Inspection on 17/10/06 for Oakfield House

This inspection was carried out on 17th October 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 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oakfield House 03/10/07

Oakfield House 26/01/06

Oakfield House 18/08/05

Oakfield House 11/02/05

Oakfield House 30/12/04

Oakfield House 22/03/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Oakfield House 6-12 Oakfield Road Selly Oak Birmingham West Midlands B29 7EJ Lead Inspector Kerry Coulter Unannounced Inspection 17th and 18 October 2006 09:45 th Oakfield House DS0000016973.V317331.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 House DS0000016973.V317331.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 House DS0000016973.V317331.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakfield House Address 6-12 Oakfield Road Selly Oak Birmingham West Midlands B29 7EJ 0121 471 1913 0121 414 0017 evem@autismwestmidlands.org.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) autism. west midlands Ms Eve Matthews Care Home 20 Category(ies) of Learning disability (20) registration, with number of places Oakfield House DS0000016973.V317331.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents must be aged under 65 years with a learning disability. Date of last inspection 26th January 2006 Brief Description of the Service: The home offers accommodation for up to 20 people with autism spectrum disorder. Oakfield House is a three storey Victorian style terraced building which has been converted and extended to create a 20 bedded home and a day care centre. The home is spacious and includes four lounges, two separate offices and a large room for staff meetings. All bedrooms are single rooms. The extensive garden to the rear of the property offers scope for large functions to be held. The home is not equipped to provide services for people with physical disabilities. Oakfield House was previously jointly registered with another home but separated into a single registration in 2005. Current fees for living at the home range from £905 to £1734, items such as toiletries and taxi fares are extra. Visitors to the home can see a copy of CSCI reports, these are located in the entrance hall. Oakfield House DS0000016973.V317331.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home and a completed pre – inspection questionnaire. One inspector carried out the unannounced fieldwork visit over two days. This was the homes key inspection for the inspection year 2006 to 2007. The staff on duty and the Manager were spoken to. The inspector met with a limited number of the service users as some were on holiday and others were undertaking activities away from the home. A tour of the premises took place. Care, staff and health and safety records were looked at. Following the fieldwork visit CSCI surveys were received from fifteen relatives and five health and social care professionals. What the service does well: The staff are friendly and helpful. The staff team is stable, and people are supported by staff they know, and who are familiar with their needs. Members of staff actively encourage service users to take responsibility for as many things are they are able, within their individual capabilities. Each service user has a care plan. Staff have the information they need so that they know how to support service users to meet their individual needs and goals. There is evidence of service users receiving regular health checks. Staff seek input from other health and social care professionals to assist in meeting individual need. The home benefits from having an on site day centre with designated staff to offer time-tabled activities to service users. The staff help people to stay in touch with family and friends. This is in person, by phone and by letter. Autism west midlands has regular Sexuality and Protection Meetings where current practice issues are discussed and good practice ideas explored. Oakfield House DS0000016973.V317331.R01.S.doc Version 5.2 Page 6 The style of management in the home is relaxed, open and inclusive, and the Manager is making clear efforts to develop the service for the benefit of the people living there. Efforts have been made to meet most of the requirements made at the time of the last inspection. What has improved since the last inspection? What they could do better: A detailed record of food eaten needs to be recorded so that staff can effectively monitor that each individual is having a varied and balanced diet. Service users need to have an up to date inventory of personal possessions to ensure that staff know what possessions each person has and it is easier to track if things should go missing. A review of the financial system is needed to ensure the safe handling of service users monies, this is already in progress. Oakfield House DS0000016973.V317331.R01.S.doc Version 5.2 Page 7 Some areas of the environment requires redecoration and general maintenance to ensure that service users have a homely and comfortable home in which to live. All staff must have regular, formal supervision sessions with their manager to make sure they are supported to meet resident’s needs. Autism west midlands must ensure the Manager gets copies of reports from the visits by their representative so that she has a clear record of any actions she needs to complete as a result of the visit. 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 House DS0000016973.V317331.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 House DS0000016973.V317331.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): 1 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Service User Guide provides prospective service users with relevant information about the home to enable them to make an informed choice about if they want to live there. Service user needs and aspirations are assessed appropriately prior to moving in. EVIDENCE: Copies of the home’s statement of purpose and service user guide were readily available in the home. The service user guide is in an easy read format that includes pictures making it easier to understand for service users. Discussion with the Manager indicates the admission procedures are satisfactory, and remain unchanged from the previous inspection. The home has one vacancy but no service users have moved in since the last inspection. The Manager said it is very unlikely this will be filled as Autism west midlands intend to reduce the number of people accommodated at the home. Oakfield House DS0000016973.V317331.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): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have the information they need so that they know how to support service users to meet their individual needs and goals. Staff support service users to make decisions and to participate in all aspects of life in the home. Service users are supported to take risks within a risk assessment framework. EVIDENCE: The care provided for three service users was case tracked. Each individual had their own person centred care plan. The plans had a recent review; this was done in a review meetings where relatives had been invited to attend. The plans contained satisfactory information to enable staff to meet service users needs, areas included routines, personal care, meals, behaviour, health, activities and cultural needs. Oakfield House DS0000016973.V317331.R01.S.doc Version 5.2 Page 11 Key-workers complete a monthly report about each service user, detailing their general well being and any significant events during the month. Behaviour management strategies were in place for individuals. These provided staff with guidance about possible triggers to behaviour, and guidance on how to prevent some behaviours occurring as well as what to do in the event of some behaviours. Guidelines were up to date. Service user’s ability to exercise choice and to make informed decisions is variable, according to their individual needs. Records showed that where a service user has made a decision this has been listened to and action taken to make sure their wishes are followed through. Records sampled and observation of practice indicates that choice is offered to include activities, meals, times of going to bed and getting up. Staff spoken with gave examples of how choice is promoted for service users such as putting all cereals in clear containers so that service users can see what is inside and can choose more easily what they want for breakfast. Service user risk assessments were sampled. There is evidence that service users are supported to take manageable risks, and individuals are encouraged to have an independent lifestyle. Assessments were up to date and included epilepsy, roads, fascination with fire, diabetes, night checks and use of scissors. These stated how staff are to support individuals to minimise the risks involved. Oakfield House DS0000016973.V317331.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): 11, 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Generally arrangements are sufficient to ensure that the people living in the home experience a meaningful lifestyle. Contact with relatives is actively promoted. Staff recognise service users rights and encourage their independence. Service users appear to enjoy the meals provided but improvement to records is needed to show a balanced diet is offered. EVIDENCE: Sampling of records and discussion with service users show that service users have opportunities to participate in a wide variety of activities. These include opportunities for personal development. The Manager has set up a new communication group who meet regularly to work on developing communication opportunities for service users. New developments have included a makaton (sign language) folder for one individual so that staff have pictures of signs he uses. Oakfield House DS0000016973.V317331.R01.S.doc Version 5.2 Page 13 Photographs have been taken of staff so that a photographic rota can be produced, this will mean that service users will be able to look at a board to see who is going to be on duty that day. Baseline communication assessments are also being completed for all individuals. The home has the facilities of an art room, training kitchen, computer room and therapy room. Sampled daily diaries for two service users recorded lots of activities and contact with relatives. Photographs located around the home show service users doing golf, music, swimming and cooking. Day centre staff spoken with said that since a recent review of timetabled activities there were now more community activities on offer. They said one new activity is occasional trips to the I-Max cinema. That afternoon staff were taking some service users to the Lickey Hills. Service users have the opportunity to have a holiday in small groups or 1 to 1 with staff. Two service users were on holiday at the time of the visit, in Stoke at a farmhouse. Service users met with were unable to give their views on the activities provided due to the nature of their learning disability and communication needs. Surveys received from relatives of service users indicated they were satisfied with the activities on offer. Contact with relatives and friends is promoted by staff. Relatives are invited to review meetings where appropriate. Good communication links are maintained with relatives through regular meetings of the ‘friends of Oakfield House’ group. At these meetings relatives are updated about things such as staffing situations and given feedback from CSCI visits. Surveys received from relatives indicate they are all satisfied with the care provided at the home. Sampled care plans included details on any restrictions placed on individuals and rationale behind it. Service users are able to choose whether or not to spend time with others, or to have private time in their own rooms. They are encouraged to look after their own rooms as best they can, and supported to do this appropriately, but individuals’ personal space is respected by members of the staff team. The home has a 4 week rotating menu, this showed a varied choice of meals are available. One service user has completed his own separate menu due to his diabetic needs. Discussion with the Manager indicates that the home does not complete a record of food eaten for service users. The Manager said service users have what is on the menu, alternatives would be recorded in their diary. A detailed record of food eaten needs to be recorded so that staff can effectively monitor that each individual is having a varied and balanced diet. A small number of service users were observed having lunch (part of meal only). A choice of meal was observed to be offered by staff. It was difficult to establish with service users their views of the meal but one individual smiled when asked if it was nice. Fridges, freezers and cupboards were observed to be well stocked with food supplies. Oakfield House DS0000016973.V317331.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): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that service users receive personal support in the way they prefer and require and their health needs are met. The arrangements for the management of medication ensures service users safely receive the medication they need. EVIDENCE: Records indicated that personal care is done in privacy and in a gender sensitive manner, in the service users’ bedrooms. Service users were well dressed and their clothes were appropriate to their age, gender, the weather and the activities that they were doing. Times for getting up/going to bed and meals are flexible depending on the individual service users activities and needs. One service user has recently been very reluctant to bathe. Records and discussion with staff show staff tried different methods and have kept detailed records of what has been successful and unsuccessful in persuading this individual to have a bath. Staff have persevered and been patient in their approach and in the last few weeks the frequency of baths achieved has increased. Oakfield House DS0000016973.V317331.R01.S.doc Version 5.2 Page 15 Health action plans were sampled for three service users. This is a personal plan about what a person needs to stay healthy and what healthcare services they need to use. These had been produced using pictures and photographs so making them easier to understand. These show that service users health needs are well planned for and annual health appointments undertaken as needed. One service user is diabetic and self administers insulin. Clear guidelines were in place regarding this practice, staff spoken with were aware of the guidelines. Health professional surveys received indicated involved professionals were satisfied with the care provided and that staff work in partnership with them. The medication administration system was satisfactory. Storage of medication was observed to be satisfactory, creams were dated on opening and stocks of controlled medication matched the record of stock held. Sampled medication administration records were satisfactorily completed. Copies of prescriptions are retained. Staff were observed checking in some medication, they spotted a discrepancy and this was reported to the Deputy Manager who telephoned the GP/Pharmacist to rectify the error. Staff records showed that following a medication discrepancy the Manager had sent a letter to all staff reinforcing the homes medication procedures in an attempt to prevent future occurrence. Safeguards in place include a log of who has handled the medication keys and a daily medication check, the Deputy Manager also undertakes a monthly audit. Staff who administer medication have received training to do so. As recommended at the last inspection the Manager has introduced annual medication assessments for staff, these are a good tool to demonstrate that staff remain competent to administer medication. Oakfield House DS0000016973.V317331.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): 22 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The arrangements for making complaints ensure that service users views are listened to and acted on. Arrangements to ensure that service users are protected from abuse are being improved to ensure they are satisfactory. EVIDENCE: There have been no complaints made to the home or the CSCI in the last twelve months. A satisfactory complaints procedure is in place. An easy to understand version is available in the Service User’s guide. As recommended at the last inspection an easy read version including pictures has now been put on display in the main hallway. This means that service users and visitors have easy access to the procedure. A comments book is also available in the entrance hall so that minor complaints or compliments can be recorded by visitors. Surveys received show that the majority of relatives are aware of the complaints procedure. Three service user files sampled, one had an inventory dated 2004 and there were no inventories in the other two files. The Manager was sure that inventories had at one time been completed but acknowledged that these needed to be updated to ensure that staff know what possessions each person has and it is easier to track if things should go missing. The pre inspection questionnaire completed by the Manager recorded that eight incidents of staff having to use ‘minor’ physical intervention had occurred in the last twelve months. Oakfield House DS0000016973.V317331.R01.S.doc Version 5.2 Page 17 Records showed that one of these incidents had resulted in a small red mark to the service users neck when a member of staff had pulled away to prevent being bitten. Sampling of records showed some incidents where service users had physically assaulted other service users, this included one incident of biting. Some incidents had not been reported to the CSCI as required by regulation. An immediate requirement was made to ensure the home does this in the future. The home has recently obtained copies of a new form to use when staff have to use physical intervention, completion of these forms will ensure that all the information needed about the incident will be available and meet with the Department of Health’s guidelines on the recording of such incidents. All four staff spoken with said they had not had to use physical intervention in the last 12 months. Some had observed other staff having to use physical intervention on rare occasions. Staff had knowledge that it should only be used as a last resort and described how other approaches would be used first. Staff confirmed they had received Studio III training or were booked for refresher training in November. One staff said that there is always a debrief with staff following any challenging behaviour incident. Systems for safeguarding service users monies were sampled. For one service user there was a missing receipt for monies spent on a meal out. However, shortly after the visit the missing receipt was found and a photocopy was sent to the CSCI. Records and discussion with staff show that it is common practice for staff to take home service users monies, for example to do shopping for their Christmas presents. The current system does not ensure appropriate safeguards are in place as some staff had large amounts of money such as £500 in their possession for several weeks. Records sampled did not show which member of staff had possession of the money. Sampling of the policy regarding service users monies showed that there was no policy or procedure in place for this practice. Following the visit a new policy and procedure for handling service users monies was written and forwarded to the CSCI, this was observed to be satisfactory. Staff have received prevention of abuse training. Autism West Midlands has regular Sexuality and Protection Meetings where current practice issues are discussed and good practice ideas explored. The Deputy Manager is part of this group. Oakfield House DS0000016973.V317331.R01.S.doc Version 5.2 Page 18 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): 24 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Redecoration work has made Oakfield House a more pleasant environment in which to live and work but some areas need attention to ensure service users live in a comfortable environment that meets their individual needs. EVIDENCE: Oakfield House is a large property accommodating up to twenty people and therefore does not present as a domestic and homely residence in some areas. A reduction in the numbers of people accommodated would have the benefit of the staff being able to offer a more homely and person centred service. The kitchen is fitted with industrial type equipment and due to the needs of service users is locked at certain times when not in use. However the home does benefit from having lots of communal space to include several lounges. An extension with a further lounge and domestic sized kitchen for use by three service users whose bedrooms are adjacent is also provided. Oakfield House DS0000016973.V317331.R01.S.doc Version 5.2 Page 19 A small number of bedrooms were seen, these were very personalised and reflected the culture and gender of the individual. One service user spoken with said that they liked their bedroom and had everything they needed. The Home has the facilities of internal day services to include art room, training kitchen, computer room and therapy room. Unfortunately the Spa bath in the therapy room is out of order. The Manager said this is due to old pipe work and currently there are no available funds to replace the spa bath. Since the last inspection some improvements to the premises have taken place. The dining room and adjacent sitting area have been redecorated, this now looks much nicer. The Manager said that new tables were also on order as the current ones are scratched. The bungalow area of the home was not observed at this visit but the Manager said that a new kitchen in this area was being installed soon. Observation of the premises showed several areas that needed attention so that the home is a nice place to live. The shower area in the therapy room had one wall with a large section of tiles missing, these need to be replaced. In another shower-room the grouting was grimy and needs replacing. The gloss paintwork on one stairway remains very worn and has not been repainted as previously required. The Manager said that a water leak had occurred in the ceiling and this had delayed repainting as the plaster had to fully dry out. The carpet in the lounge adjacent to the dining area was very stained. The Manager said the carpet was only 18 months old but had proved unsuitable for this area. This will need deep cleaning to remove the stains or preferably replaced with a more suitable type of flooring. Curtains were observed on a stairway stained and covered in dust, attached to a loose rail. These will need to be replaced. The lock was broken on one toilet door, the Manager said this had not previously been reported as requiring repair. The garden was generally well maintained but contained an old broken garden bench that looked like it had been there for some time. There was no evidence of arrangements being made for its removal. Observation of the homes maintenance book shows that once items are reported for repair they are usually quickly addressed. However a number of repairs have been identified as needed that have not been reported. Discussion with Manager indicates regular environmental audits are not completed. It is recommended that these are introduced so that things such as broken locks and loose rails are identified, reported and repaired. The main kitchen was quite grimy one door had several liquid stains and a worktop was discoloured in parts. The Manager said that a professional cleaning company was coming to do a deep clean of the whole kitchen the next week. Appropriate hand washing facilities were observed in kitchen and laundry areas. The Manager said the home was getting two new tumble dryers as the current ones keep breaking down. Red disintegrating bags were observed to be available for soiled laundry. Oakfield House DS0000016973.V317331.R01.S.doc Version 5.2 Page 20 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): 32, 33, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Generally sufficient arrangements are in place to ensure that service users benefit from a staff team that is competent and qualified to meet their individual needs. EVIDENCE: Discussion with the Manager indicates that just below 50 of the staff have achieved the standard of having an NVQ in care. To meet this standard at least 50 of staff should have NVQ level 2 or above. Therefore, this standard is not yet met. However many staff are working towards completing this qualification. It was noted that both staff and service users appear comfortable in each other’s company and enjoy a good general rapport. They give support with warmth, friendliness and patience and treat people respectfully. Staff spoken with were knowledgeable about individuals needs, this was also confirmed in the surveys received from relatives and health and social care professionals. Copies of the staff rotas were sent with the pre inspection questionnaire, this showed satisfactory levels of staff. The current rota was sampled at the visit, Oakfield House DS0000016973.V317331.R01.S.doc Version 5.2 Page 21 whilst this was generally satisfactory care staff are currently helping out with some cleaning duties as the home has no housekeeper. The Manager said one housekeeper is off sick. A replacement has been recruited and is due to start work soon. Staff records were sampled. These included all the required recruitment checks had been completed to ensure that staff are suitable to work with the service users. Discussion with the Manager and sampling of records indicates that a variety of training has been undertaken by staff. Staff had done mandatory training plus service user specific training to include first aid, studio III, health and safety, sexuality and aspergers, food hygiene, autism. A programme of cyclical fire training has now been established and has resolved previous problems of staff not receiving refresher training six monthly. Certificates show staff have the opportunity to complete the Learning Disability Award Framework. The Manager said that the only training she has struggled to get places for staff is on diversity training as places have been limited. Staff spoken with all were happy with the availability and quality of training on offer. Staff records sampled showed that not all staff had regular, formal, recorded supervision sessions with their line manager. However, all staff spoken with commented that they felt fully supported in their role. One Team leader described how it had been difficult for him to keep up to date in doing staff supervisions due to sickness. Each member of staff should have at least six supervision sessions a year so they know how to support service users appropriately and any training and development needs can be identified. Records showed that staff meetings are fairly regular. Oakfield House DS0000016973.V317331.R01.S.doc Version 5.2 Page 22 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): 37, 38, 39 and 43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The current management arrangements ensure that service users benefit from a well run home. Arrangements are in place so that the health, safety and welfare of service users are protected and promoted. Quality assurance systems are generally satisfactory but more could be done to seek service users views in the development of the home. EVIDENCE: The style of management in the home is relaxed, open and inclusive, and the Manager is making clear efforts to develop the service for the benefit of the people living there. Four staff were spoken with, they confirmed the Manager listens to their opinions, is approachable and does not spend all her time in the office. Oakfield House DS0000016973.V317331.R01.S.doc Version 5.2 Page 23 The Managers training record evidenced she has done an NVQ 4 and the Registered Managers Award and keeps up to date with regular training and attending care conferences. Following the inspection visit the Manager was quick to send evidence to the CSCI regarding what was being done to address areas needing improvement. It is the responsibility of the organisation to ensure that their representative visits the home on a monthly basis to ensure it is being well managed. The Manager said these visits are happening but there were no reports of these visits in the home since February. To fulfil their purpose the Manager must have a copy of these reports so that she has a clear record of any actions she needs to complete as a result of the visit. The home is part of an accreditation system with the National Autistic Society. Relatives have the opportunity to contribute to the accreditation scheme, along with service users who are spoken with during the accreditation visit. The home is accredited on an annual basis and prior to the accreditation visit a folder of evidence is prepared. Following accreditation an action plan is devised to address any issues identified as needing improvement. It was discussed with the Manager that the home could do more to seek the views of service users and that consideration could be given to developing service user questionnaires. Systems are in place to ensure service user safety, an external company have recently completed a health and safety audit of the home and the Manager had completed an action plan to address all issues arising from the audit. Urgent areas had been rectified such as repair to one 1st floor window restrictor. Risk assessments for the premises were available and up to date. Fire records show alarms and lighting are regularly tested. Fire drills are conducted regularly; the last one was in August. Certificates evidenced the regular servicing of the fire alarm system. Discussion with the Manager and deputy show a programme of cyclical fire training is now established for staff as previously required. The home has recently had a visit from the West Midlands Fire service, some requirements were made and the Manager was able to evidence that action was being taken to address the requirements. As required at the last inspection one radiator in a bathroom has been covered to protect service users from the risk of scalding on the hot surface. A specialist water company has a contract to regularly monitor the water to ensure it is safe but records of water temperatures were quite difficult to track due to the technical contents of the report. It is recommended that the recording system is reviewed to enable the reader to clearly see that temperatures are maintained around 43°C and are protecting service users from the risk of scalding. Oakfield House DS0000016973.V317331.R01.S.doc Version 5.2 Page 24 New thermostatic temperature valves have recently been fitted. Hand testing and use of thermometer for temperature of hot water in bathrooms showed it was safe for service users. Oakfield House DS0000016973.V317331.R01.S.doc Version 5.2 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. 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 3 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 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 3 34 3 35 3 36 2 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 4 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 2 X 3 X X Oakfield House DS0000016973.V317331.R01.S.doc Version 5.2 Page 26 YES, ONE 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. 2. 3. Standard YA17 YA23 YA23 Regulation 17 (1) Schedule 2 12(1) 13(6) 13(6) 37 Requirement Timescale for action 30/12/06 4. YA23 13(6) The Manager must ensure that staff maintain a record of food eaten by service users. Ensure all service users have 30/12/06 an up to date inventory of personal possessions. All accidents and incidents as 18/10/06 detailed in regulation 37 of the Care Home Regulations 2001 must be reported to the CSCI without delay. A review of the financial 30/11/06 system is needed to ensure the safe handling of service users monies. New procedure forwarded to the CSCI following the inspection. Hallways and stairwayspaintwork requires repainting. Outstanding requirement from 30/04/06. Ensure dining area carpet and stairway curtains are deep cleaned to remove stains, or replaced if stains cannot be removed. Ensure the following general maintenance issues are DS0000016973.V317331.R01.S.doc 5. YA24 23(2) 30/01/07 6. YA24 YA30 23(2)(a) 30/11/06 7. YA24 YA30 23(2)(a) 30/11/06 Oakfield House Version 5.2 Page 27 8. YA36 18 (2) 9. YA39 26 addressed: Lock on ground floor toilet door. Missing tiles in therapy room shower. Dirty grouting in shower room. Ensure the broken bench is removed from the garden. All staff must receive regular, recorded formal supervision sessions with their line manager. Ensure copies of the reports of monthly visits by the Provider’s representative are available in the home. 30/12/06 30/11/06 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. 2. 3. 4. Refer to Standard YA24 YA35 YA39 YA42 Good Practice Recommendations Introduce a formal system for the regular auditing of the premises. Autism west midlands should consider increasing the number of places available on diversity training for staff. Increase the opportunities for service users to contribute towards the development and improvement of the home. It is strongly recommended that the current recording system for monitoring water temperatures is reviewed to enable the reader to clearly see that temperatures are maintained around 43°C. Oakfield House DS0000016973.V317331.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 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 House DS0000016973.V317331.R01.S.doc Version 5.2 Page 29 - 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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