Inspection on 18/12/06 for Oakfield

This inspection was carried out on 18th December 2006.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oakfield 26/09/08

Oakfield 30/04/08

Oakfield 14/08/07

Oakfield 26/10/05

Oakfield 12/05/05

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 Irene Miller Key Unannounced Inspection 18th December 2006 11:30 Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakfield Address Easton Maudit Wellingborough Northants NN29 7NR 01933 664222 01933 664333 lr.oakfieldltd.btconnect.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Oakfield (Easton Maudit) Limited Vacant Care Home 18 Category(ies) of Learning disability (18), Mental disorder, registration, with number excluding learning disability or dementia (8) of places Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No one falling within category MD may be admitted into the home where there are eight persons of category MD already accommodated within the home. 26th October 2005 Date of last inspection 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 and mental health needs. 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 homes is set in a rural location, on the outskirts of Easton Maudit, within the grounds there is land on which two pigs, a donkey and two Shetland ponies that belong to the home are looked after by service users with support from the staff. There is a pleasant outdoors seating area overlooking the open countryside. Fees range from £700 to £1400 per week. The home is owned by Oakfield, and is a registered charity and a board of trustees and directors provide oversight of its operation. Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 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 based upon outcomes for Service Users and their views of the service provided. This inspection was a second ‘Key Inspection’ that focused on the key standards under the National Minimum Standards and the Care Standards Act 2000 for homes providing care for adults (18-65) Prior to the inspection taking place the Commission for Social Care Inspection sent out to the home a pre-inspection questionnaire. The completed preinspection questionnaire was returned to the Commission for Social Care Inspection and provided information on the management systems within the home. The primary method of inspection used was ‘case tracking’ that involved selecting three residents and reviewing the care that they received and viewing written information on their care, such as the care plans (a care plan sets out how the home aims to meet the individual residents personal, healthcare, social and spiritual needs). Discussion took place with residents and staff, and general observations of care practices were made. Policies, procedures and records in relation to staff recruitment, complaints, and general maintenance and upkeep of the home were viewed. The registered managers post is currently vacant, however the deputy manger was available at the home throughout the inspection. The inspector spent two hours planning the areas to focus on at this inspection, based upon information gained from reviewing the homes service history, the last two inspection reports and information from the pre inspection data collection system. The inspection took place over a period of approximately six hours. Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? The Statement of Purpose and the Service User guide has been reviewed and updated since the last inspection visit. Contracts including the terms and conditions of residency had been signed and agreed between the home and the service users or on their behalf by families/significant others. The care plans had been reviewed and included specific details for staff to follow to ensure that the service users needs are met. A quality assurance system has been implanted to enable the service to conduct annual reviews of the home’s performance in meeting the service users needs and choices. Communication had taken place with service users and their representatives on seeking the services users wishes, in relation to aging, illness and end of life, the documentation viewed demonstrated that this area of the national minimum care standards in meeting the needs of service users had been addressed with sensitivity and respect. Staff supervision is taking place regularly. Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 Quality in this outcome area is good. Prospective service users needs and aspirations are assessed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes statement of purpose had been reviewed and updated, and individual service users contracts were in place that had been signed by the service user or their representative. The care of three service users was tracked; there was needs assessment in place that covered the service users health, emotional, and physical needs, in addition there was records of assessments having been carried out by placing authorities. Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7 & 9 Quality in this outcome area is good. Resident’s individual needs and choices are identified and accommodated. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans were individualised, each service users had a programme of activities, and there were records of the service users wishes in terms of their chosen activities and what support they wanted/needed from staff. The care plans viewed had all been signed by the service users, and contained sufficient detail for staff to follow, reviews to the care plans had recently taken place. Risk assessments for service users and staff general home safety were in place and risk assessments specific to individual service users were in place. Theses gave instructions for staff to follow in recognising the signs and triggers that had the potential to lead up to a service user to becoming over anxious and result in disruptive or challenging behaviour towards other service users and staff, the instructions for staff to follow were specific to each individual service Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 11 user to ensure that there was a consistent staff approach when responding to any challenging behaviour. Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14,15,16 & 17 Quality in this outcome area is good. Service users are enabled to live as independent a life as possible within a supported environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was service user individual activity programmes in place; areas covered in the programmes were the promotion of daily living skills, such as tidying their bedrooms, laundry and general housekeeping chores, and leisure and sport activities such as swimming, sailing, feeding the animals and educational activities. There was records of service users attending educational courses such as Information Technology (IT) computer courses, one of the service users spoken with said that they would like to have their own computer, as they enjoyed attending the local college and would like to have more opportunity to practice the skills that they had learned. Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 13 A day service is available within the home which service users attend, and they also attend local social clubs were they can meet up with friends and take part in peer and cultural activities of their choosing. Within the grounds of the home there was a small animal farm that had two pigs, two Shetland ponies and a donkey, each of the service users had allocated days each week when they contribute in feeding and caring for the animals, with staff support. The service users were encouraged to integrate with the local community; regular outings to local public houses and places of entertainment were documented in the service users care plans, and records of communication with families and family contact were seen in the individual care plans. The service users rights to experience appropriate, personal relationships, is recognised within the individual care plans and treated with sensitivity and respect. The weekly food menus seen demonstrated that varied, nutritious meals were provided. The service users participate in choosing what is to be included on the menus two weeks in advance and within the daily menu requests seen individual choices of foods were provided. There was information available for catering staff informing them of service users who had food allergies and food intolerances, on speaking with the catering staff they were very aware of each service users food likes, dislikes and dietary requirements. Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19,20 & 21 Quality in this outcome area is good. The physical, emotional and healthcare needs of service users are identified and met by the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Within the care plans seen there was detailed information for staff to follow on the individual service users personal support requirements, within one of the care plans viewed there was very detailed information for staff to follow to ensure that the service user exercised their rights to choose how their personal support was given. All of the service users were registered with local General Practitioners, and records were available within the care plans of visits to the optician, dentist and chiropodist. The staff were observed to provide support to service users, in a respectful manner and promoting the service users rights to be as independent as possible. There was a homely atmosphere and the service users were relaxed and friendly with each other. Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 15 Communication had taken place with service users and their representatives on seeking the services users wishes, in relation to aging, illness and end of life, the documentation viewed demonstrated that this area of the national minimum care standards in meeting the needs of service users had been addressed with sensitivity and respect. All medications are administered by staff, the homes medication policy was available and the storage and administration records were viewed, there was some gaps n the medication administration records were staff had not signed on administering the medication, however overall the records viewed were seen to be satisfactory and in keeping with medication policy. One of the service users case tracked was in the process of having their medication reviewed by their GP, and therefore the instructions on the medication record sheets had been handwritten, discussion took place with the person in charge about the need for a system to be in place to double check any handwritten instructions to ensure that they are accurate and legible. On viewing the daily records of service users there was an occasion when a medication storage error had been reported by the staff and of the home taking appropriate action. An inspection of the homes medication storage and administration procedures was carried out by the dispensing pharmacy in August 2006, and good practice recommendations had been followed through by the home. Medication training was provided through the dispensing pharmacy and the County Council, the person in charge confirmed that an experienced member of staff supervises staff that are assigned the responsibility for administering medication until they are deemed competent to administer medication unsupervised. Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 & 23 Quality in this outcome area is good. There is an effective complaints policy in place, and systems are in place to safeguard residents from any form of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure was outlined in the homes statement of purpose, service user guide and in the individual service users contracts, the procedure was only available in a written format, discussion took place with the person in charge about the need for other formats to be available to ensure that all service users can be confident that any concerns or complaints they may have can be communicated In discussion with the person in charge it was suggested that having a copy available on the notice board within the front entrance might also be of benefit. The responsible individual for the home had dealt with one safeguarding referral appropriately and records were available of the involvement of Care Management and the Commission for Social Care. Training was provided to staff on recognising what constitutes abuse and reporting procedures. Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 & 30 Quality in this outcome area is good. The service users live in a safe, comfortable and homely environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was furnishing and decorated in a homely style, within the communal areas there was a range of media equipment available for service users such as satellite television, books, games, CD’s, DVD’s and videos. The service users bedrooms were very individualised, and decorated to a good standard, having good quality soft furnishings, personal pictures, ornaments, personal CD’s and TV’s. The kitchen was clean and tidy; the catering staff confirmed that refurbishment work to the main kitchen was to take place in 2007. There was records available of food safety standard checks, since the last inspection by the Commission for Social Care Inspection, there had been an inspection from the Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 18 environmental health officer (EHO) and the home was provided with a copy of the Safer Food Better Business Guidance that had been provided by the EHO, and this was seen to have been put into use. The laundry was viewed and seen to be clean, staff information notices were on display to re-enforce good hygiene practices and reduce the risks of cross infection Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32,34 & 35 Quality in this outcome area is good. There is a loyal, trained and experienced staff group to support residents living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was a system in place for staff to receive individual one to one supervision and participate in regular team meetings; records were seen of supervision sessions and the minutes of team meetings. Three staff recruitment files were viewed and all contained evidence that robust recruitment and selection procedures were followed, such as checks with the criminal records bureau (CRB) and the protection of vulnerable adults (POVA) list, two written references, and the investigation of employment histories. There was a staff induction programme in place, the induction record of one new member of staff was seen, and demonstrated that there was a commitment to ensuring that staff receive a comprehensive introduction to the home and that this was supported by appropriate training. Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 20 There were records of mandatory training having taken place such as fire awareness, food hygiene, health and safety, manual handling and first aid. In addition training had been provided on medication awareness, protection of vulnerable adults, challenging behaviour and breakaway training. The staff spoken with confirmed that they felt well supported by the homes management and by their peers. Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37,39 & 42 Quality in this outcome area is good. In the absence of a registered manager, the registered provider and staff team have ensured that standards have been maintained in supporting the service users living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Currently the registered managers position is vacant, the deputy manager, was supported by a full time administration assistant and had the responsibility for the day-to-day running of the home. Standard 37 has been given a score of 2 (standard almost met), however this is not a reflection that the deputy manager lacks the ability to manage the home, the scoring reflects the standard not being fully met due to the lack of a registered manager being in post. Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 22 A requirement has been made that the registered provider must notify the Commission for Social Care Inspection in writing of the absence of a registered manager and the arrangements that have been made for the running of the home during the absence. Work had progressed in putting in place a quality assurance system to seek the views of service users, staff and relatives and records were seen of a survey that had taken place in January 2006, and the outcomes and action points identified from the survey results. The staff training records viewed demonstrated that training was provided for staff that was appropriate to their roles and responsibilities. The staff were observed to provide support for the service users with patience and respect, the staff spoken to said that they enjoyed working at the home, the staff were committed to supporting the service users living at the home, many had worked at the home for a number of years and had come up through the ranks to take up senior care positions. Improvements to the service users care plans and associated risk assessments had resulted in the information being clear and easy to follow by staff, this had ensured that all staff fully understood the care plans and that there was a consistent approach to the delivery of care and support for the service users. All maintenance records and risk assessments looked at were thorough and up to date. Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 2 X 3 X X 3 X Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 24 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 YA37 Regulation 38 (1) (b) (e) Requirement The registered provider must notify in writing to the Commission for Social Care Inspection, what arrangements are in place to appoint another person to manage the home, including the proposed date by which the appointment is to be made. Timescale for action 05/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Text phone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Oakfield DS0000012876.V322605.R01.S.doc Version 5.2 Page 26 - 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. 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