oakfield.V225819.12.05.05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. This inspection report additionally addresses specific areas where requirements and/or recommendations were identified at the previous inspection. Two requirements and eleven recommendations were made at the last inspection, which were reported in an action plan dated February 2005 as having been or were being addressed by the Board of Directors. Oakfield has had no Registered Manager since July 2004. This was an unannounced inspection carried out by two inspectors lasting five hours and was conducted with the Senior Care Team Leader. Records and staff files were examined. Five staff were interviewed. Issues were raised that will be directly discussed with the Board of Directors concerning practices at the home, management, staffing and food provision. What the service does well: What has improved since the last inspection? The home continues to redecorate some upstairs bedrooms and the upstairs lounge/dining room has been completed. Oakfield C51.C08.S12876.Oakfield.V225819.12.05.05 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. Oakfield C51.C08.S12876.Oakfield.V225819.12.05.05 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 Oakfield C51.C08.S12876.Oakfield.V225819.12.05.05 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) EVIDENCE: This area was not assessed. Oakfield C51.C08.S12876.Oakfield.V225819.12.05.05 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) EVIDENCE: This area was not assessed. Oakfield C51.C08.S12876.Oakfield.V225819.12.05.05 Stage 4.doc Version 1.30 Page 10 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) 17 The home uses too much processed re-formed food and not enough fresh local vegetables, fruit, meat and fish. People living at the home need time to relax and talk with staff and enjoy mealtimes before starting their next planned activity. EVIDENCE: Lunchtime was highly organised with all service users filing in from the day service session and sitting with staff. The dining room was very quiet during the lunch with little sense of conversation or communication between staff and service users. Staff members said later that meals are often hurried to fit in with other routines such as teeth-cleaning for all service users. The meal consisted of a hot-dog sausage or cheese roll and fresh fruit or yoghurt. From the pre-planned menu it was noted that lunchtime is largely snack type food with the main meal cooked in the evening. From checking of the menu and looking at food stocks there is clearly an overdependence on frozen processed and re-formed items such as chicken nuggets, reconstituted lamb cutlets, etc. There is no weekend cook and the main Sunday meal regularly is bought in as frozen cooked meat and served with either fresh or frozen vegetables. The Oakfield C51.C08.S12876.Oakfield.V225819.12.05.05 Stage 4.doc Version 1.30 Page 11 senior cook on duty said that improvements were under way to buy additional fresh supplies from a greengrocer and butcher regularly. Oakfield C51.C08.S12876.Oakfield.V225819.12.05.05 Stage 4.doc Version 1.30 Page 12 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) EVIDENCE: This area was not assessed. Oakfield C51.C08.S12876.Oakfield.V225819.12.05.05 Stage 4.doc Version 1.30 Page 13 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) 23 Staff do not have confidence in the home’s complaint procedure as issues raised do not appear to be addressed. EVIDENCE: In April 2005 CSCI sent details of two anonymous complaints for investigation to a named Director regarding the conduct of the home, poor communication with the Board of Directors, unfair management recruitment and lack of action regarding concerns raised via the home’s consultant. The Director requested further details and the final date for reply was extended to 25 May 2005 as no investigation had been completed. Staff raised similar issues during this inspection. Staff also said that there have been occasions when some members of staff had been physically and emotionally abusive to people living at the home. Staff who have been worried have spoken to other members of staff and to a consultant who was brought into the home by the Directors. Staff said that no action was taken to sort the issues out and they say they are frightened to speak out again for fear of losing their jobs. The allegations cover various people being pushed, held, shouted at, given medication unnecessarily and being stopped from joining in activities outside the home. These staff concerns will be raised urgently with the Board of Directors and will need to be referred to the Northants County Council Protection Of Vulnerable Adult Procedures. Oakfield C51.C08.S12876.Oakfield.V225819.12.05.05 Stage 4.doc Version 1.30 Page 14 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 Generally upkeep of the home is satisfactory. EVIDENCE: All public areas of the home were clean, tidy and odour free. Rolls of new carpet were stored in the staff sleeping-in room and were due to be fitted in bedrooms and in a corridor although staff were unaware of when this work was to be done. Oakfield C51.C08.S12876.Oakfield.V225819.12.05.05 Stage 4.doc Version 1.30 Page 15 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) 31, 32, 34, 35 and 36 Staffing structures are not adequate and fail to ensure that staff are properly recruited, trained and supported through regular supervision. This is considered to place service users at risk. EVIDENCE: Not all staff members have a job description to clarify roles and responsibilities. Staff supervision has not taken place at two-monthly intervals and staff said they felt unsupported. From the pre-inspection questionnaire it was noted that the home uses agency staff on a regular basis to cover vacancies on shifts. Only four staff out of twenty hold a National Vocational Qualification Level 2 or its equivalent; by 2005 the expectation is that 50 of care staff should be qualified. Senior care staff and the Acting Manager are unqualified. Staff files were checked and there was insufficient paperwork relating to recruitment. From two staff files it was noted that the home had, for a carer employed in January 2005, obtained only one reference and that it was not from the most recent relevant employer and in the other file there was no written evidence of any references. From the pre-inspection questionnaire Oakfield C51.C08.S12876.Oakfield.V225819.12.05.05 Stage 4.doc Version 1.30 Page 16 information there was in addition no confirmation that a Criminal Records Bureau disclosure check had been obtained for this second member of care staff who was allowed to start work in the personal care of service users in July 2004. This same member of staff was suspended from duty in March 2005 and subsequently dismissed. The process of suspension and dismissal was handled well following the clear guidance obtained from the home’s consultants in employment and business matters. Oakfield C51.C08.S12876.Oakfield.V225819.12.05.05 Stage 4.doc Version 1.30 Page 17 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, 42 and 43 The home is lacking the stability of a dedicated and skilled manager to ensure that it meets the needs of the people living there. There is limited evidence that the Board of Directors is responding appropriately to the development needs of the home or to the maintenance of legal requirements. EVIDENCE: Some staff members said they are concerned at lack of leadership and management ability in the home and that they have already formally raised issues via a consultant brought into the home in November 2004 but with no feedback from the Board of Directors or improvement in the operation of the home. There have been recent resignations from within the Board of Directors with new responsibilities being delegated to newly recruited members. Oakfield C51.C08.S12876.Oakfield.V225819.12.05.05 Stage 4.doc Version 1.30 Page 18 Ccpies of the Board of Director’s monthly visit report for November and December 2004 sent to CSCI show that the home is being visited on an unannounced basis to monitor standards. The home has had no Registered Manager since 2003. Having had no success in recruiting a manager who meets the required qualifications and criteria for registration, the Board of Directors has recently submitted an application for consideration by CSCI for registration of the Acting Manager who has been running the home in recent times. Oakfield C51.C08.S12876.Oakfield.V225819.12.05.05 Stage 4.doc Version 1.30 Page 19 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 x x x x Standard No 22 23 ENVIRONMENT Score x 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x x 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 x x x x 2 Standard No 31 32 33 34 35 36 Score 2 2 x 1 1 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oakfield Score x x x x Standard No 37 38 39 40 41 42 43 Score 1 1 x x x 1 1 C51.C08.S12876.Oakfield.V225819.12.05.05 Stage 4.doc Version 1.30 Page 20 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 37 Regulation 8(1)(2) Requirement This requirement is restated from the previous report of November 2004 as it has not been met in full. CSCI must receive notice in writing of the formal arrangements to be made for management of the home until a Registered Manager commences employment. Timescale is restated. Advice from a Dietitian must be sought to assess the nutritional value of the planned menues and any recommendations actioned.. The homes Complaint Procedure must allow for issues to be raised with confidence that concerns will be fully investigated and action taken where necessary. Written confirmation of names of staff enrolled on NVQ training must be submitted to CSCI. All staff must have obtained a satisfactory Criminal Records Bureau disclosure at enhanced level prior to commencement of employment. All staff must have formal supervision on a regular basis. Staff files must evidence two Timescale for action 6 June 2005 2. 17 16(2)(i) 30 June 2005 6 June 2005 3. 23, 38 12(1,2,3, 4,5,)and 13(6) 4. 5. 32,35 34,40, 42 18(1) 19 30 June 2005 6 June 2005 6. 7. Oakfield 36 34, 40, 42 18(2) 19 30 June 2005 30 June Page 21 C51.C08.S12876.Oakfield.V225819.12.05.05 Stage 4.doc Version 1.30 written references relating to the person 8. 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 31 Good Practice Recommendations Staff job descriptions should be revisited and recirculated to each staff member to clarify roles and responsibikities.. Oakfield C51.C08.S12876.Oakfield.V225819.12.05.05 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Newland House Campbell Square Northampton NN1 3EB 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 Oakfield C51.C08.S12876.Oakfield.V225819.12.05.05 Stage 4.doc Version 1.30 Page 23 - 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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