Inspection on 18/08/05 for Oakfield House

This inspection was carried out on 18th August 2005.

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

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

Other inspections for this house

Oakfield House 03/10/07

Oakfield House 17/10/06

Oakfield House 26/01/06

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 B29 7EJ Lead Inspector Kerry Coulter Unannounced 18 August 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 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 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Autism West Midlands Ms Eve Matthews Care Home 20 Category(ies) of Younger Adults, Learning Disability [20] registration, with number of places Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents must be aged under 65 years with a learning disability. Date of last inspection 11 February 2005 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 seperated into a single registration in 2005. Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and was conducted by one inspector. The inspector did not spend a significant amount of time with service users at this inspection as the majority were involved in their daytime activities. A tour of parts of the building and garden was made. Service user care plans and risk assessments were inspected. Staff recruitment procedures were examined, and a number of Health and Safety records were inspected. The inspector had the opportunity to talk with the Manager, Deputy Manager and several members of staff. During this visit the inspector did not have opportunity to speak with relatives and other professionals. What the service does well: What has improved since the last inspection? The Manager has considerable experience of working with people with autistic spectrum disorder and care management and has now built on this by completing an NVQ 4 in care. As required at the last inspection the hours worked by the Manager and Deputy are now recorded on the staff rota. A system for medication competence assessments for staff has been introduced. Autism.west midlands are moving towards updating the care planning documentation with the intention of standardising documents across its care homes. Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) N/A EVIDENCE: These standards were not assessed at this inspection. Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9 There is a clear and consistent care planning system in place to provide staff with information they need to meet service user needs. People are supported to take responsible risks, but some work needs to be done on how this information links in with the care plans. EVIDENCE: Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 Page 10 Two service user care plans were sampled. Both were seen to be well constructed with detailed information about the levels and type of support required by service users in accordance with their assessed needs. Individual plans also include information about service users preferred routines and the activities they take part in. Evidence was found within the care plans of the involvement of service users where appropriate, relatives and key workers in compiling them. It was initially not evident that care plans had been reviewed on a six monthly basis, however the Deputy was able to provide up to date care plan review minutes that were located in a filing cabinet rather than the care plan folder. The Manager must ensure these are transferred into the relevant folder. Discussion with the Manager indicates that autism. west midlands is moving towards updating the care planning documentation with the intention of standardising documents across its care homes. There is evidence that service users are supported to take manageable risks, and encourage individuals to have an independent lifestyle. Risk assessments were noted to in place for the home, day centre and community and new risk assessments had been created. As required at the inspection in February a risk assessment for one service user who may eat and drink substances not fit for human consumption is now available. Some documentation was noted to be very detailed regarding behaviour and sexuality. All risk assessments sampled were seen to have been reviewed. Some improvement is needed to the presentation of the risk assessments, each risk assessment should be directly cross-referenced to the element(s) of the care plan to which it relates, and vice versa, so that the reader is naturally directed from one to the other. One of the outcomes for completing risk assessments and care plans should be that the finished article is a simple and effective working document, in which essential information can be easily found. Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 17 A range of activities is offered in order to promote personal development, participation in the life of the local community and enjoyable leisure time. Service users enjoy a healthy and nutritious diet and exercise choice about what they eat. EVIDENCE: Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 Page 12 Service users have access to a day centre on the same site as their home, this is open during weekdays and is staffed separately to the home. Individual activity plans are provided for each service user and are presented by use of pictures that describe the activities on offer during each weekday. Activities on offer on the day of inspection included music, crafts, aromatherapy, computing, self help / laundry skills and a day trip. There was documentary evidence that service users enjoy going to pubs, the cinema, parks, bowling, swimming and going out for meals. The home employs two cooks. The home has a four week rolling menu that is revised twice a year. One service user who is an insulin dependent diabetic, is less willing to have a wide range of foods therefore, he has his own dedicated menu, which is collated by the cook with his direct input. Each service users care plan includes food likes and dislikes. Food stocks were observed to be satisfactory. Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 20 The health needs of service users are generally met. The systems for the administration of medication are generally good with clear and comprehensive arrangements being in place to ensure service users receive the medication they need. EVIDENCE: A sample inspection of service users’ health records indicates that service users are receiving routine access to general health services, such as well person’s checks, dentist, eye tests and chiropodist. Referrals are made to other health professionals as required to include the Continence Advisor. Service users do not have individual health action plans. This is something that the Government paper, ‘Valuing People’ recommended that each person with a learning disability had by 2005. This is to ensure individuals receive all the care they need to stay healthy. Discussions with the Manager and Deputy Manager indicate that they intend to commence health action planning but are committed to introducing a format that will enhance the current care planning process rather than introducing a format as a token gesture. It may be that this is an opportune time to engage with the local Community Nurse (Learning Disability) Service in order to move this forward. The system for the administration of medication is satisfactory. Medicines were seen to be stored appropriately in a secure location. A random audit of Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 Page 14 stocks held revealed no discrepancies, and there were no gaps on the administration record. Discussion with the Manager indicates that not all staff have received accredited medication training. However, medication competence assessments are now being completed for all staff who administer medication and medication training has been booked for staff who require it. Detailed protocols on the use of ‘as required’ medication had been completed. One service user self administers medication, a risk assessment was observed to have been completed for this practice. Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Adult protection procedures show that service users are being protected from abuse and that their welfare is being promoted. EVIDENCE: The homes adult protection procedures were assessed as satisfactory at the last inspection in February 2005. Staff had also received training in adult protection and studio III. The CSCI have been notified of an adult protection incident that occurred at college, the home took appropriate steps to ensure the protection of the service user and liaised with the college and Social Care and Health as appropriate. Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 27 and 30 Some redecoration of the premises is required to ensure the home presents as a homely and comfortable environment for service users. 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. For example 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. Efforts have been made to create domestic touches in communal rooms such as the use of pictures, photographs and ornaments. The home has seven bathrooms, some of these were observed to require redecoration due to areas of worn and peeling paint. One bathroom had a crack in the plastic adjacent to the bath, the Manager said she had not been aware of this and would report it for repair. The ground floor ladies toilet did not have a locking mechanism fitted, this will need to be repaired. Some extractor fans were observed to require cleaning as they were clogged with dust and dirt. Extractor fans were observed to require cleaning at the last Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 Page 17 inspection, the Manager will need to ensure that this forms part of the homes cleaning schedule. Some communal rooms were observed to require redecoration as they were worn in appearance. A small lounge and the dining room were observed to have some staining to areas of wallpaper. The Manager stated that the home has a five year cyclical redecoration programme and that several companies had recently visited the home to quote for work required but that she was unsure of any proposed timescales for redecoration. Oakfield House has a large laundry area with commercial washing machines and tumble driers. The laundry room is situated away from areas where food is prepared, stored and eaten. Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34 and 36 Staffing levels are appropriate to ensure service users are supported by sufficient numbers of staff to meet their needs. EVIDENCE: 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. Staffing levels are appropriate to the needs of the service users. Five care staff are provided during day time hours as well as five day care staff. The Manager and Deputy work supernumary and are available for extra care support if needed. A handover period of thirty minutes takes place at the end of each shift. The majority of service users at the home are male and it was noted that a significant number of male staff are employed. As required at the last inspection the hours worked by the Manager and Deputy are now recorded on the staff rota. Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 Page 19 The manager said that the home had only one staff vacancy, this was at the daycentre. The home does not use agency staff, staffing deficits are covered by the homes own relief staff. Records evidence that staff meetings are held on a monthly basis. The records of two recently recruited members of staff were sampled. Copies of application forms, written references and proof of identity were available. Information was also available to evidence that Criminal Bureau Record checks had been undertaken, however a copy of the CRB disclosure was not available for inspection. CSCI inspectors are eligible to see disclosures as part of their inspection. Exceptions are made by the CRB to the normal code of practice rule that disclosures may be kept for a maximum of six months, care homes can retain the disclosure for twelve months. The Manager must ensure that staff records contain the required CRB information to evidence that service users are appropriately safeguarded by the home’s recruitment practice. Staff supervision records were not sampled at this inspection but the inspection in February found that staff received regular supervision. At the time of this inspection the Manager was conducting formal supervision with a member of staff and the Deputy was in the process of typing up the minutes of a completed supervision session. This would indicate that supervision continues to be offered to staff on a regular basis. Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 and 42 Some improvements are needed to ensure the health, safety and welfare of the service users is adequately promoted and protected. EVIDENCE: The Manager has considerable experience of working with people with autistic spectrum disorder and care management. The Manager clearly leads by example and was open to the inspection process. Since the last inspection the Manager has completed an NVQ 4 in care. Fire records indicated that the fire equipment had been regularly tested by staff and serviced by an engineer. Records evidence that a fire evacuation took place in January. Five staff had received recent fire training but the majority of staff need refresher training to ensure they are aware of fire prevention and react appropriately in the event of a fire occurring. Records in the home evidenced that the fire door to one lounge was not closing properly, no planned date was available for the repair of the door. Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 Page 21 The most recent available certificate for gas safety was dated July 2004. The Deputy said that the gas appliances had recently been checked by an engineer and the home were awaiting the certificate. Some remedial works were required following checking of the homes electrical installations, these are in the process of being completed. The home does not monitor water temperatures on a monthly basis. This is required to ensure that water is delivered at a safe temperature to reduce the risk of scalding to service users. Hand testing of water temperatures at two baths indicated that the water temperature was very hot, the Manager stated she would ensure the temperature was reduced. Not all accidents and incidents occurring in the home had been notified to the CSCI as required, guidance was given to the Manager and Deputy on when notification is required. Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x 2 x x 2 Standard No 11 12 13 14 15 16 17 x 3 3 x x x 3 Standard No 31 32 33 34 35 36 Score x x 3 2 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oakfield House Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x x x 2 x E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 Page 23 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. 2. Standard 9 19 Regulation 13(4) 15 12(1) 13(1 23 (2) (b, c, d) Requirement Risk assessments must cross reference to care plans and vice versa. Health action plans must be introduced for all service users in line with the Government paper Valuing People. An audit of the standard of decoration in the dining room, small lounge and bathrooms is required, a planned schedule for redecoration must then be forwarded to the CSCI. First floor bathroom- cracked plastic adjacent to the bath requires repair. Ground floor ladies toilet requires a replacement locking mechanism to be fitted (of a type that is accessible in an emergency). The Manager must ensure extractor fans are cleaned on a regular basis. Outstanding from inspection in February 2005. The Manager must ensure that Criminal Records Bureau (CRB) disclosures are available for inspection by the CSCI. Staff must receive fire training on a six monthly basis. Timescale for action 30/10/05 30/11/05 3. 24 and 27 15/10/05 4. 5. 24 and 27 24 and 27 23 (2) (b, c, d) 12(4)(a) 23(2)(b) 30/9/05 30/9/05 6. 30 13(3) 30/9/05 7. 34 13 (6)Schedu le 2 13(4) 23(4)(d) 30/9/05 8. 42 18/9/05 Immediate Page 24 Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 9. 42 13(4) A copy of the up to date certificate for gas safety must be forwarded to the CSCI. Ensure all fire doors close properly and take action to repair the lounge fire door. Ensure accidents/ incidents are reported to CSCI as required under regulation 37. 10. 42 13(4) 23(4)(c ) 12(1) 13(4) 37 11. 42 requiremen t 25/8/05 Immediate requiremen t 30/8/05 Immediate requiremen t 19/8/05 Immediate requiremen t RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Oakfield House E54 S16973 Oakfield House V245834 180805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Birmingham & Solihull Local Office 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham, B2 4UZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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