Inspection on 26/10/05 for Oakfield

This inspection was carried out on 26th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 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 18/12/06

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 Mrs Helen Wilson Unannounced Inspection 26th October 2005 14:00 Oakfield DS0000012876.V261517.R01.S.doc Version 5.0 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.V261517.R01.S.doc Version 5.0 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.V261517.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Oakfield Address Easton Maudit Wellingborough Northants NN29 7NR 01933 664222 01933 664333 postmaster@oakfieldjm.force9.co.uk 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 Mrs Linda Ann Remmington Care Home 18 Category(ies) of Learning disability (18), Mental disorder, registration, with number excluding learning disability or dementia (8) of places Oakfield DS0000012876.V261517.R01.S.doc Version 5.0 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. 12/05/05 Date of last inspection Brief Description of the Service: Oakfield is situated in substantial grounds 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 additionally 8 people may have care needs relating to mental disorder. 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. Oakfield DS0000012876.V261517.R01.S.doc Version 5.0 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 on 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 was carried out on 25 October 2005 and included a partial tour of the premises, a review of selected records, and conversations with the staff members on duty and with service users. The registered manager was present during the visit. The primary method of inspection used was ‘case tracking’ which involved selecting three service users and tracking the care received through review of the case records. This inspection report additionally addresses specific areas where requirements and/or recommendations were identified at the previous inspection. What the service does well: What has improved since the last inspection? Oakfield DS0000012876.V261517.R01.S.doc Version 5.0 Page 6 The home has employed a full-time chef who has introduced a rage of new meals to the service users. The weekend meals no longer are based on precooked ingredients. Service users said that they liked the food. Arrangements have been made to change the home’s supplying pharmacist and to make improvements in the system for recording and administration of medication 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 DS0000012876.V261517.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Oakfield DS0000012876.V261517.R01.S.doc Version 5.0 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 the following standard(s): 1,4,5 The published written information about the home is unclear and does not accurately describe its services. The home has failed to set up contractual agreements for service users. EVIDENCE: The home’s Statement of Purpose and the Service User guide requires further revision and needs to be circulated to all service users and their families/significant others. From examination of three case files there is no evidence of contracts/terms and conditions signed and agreed between the home and the service users or on their behalf by families/significant others. Service users are given the opportunity to visit the home prior to deciding to live there permanently. Positive comments have been received by CSCI following a recent admission of a service user to the home. Oakfield DS0000012876.V261517.R01.S.doc Version 5.0 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 the following standard(s): 6,9 Although a programme of reviews held with Placing Authorities has been recently initiated, many service users’ care needs have not been reassessed for an unacceptable period of time. EVIDENCE: Documentation in three case files showed that reviews of care needs had not taken place for long periods of time and in the Registered Manager reported difficulties in establishing contacts within certain Placing Authorities. There have been some reviews held recently due to the proactive stance of the manager but many service users’ reviews have yet to be arranged. Care plans are lacking detail of how staff are to specifically support and provide levels of assistance to meet individual service user needs. Over reliance is placed on individual staff member’s own knowledge and interpretation of service users’ abilities and needs. There was evidence in case file records of thorough risk assessments for activities and handling of equipment by service users. Oakfield DS0000012876.V261517.R01.S.doc Version 5.0 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 the following standard(s): 11,12,13,17 The home provides a good range of activities for service users. There has been marked improvement in the provision of food. EVIDENCE: All service users at home during the visit appeared happy and confidently involved with staff. Several people told the inspector that they enjoyed living at the home. Most service users attend day services at the home’s premises and some people regularly go riding and swimming as part of their planned activities. A few service users are enrolled on college courses. The recent appointment of a full-time chef has improved the provision of meals and has introduced service users to a wider variety of recipes prepared from quality fresh ingredients. Weekend main meals are no longer based on precooked meat and pre-formed convenience food is not served. Oakfield DS0000012876.V261517.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 18,19,20.21 The home has failed to adequately guide staff by means of clear care plans on the methods to be used in providing care and support to individual service users and this may potentially lead to inappropriate working practices. EVIDENCE: Care plans for each service user must specifically detail to staff how care is to be delivered to appropriately meet care needs. Present care plans gave vague directions such as “ needs a minimum of staff intervention” or “Staff must be observant” and this may result in inconsistent interpretation and inappropriate care being provided by staff. Service users are registered with local GPs and have access to dentist and chiropody services. Proactive arrangements have been made to change the home’s supplying pharmacist and to make improvements in the system for recording and administration of medication The home has begun a process of identifying the known final wishes relating to illness and death arrangements by initially writing to service users’ families/supporters. Oakfield DS0000012876.V261517.R01.S.doc Version 5.0 Page 12 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 the following standard(s): EVIDENCE: These standards were not assessed. Oakfield DS0000012876.V261517.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 28, 30 Standards of housekeeping and general furnishing were well met. EVIDENCE: The home is clean, comfortable and generally well maintained. Three service users were eager to show off their first floor lounge and kitchen/diner facilities, areas that were freshly decorated and appropriately furnished. Oakfield DS0000012876.V261517.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36 There is a robust recruitment process that protects service users. The home has failed to supervise staff appropriately and this potentially is a risk to service users. EVIDENCE: Staff are hired following a thorough recruitment process and receive a range of basic training. Five care staff have achieved National Vocational Qualification certificates at Level 2 and seven others are again working towards either Level 3 and Level 2 awards. Staff supervision has not taken place at two-monthly intervals. This is an unmet requirement of the last report dated May 2005. Following discussion with the Registered Manager and a staff member concerning an issue reported during a supervision session, it was clear that the manager must retain responsibility for monitoring supervision notes delegated to other senior staff to ensure appropriate action is taken. Oakfield DS0000012876.V261517.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,43 The newly registered manager will need to identify and address outstanding management tasks and ensure the needs of service users are met. EVIDENCE: The Registered Manager Mrs Remmington is undertaking the required training awards expected for her post. Since her registration Mrs Remmington has begun to identify and action outstanding and overdue management tasks. A range of meetings is regularly organised for individual staff teams and for service users and minutes kept of information and items discussed. There is no formal annual Quality Assurance review process involving the views of service users, families/significant others and relevant agencies and professionals. Existing Policies and Procedures were discussed and it was agreed that work needs to be done to provide relevant documents in a format appropriate to Oakfield DS0000012876.V261517.R01.S.doc Version 5.0 Page 16 service users. The Registered Manager stated she had identified this as necessary to action. The home employs a Finance Manager who was able to state that the home is financially viable. There is a business and financial plan for the home and its service which is reviewed on an annual basis. Oakfield DS0000012876.V261517.R01.S.doc Version 5.0 Page 17 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 1 X X 3 1 Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 1 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X 3 X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 1 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oakfield Score 1 2 2 2 Standard No 37 38 39 40 41 42 43 Score 2 2 1 2 X X 3 DS0000012876.V261517.R01.S.doc Version 5.0 Page 18 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 YA36 Regulation 18(2) Requirement Staff supervision must take place regularly and at a minimum of six times per year. This is an unmet requirement of the last report dated May 2005. The Statement of Purpose and the Service User guide requires further revision and must be circulated to all service users and their families/significant others. There must be evidence of contracts/terms and conditions signed and agreed between the home and the service users or on their behalf by families/significant others. Care plans for each service user must specifically detail to staff how care is to be delivered to appropriately meet care needs. A quality assurance process must be established that publishes an annual review of the home’s performance. Written confirmation that this process has been developed and initiated to include the views of service users, DS0000012876.V261517.R01.S.doc Timescale for action 31/12/05 2 YA1 4,5 31/12/05 3 YA5YA1 5 31/12/05 4 YA18YA6YA5 15 31/12/05 5 YA39 24(1,2,3) 31/12/05 Oakfield Version 5.0 Page 19 families/significant others, relevant agencies and professionals must be forwarded to CSCI. 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.V261517.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor 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 DS0000012876.V261517.R01.S.doc Version 5.0 Page 21 - 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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