CARE HOME ADULTS 18-65
Oakfield House 6-12 Oakfield Road Selly Park Birmingham West Midlands B29 7EJ Lead Inspector
Kerry Coulter Unannounced Inspection 26th January 2006 10:30 Oakfield House DS0000016973.V280603.R01.S.doc Version 5.1 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.V280603.R01.S.doc Version 5.1 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.V280603.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Oakfield House Address 6-12 Oakfield Road Selly Park 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.V280603.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Residents must be aged under 65 years with a learning disability. Date of last inspection 18th August 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 which is also used 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. Oakfield House DS0000016973.V280603.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over three hours. The Manager and the Deputy were available for all of the inspection. Several service users were spoken with. During this visit the inspector did not have opportunity to speak with relatives and other professionals. A partial tour of the premises took place. Care and health and safety records were looked at. This was the second of the statutory inspections for this home for 2005/2006 and not all of the National Minimum Standards were assessed. To get a full picture of the home it is advised to read this report in conjunction with the report from August 2005. What the service does well:
Members of staff actively encourage service users to take responsibility for as many things are they are able, within their individual capabilities. 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. Staff try hard to encourage service users to live as independently as they are able. The staff are very good at helping people stay in touch with their family. This includes making phone-calls, writing letters and in person. The home also has regular meetings with relatives, minutes of these meetings show that relatives are kept up to date with what is happening. At least 50 of the staff have achieved the standard of having an NVQ in care. Efforts have been made to meet most of the requirements made at the time of the last inspection. Oakfield House DS0000016973.V280603.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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 DS0000016973.V280603.R01.S.doc Version 5.1 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 House DS0000016973.V280603.R01.S.doc Version 5.1 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, 2 and 4 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: A statement of purpose is available, this was observed to be a satisfactory document. The service user guide is available in a written and pictorial format and is an easy to understand and informative document. It is advised that additional pictures of places of worship are added as currently only a picture of a church appears. The Manager agreed to do this, recognising that it was important to demonstrate that the home valued other religions/faiths. The home has one vacancy but no service users have moved in since the last inspection. Discussion with the Manager and Deputy indicate that they both have good knowledge of the admission and assessment procedures. Service users would, where appropriate be offered the opportunity to visit the home. However, the Manager said that due to the nature of autism this may not be appropriate for some individuals but this would be discussed with relatives and health and social care professionals before any decision was taken. Oakfield House DS0000016973.V280603.R01.S.doc Version 5.1 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): 7, 9 and 10 Service users are supported to exercise choice and make their own decisions where this is possible. In general, responsible risk taking is encouraged, but some work needs to be done to ensure all risks are assessed and updated. Confidential information about service users was appropriately handled within the home. EVIDENCE: Care plans were not sampled as the standard was found to be met at the inspection in August 2005. Service user’s ability to exercise choice and to make informed decisions is variable, according to their individual needs. Daily care records were of a good standard. Staff generally write detailed entries enabling the reader to track all the care provided. Records sampled and observation of practice indicates that choice is offered to include activities, meals, times of going to bed and getting up. Service user risk assessments were sampled. There is evidence that service users are supported to take manageable risks, and encourage individuals to have an independent lifestyle.
Oakfield House DS0000016973.V280603.R01.S.doc Version 5.1 Page 10 Risk assessments were noted to be in place for the home, day centre and community and new risk assessments had been created. A very small number of risk assessments were overdue for review. It was also discussed with the Manager that further risk assessment was needed for one individuals use of the kitchen to ensure all areas of risk are identified. As required previously a new system has been introduced that links the risk assessments to the care plans. On the day of the inspection the confidential records pertaining to the service users were securely kept, indicating good practice on behalf of staff handling confidential information. No inappropriate communication between staff about service users was observed. Oakfield House DS0000016973.V280603.R01.S.doc Version 5.1 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 the following standard(s): 15 and 16 Contact with relatives is actively promoted. Staff recognise residents’ rights and encourage their independence. EVIDENCE: It is evident from records and discussion with the Manager that service users are supported to maintain contact with their family and friends. Some service users visit members of their family at their home, occasionally staying overnight. The home also has regular meetings with relatives, minutes of these meetings show that relatives are kept up to date with what is happening, for example staff vacancies. 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. Oakfield House DS0000016973.V280603.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19 Service users receive personal support in the way they prefer and require. Satisfactory arrangements are in place to ensure that individual service users health needs are met. 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, 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 can sometimes take a very long time with his personal care in the morning and he requires a great deal of support from staff. Records indicate that staff manage this with sensitivity. 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. As required at the last inspection Health Action Planning for service users has commenced. 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.
Oakfield House DS0000016973.V280603.R01.S.doc Version 5.1 Page 13 The health action plan sampled was an excellent document as it was very comprehensive in content and in an easy to understand style that included photographs. This means that it will be easier for service users to understand. The system for the administration of medication was not sampled as the standard was found to be met at the inspection in August 2005. Oakfield House DS0000016973.V280603.R01.S.doc Version 5.1 Page 14 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): 22 The arrangements for making complaints are adequate to ensure that service users views are listened to and acted on. EVIDENCE: There have been no complaints about the home since the last inspection. A satisfactory complaints procedure is in place. An easy to understand version is available in the Service User’s guide. In the entrance area to the home there are a variety of documents available to any visitors, to include copies of inspection reports and a book in which compliments can be recorded. It is recommended that a copy of the complaint procedure is also made available in this area to ensure that any visitors are fully aware of the procedure to follow in the event they have a complaint. Oakfield House DS0000016973.V280603.R01.S.doc Version 5.1 Page 15 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): 24 and 30 Redecoration work has made Oakfield House a more pleasant environment in which to live and work but some areas remain worn in appearance. 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. 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. A service user showed the Inspector around the extension area and stated that he had everything he needed. Autism West Midlands is considering plans to further reduce the numbers of service users accommodated at the home by using a vacant house next door to accommodate four service users who live at Oakfield. 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. Oakfield House DS0000016973.V280603.R01.S.doc Version 5.1 Page 16 At the last inspection many of the bathrooms were observed to require redecoration due to areas of worn and peeling paint. These rooms have now been repainted. The Manager said that new blinds were also due to be delivered that day. One bathroom had a crack in the plastic adjacent to the bath, this remains outstanding for repair since the last inspection despite the Manager making several requests to the maintenance department for it to be done. The small lounge has also been redecorated, making it a more pleasant place to spend time. Unfortunately plans to redecorate the dining area had to be postponed due to the illness of the decorator. The Manager said that it was hoped this would be repainted in the next few weeks. Hallways and paintwork on some stairs were observed to be quite worn in appearance and these will also require attention. The home was generally clean. At the last inspection several extractor fans were observed to be very clogged with dust, these have now been cleaned. Oakfield House DS0000016973.V280603.R01.S.doc Version 5.1 Page 17 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 and 35 With the exception of fire training, staff generally receive the training they need to meet service users’ needs. Some improvement is needed to staff files to show that recruitment practices safeguard individuals. EVIDENCE: Discussion with the Manager indicates that at least 50 of the staff have achieved the standard of having an NVQ in care. A further five staff are in the process of competing this qualification, good support is provided for this with the NVQ assessor spending two days a week in the home. Criminal Record Bureau disclosures are normally kept at the organisations headquarters. The regulations require that these disclosures are kept in the home so that they are available for inspection. If the organisation wishes to continue in storing them at their headquarters they must write to the CSCI to seek permission to do this. Discussion with the Manager and sampling of records indicates that a variety of training has been undertaken by staff in 2005. This includes Health and Safety, First Aid, Studio III (physical intervention), Medication, Autism and the Learning Disability Award Framework. It was required at the last inspection that staff must receive fire training at least six monthly. Discussion with the Manager indicates that eight staff have received this training since the last inspection. However, the home has over sixty staff and discussion with the
Oakfield House DS0000016973.V280603.R01.S.doc Version 5.1 Page 18 Manager indicates that it has been difficult for staff to receive this training at the required frequency. To ensure this is met in future, the Manager and Deputy have designed a new fire training package to be done in house. This is booked to commence initially with new staff and night staff. Oakfield House DS0000016973.V280603.R01.S.doc Version 5.1 Page 19 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): 39 and 42 The home has satisfactory quality assurance systems in place. Systems require improvement to ensure the health and safety of service users and staff. EVIDENCE: It is the responsibility of the organisation to ensure that their representative visits the home on a monthly basis. Reports of these visits are forwarded to the CSCI as required. The home is also part of an accreditation system with the National Autistic Society. Fire records indicated that the fire equipment had been regularly tested by staff and serviced by an engineer. The previous arrangements for staff training on fire are not satisfactory. Staff require refresher training every six months to ensure they respond appropriately in the event of fire, however new arrangements for this training are in progress. The Manager said that the gas appliances had recently been checked but that the home had not yet received a certificate to evidence this. The Manager forwarded the certificate shortly after the inspection.
Oakfield House DS0000016973.V280603.R01.S.doc Version 5.1 Page 20 Since the last inspection the water supplies have been risk assessed and tested for Legionella and monitoring of water temperatures have commenced to ensure they are safe for service users. The Manager said it has been identified that new water temperature control valves are needed, these are due to be fitted soon. Risk assessment of the environment have been completed, most of these but not all were observed to be up to date. Some radiators in bathrooms were observed to be very hot to touch, posing a risk of burning to service users. An immediate requirement was made to ensure they are maintained at a safe temperature. A vacuum cleaner was also observed to have been left unattended in a hallway, posing a tripping hazard. The position of the vacuum was immediately altered by the Manager to reduce the risk of someone tripping. Oakfield House DS0000016973.V280603.R01.S.doc Version 5.1 Page 21 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 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 X ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X 2 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X X X 3 X X 2 X Oakfield House DS0000016973.V280603.R01.S.doc Version 5.1 Page 22 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 YA9YA42 Regulation 12(1) 13(4) 23 (2) (b,c, d) 23(2) 13(6) 19 Sch2 Requirement Ensure all potential risks are assessed and kept under review, at least six monthly for service user risk assessments. First floor bathroom- cracked plastic adjacent to the bath requires repair. Outstanding requirement from 30/09/05 Dining area, hallways and paintwork on some stairways require repainting. The Manager must ensure that Criminal Records Bureau (CRB) disclosures are available at the home for inspection by the CSCI. Outstanding from 30/09/05. Staff must receive fire training on a six monthly basis. Outstanding requirement from 18/09/05, met in part. Ensure radiators are maintained at a safe temperature and do not present a risk of burning to service users. Timescale for action 26/03/06 2. YA24 28/02/06 3. 4. YA24 YA34 30/04/06 26/02/06 5. YA35YA42 13(4) 23(4)(d) 12(1) 13(4) 28/02/06 6. YA42 07/02/06 Oakfield House DS0000016973.V280603.R01.S.doc Version 5.1 Page 23 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 YA22 Good Practice Recommendations It is recommended that a copy of the complaint procedure is made available in this area to ensure that any visitors are fully aware of the procedure to follow in the event they have a complaint. Oakfield House DS0000016973.V280603.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Birmingham 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. Extracts may not be used or reproduced without the express permission of CSCI Oakfield House DS0000016973.V280603.R01.S.doc Version 5.1 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
