Inspection on 03/10/07 for Oakfield House

This inspection was carried out on 3rd October 2007.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oakfield House 17/10/06

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 Key Unannounced Inspection 3rd & 4th October 2007 10:15 Oakfield House DS0000016973.V345276.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.V345276.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.V345276.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.V345276.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 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 Recource 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 people living at the home range from £970 to £1,802, as recorded in the statement of purpose for the home. Visitors to the home can see a copy of CSCI reports, these are located in the entrance hall. Oakfield House DS0000016973.V345276.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The visit was carried out over two days; the home did not know the inspector was going to visit. This was the homes key inspection for the inspection year 2007 to 2008. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home and a questionnaire about the home – Annual Quality Assurance Assessment (AQAA). Surveys were received from three relatives, one health professional and nine staff, their views are included in this report. Three people who live at the home were case tracked this involves establishing individuals experience of living in the care home by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking people’s care helps us understand the experiences of people who use the service. What the service does well: Each person has a care plan. Staff have the information they need so that they know how to support people to meet their individual needs and goals. People are provided with opportunities to participate in appropriate activities and have a holiday if they want. The people living there have regular health checks and health professionals are involved in their care to help make sure that their health needs are met. The staff help people to stay in touch with family and friends. This is in person, by phone and by letter. The commitment of staff to helping people with this is commendable. People have a choice of meals that are healthy and that they enjoy. Each person has a Health action plan. This is a personal plan about what a person needs to stay healthy and what healthcare services they need to access. Staff give support with warmth, friendliness, patience and treat people respectfully, one relative commented ‘care staff are wonderful’. Oakfield House DS0000016973.V345276.R01.S.doc Version 5.2 Page 6 All the people living at Oakfield House have a single bedroom. These are all very different, and each person’s room contains the things that are important to them. 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. What has improved since the last inspection? What they could do better: Review individuals care records to ensure they comply with the Data Protection Act and written information about people is stored in a way that respects people’s privacy. Ensure all medications and creams are appropriately labelled so that people are not put at risk of being given the wrong medication. Ensure that the repairs and redecoration to the premises that are needed are done so that people live in a homely and well maintained environment. The numbers of relief staff on duty should not exceed the numbers of permanent staff to ensure that people are always supported by an effective staff team who know their needs well. Oakfield House DS0000016973.V345276.R01.S.doc Version 5.2 Page 7 Autism west midlands should consider offering diversity training for staff who have not done this training. Employment application forms must be obtained for prospective new staff to ensure there is enough information about the person for the employer to make a decision about their suitability to work with vulnerable people. 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.V345276.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.V345276.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, 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose and Service User Guide provide prospective service users with relevant information about the home to enable them to make a choice about if they want to live there. Individual’s needs are assessed before they move in so they know whether their needs can be met there. 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 people who live at the home. Information within both documents was observed to be up to date but it would be useful to the reader if the documents were dated on production so that they could see when they were last updated. Discussion with the Manager and information recorded on the AQAA indicates the admission procedures are satisfactory, and remain unchanged from previous inspections. Sampled files showed that assessments had been carried out before current people moved into the home. The home has had one vacancy for some time but no one has 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.V345276.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, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have most of the information they need in care plans and risk assessments so they know how to support people safely to meet their needs and achieve their goals. The people living there are supported to make choices about their day-to-day lives. EVIDENCE: The care provided to three people was case tracked. Each individual had their own person centred care plan. Two plans had a recent review and for the other person a review was scheduled. This is done in a review meeting where relatives and social workers are invited to attend. The plans generally contained satisfactory information to enable staff to meet people’s needs, areas included routines, personal care, communication, family contact, finances, making choices, meals, behaviour, health, activities and cultural needs. Relatives made positive comments about the care provided by the home, this included ‘my son could not be treated anywhere better’ and ‘they understand individual needs’. Positive comments were also made by a health professional about care planning being person centred. Oakfield House DS0000016973.V345276.R01.S.doc Version 5.2 Page 11 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 occurring. Guidelines sampled were up to date. One person has a behaviour where they accumulate scrunched up and cut up pieces of paper in their room. A risk assessment had been completed about the risk of fire from accumulated paper and this guided staff to support the person to remove excess paper on a weekly basis. On the day of the visit this person’s bedroom had excessive amounts of paper and records did not show that accumulated paper is regularly removed. Their behaviour management guidelines need to be further developed so that staff are consistent in how they support the person to do this and what staff should do if the person refuses to clear their room of the paper. People’s ability to exercise choice and to make informed decisions is variable, according to their individual needs. Records showed that where an individual has made a decision this has been listened to and action taken to make sure their wishes are followed through where practicable and safe. Records sampled and observation of practice indicates that choice is offered to include activities, meals, times of going to bed and getting up. People are involved in the running of the home where possible, for example one person has recently helped staff do the weekly fire alarms test. It is nice that staff have given her a certificate of achievement for this. Discussion with the Manager indicates that Autism west midlands is considering the future of the home and possibly looking to move towards smaller homes. One option under consideration is moving three people into the property next door. 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, however this needs to be balanced with the fact that many people have lived at the home for a long time and like it there. Surveys from relatives show they have concerns about the future plans for the home. Any moves for people need to be undertaken with their consultation or their relatives / advocate if they are unable to voice their own views. People’s risk assessments were sampled. There is evidence that people 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. One risk assessment about checking an individual at night also referred to another person who lives at the home who needed checking. Personal information about other people should not be in individual’s assessments to protect their privacy. Oakfield House DS0000016973.V345276.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, 14, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are sufficient to ensure that the people living in the home experience a meaningful lifestyle. Contact with relatives is actively promoted. Staff recognise people’s rights and encourage their independence. People are offered a healthy diet and are encouraged to choose what they want to eat and drink. EVIDENCE: Staff provide people at the home with excellent opportunities for personal development. This has been facilitated in part by staff communication group who meet regularly to work on developing communication opportunities for people who live at the home. New developments have included a photographic activity planner on display, choice cards and a photographic daily menu board. People at the home are provided with opportunities to participate in a wide range of activities, some of these are designed to promote personal development. These include sessions on personal Oakfield House DS0000016973.V345276.R01.S.doc Version 5.2 Page 13 grooming, making choices and cookery. Personal development is also incorporated into people’s person centred plans. The home has the facilities of an art room, training kitchen, computer room and therapy room. Sampled daily records showed that people take part in activities such as gardening, aromatherapy, crafts, music, shopping, swimming, meals out, golf and trips to places such as the cinema, theatre, Botanical Gardens and the Space Centre. One person who lives at the home said he had been out that day for a drive to the country that he had enjoyed. Another person showed some artwork they were doing, they were very pleased with it. People who want to have the opportunity to go on holiday, at the time of the visit one person was on holiday with two staff at a farm. Other people have been to places such as Devon and Centre Parcs this year. On the second day of the inspection visit five people were observed doing an art activity with a member of staff. Using play clay, people chose what they wanted to make. Staff support was good throughout the activity, people were spoken to with respect and encouragement. Daily records and care files sampled show contact with family and friends is supported. During the visit one member of staff was arranging for someone who lives at the home to go out and buy a card for a relative who had recently had a baby. Other people had been making Christmas cards in art sessions to send to friends and family. 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. The home has a four week rotating menu, this showed a varied choice of meals are available. One person has his own separate menu due to his diabetic needs. Fridges, freezers and cupboards were observed to be well stocked with food supplies to include fresh fruit and vegetables. Since the last visit the home has developed lists about people’s food preferences so they have more information on what people like to eat. Food records sampled showed that a variety of food is offered that includes fruit and vegetables to ensure that people are having a healthy diet to ensure their well-being. The Cook was observed to be doing salmon for the evening meal and two different meals for people who do not like salmon. One person said the next day that he had salmon for his dinner last night and it was ‘delicious’. Oakfield House DS0000016973.V345276.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, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements ensure that the personal care and health needs of the people living there are met. The management of medication needs minor improvement to fully protect people and ensure their well-being. EVIDENCE: Care plans sampled included information for staff on how to support individual’s to meet their personal care and health needs. The people living there were well dressed in good quality clothes that were appropriate to their age, gender and the activities they were doing. Discussion with staff and observation of finance records shows that people have their own personal toiletries and are supported to go to the barbers or hairdressers if they want to. Records sampled showed that other health professionals are involved in the care of individual’s where this is appropriate. The health professional survey received indicated they were satisfied with the care provided by the home and that people’s health needs were met. Oakfield House DS0000016973.V345276.R01.S.doc Version 5.2 Page 15 Health action plans were sampled for three people. 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 people’s health needs are well planned for and annual health appointments undertaken as needed. Weight records showed that staff regularly check people’s weight to ensure they are not losing or gaining a significant amount of weight that could be an indicator of an underlying health need. The health action plan would be further improved if there was more information in them where people are trying to lose weight. One person is diabetic and self-administers insulin. Clear guidelines were in place regarding this practice. Satisfactory plans were also in place for people who had asthma or epilepsy. Staff who administer medication have received training to do so. An annual medication assessment is also completed for staff to demonstrate that they remain competent to administer medication. Discussion with the Manager showed that people had their medication reviewed regularly to ensure that this is still of benefit to them and is effective in meeting their health needs. Sampled medication administration records were satisfactorily completed. Copies of prescriptions are retained so that staff can check the correct medication has been received from the chemist. Where people are prescribed PRN (As required) medication a protocol is in place stating when, why and how this should be given. Some creams were observed in the medication cupboard that were not labelled with who they belonged to, the directions for administration or the date of opening. These will need to be returned to the pharmacist and new creams obtained that are properly labelled. Where people are prescribed PRN medication the home keeps a single tablet in tablet bottles for day centre staff to take out with them if needed. Many bottles had labels where the writing was worn away making it very difficult to see who the medication was for, what it was and the correct dose. This could result in medication errors where people get the wrong medication. The Manager was aware that some of the labels were worn and provided evidence that new labels had been ordered from the pharmacist. The system must be reviewed to ensure that staff do not use tablet bottles where there is not a satisfactory label. Oakfield House DS0000016973.V345276.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, 23 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 the views of the people living there are listened to and acted on. Arrangements generally ensure that the people living there are protected from abuse, neglect and self-harm. EVIDENCE: The CSCI has not received any complaints regarding this service 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 and an easy read version including pictures is on display in the main hallway. This means that people living at the home 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 relatives are aware of the complaints procedure. The home has satisfactory policies and procedures for safeguarding adults. Staff have received prevention of abuse training. One senior member of staff was spoken with about what they would do if an allegation of abuse was reported to them, their answer showed they know what to do to keep people safe. Autism West Midlands has regular Sexuality and Protection Meetings where current practice issues are discussed and good practice ideas explored. One member of staff is part of this group and feeds back important issues to the staff team. The Manager said that she was due to attend training on the Mental Capacity Act. This came into force this April and is about assessing each Oakfield House DS0000016973.V345276.R01.S.doc Version 5.2 Page 17 person’s capacity to make decisions so it is important that staff know about this. The Manager said that five staff are also booked to attend training on the Criminal Justice System so that they could give appropriate support to people at the home if it was needed. Two people’s finance records were looked at. Receipts of each purchase were available. As required at the last inspection the home has put new procedures in place for staff handling people’s money. Staff now sign monies in and out of the home and this means that people’s monies are safeguarded. Each person now has an up to date inventory of their possessions to ensure that staff know what possessions each person has and it is easier to track if things should go missing. At the last inspection it was identified that some incidents in the home had not been reported to the CSCI as required by regulation. This is now being done. The AQAA completed by the Manager recorded there had been some incidents where physical intervention had been used. The home has good systems in place for recording such incidents that meet with Department of Health guidelines. Sampling of records showed that physical intervention is not regularly used and is only used for the protection of people. It is good that an analysis is done where an incident has occurred to see if there are any patterns in behaviour. The systems in place for the recruitment of new staff are generally satisfactory but minor improvement is needed to ensure people are fully protected, this is detailed in the staffing standards of this report. Oakfield House DS0000016973.V345276.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, 26, 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 people 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. The kitchen is fitted with industrial type equipment and due to the needs of people is locked at certain times when not in use, however the home has the facility of a training kitchen. 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 people whose bedrooms are adjacent is also provided. A small number of bedrooms were seen, these were in good decorative order, very personalised and reflected the culture and gender of the individual. Oakfield House DS0000016973.V345276.R01.S.doc Version 5.2 Page 19 Since the last inspection some improvements to the premises have taken place to include refurbishment of the kitchen in the bungalow, repainting of some hallways, new dining tables and commencement of externally repainting the front windows. The Manager and Cook said that it was planned to refurbish the main kitchen soon. Observation of the premises showed several areas that needed attention so that the home is a nice place to live. As identified at the last inspection the shower area in the therapy room had one wall with a large section of tiles missing, these need to be replaced. The carpet in the lounge area adjacent to the dining room has been cleaned since the last inspection but it is still stained, it should be considered if carpet is the best type of covering for this area. The dining room ceiling was observed to have a large stain, the Manager said this had been a result of a water leak. Several hallways in the home still need repainting and the hallway outside the main kitchen has some areas where the plaster needs repair. Whilst the small lounge was homely in style this was detracted from by the ceiling light having no light covering exposing the light bulb. The décor in the main lounge needs attention as some areas of wallpaper are torn and the settees in this room are quite worn with the cushions sunken. These were not that comfortable to sit in. One bathroom on the first floor needed attention to the décor where paint was peeling from the wall. Most areas of the home were observed to be clean and there were no unpleasant odours as the home benefits from having its own housekeepers. There were some areas that needed attention. Several extractor fans in bathrooms were clogged with dust making them less effective. One shower room needs redecorating due to the build up of mould on the walls caused by a lack of ventilation in this room. One bathroom was observed to have a toilet seat where the white paint had worn away exposing the wood underneath. This needs repair or replacement. The Manager was aware of the work that needed doing and had sent a request to the maintenance department on the 18th September for a lot of work to be carried out. Some of this had been done but as this visit shows there are still lots of repairs and redecoration work needed. The Manager did not know when the outstanding work would be done as she said the maintenance department had other homes that wanted work doing too. Dates for the work to be done need to be agreed so that people live in a nice environment. Oakfield House DS0000016973.V345276.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, 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Generally the arrangements in place ensure that people living at the home benefit from a staff team that is competent and qualified to meet their individual needs. EVIDENCE: Staff were observed to give support with warmth, friendliness, patience and treat people respectfully. Information from the AQAA shows that the home has a low turnover of staff and that 60 staff have achieved or are working towards an NVQ in care, so ensuring that they have the skills and knowledge to meet the needs of the people living there. Relative surveys received show staff who can meet peoples needs are employed, one relative commented ‘care staff are wonderful’. Staff surveys recorded that there were usually enough staff on duty to meet people’s needs. Discussion with the Manager indicates that they now got extra funding for providing 35 hours extra staff support per week for one person so he can have more 1:1 support. Staff rotas were sampled and these showed that the home maintains five staff on day shifts plus Recource Centre staff (usually seven). The home has some staff vacancies and so relief staff Oakfield House DS0000016973.V345276.R01.S.doc Version 5.2 Page 21 are being used to maintain numbers. The rota showed that relief staff have been used most days recently and on some days, particularly at weekends there were more relief staff on duty than regular staff. Whilst most relief staff work regularly in the home this is not the case for all of them and so the Manager should ensure that the numbers of permanent staff on duty exceed the numbers of relief staff. The Manager is trying to recruit to the staff vacancies and interviews for new staff were taking place on the second day of the inspection visit. Two new staff records were looked at. These included most of the required recruitment records including evidence that a Criminal Records Bureau (CRB) check had been done before the person started working there to ensure they are ‘suitable’ to work with the people living there. Evidence was also available to show that satisfactory references had been obtained before people started work in the home. Sampling of the records and discussion with the Manager indicates that for one new staff there was no application form as they had been recruited via an agency. An application form needs to be obtained for all new staff to ensure there is enough information about the person to make a decision about their suitability to work with vulnerable people. 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, manual handling, studio III, health and safety, sexuality and aspergers, food hygiene, abuse and autism. A programme of cyclical fire training is in place and training for staff who needed refresher fire training was scheduled for the coming Friday. 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 are still limited. Consideration could be given to doing this training in house. Staff surveys show that staff are satisfied with the availability and quality of training on offer. Minutes of staff meetings showed that meetings are regular so that staff know about the changing needs of the people who live there and are kept up-to-date with best practice. At the last inspection it was identified that staff supervision needed to be more regular. The Manager said to facilitate this she has now allocated senior staff administration days so they can keep up to date with doing supervisions. One senior staff was on an administration day during the visit and had scheduled supervision for two staff. She said the new arrangements were ‘a big help’. Surveys from staff indicate they have regular supervision, one staff commented ‘I can discuss any problems that arise’. Oakfield House DS0000016973.V345276.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, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from a well run home. The people living there can be confident that their views underpin all self-monitoring, review and development by the home. The health, safety and welfare of the people living there is promoted and protected. 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. The Managers training record evidenced she has completed an NVQ 4 and the Registered Managers Award. One relative said ‘management keep us fully informed’ and staff said ‘management are very approachable and accessible’. There were however some staff comments in staff surveys about senior managers and the chief executive not visiting the home enough. However there was evidence that the chief executive has visited the home recently to attend a meeting with relatives. Oakfield House DS0000016973.V345276.R01.S.doc Version 5.2 Page 23 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. Reports of these visits were available in the home. The current system relies on home managers visiting other homes to do the visits. Discussion with the Manager indicates that the Provider is intending to appoint a new senior manager, this is a new role within the organisation. Part of this role will include responsibility for visiting the home monthly and also to undertake supervision with the home manager. 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 people who live at the home 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. As recommended at the last inspection the home has improved opportunities for people to contribute towards the development and improvement of the home. Questionnaires have been developed for people who live at the home. It is good that these take account of peoples individual communication needs and staff have assessed which people are able to complete them. The surveys have big writing and pictures and cover people’s views on their bedroom, food, day centre, activities and holidays. A development plan was completed for the home in July 2007. This is a detailed plan but it would be improved further if the Manager added a tracking system to record progress made towards objectives. Fire records showed that an engineer regularly services the fire equipment. Staff test the fire alarms and emergency lights regularly to make sure they are working. Regular fire drills are held with people who live at the home and staff so that they all know what to do if there is a fire. The fire procedure was produced using pictures making it easier to understand. A Corgi registered engineer has completed the annual test of gas equipment to make sure it is safe. Staff test the fridge and freezer temperatures daily to ensure food is stored safely and reduce the risk of people having food poisoning. A specialist water company has a contract to regularly monitor the water to ensure it is safe but at the last inspection the records of water temperatures were quite difficult to track due to the technical contents of the report. These now clearly show the tap temperatures. Records showed that water temperatures were safe and protect people from the risk of scalding. Since the last inspection the housekeeper now does a general health and safety audit of the building, this includes checking fire exits, date of alarm Oakfield House DS0000016973.V345276.R01.S.doc Version 5.2 Page 24 tests, fire fighting equipment, light bulbs, tripping hazards and maintenance requests. Oakfield House DS0000016973.V345276.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 3 ENVIRONMENT Standard No Score 24 2 25 X 26 3 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 2 34 2 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 2 LIFESTYLES Standard No Score 11 4 12 3 13 3 14 3 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 3 X X 3 X Oakfield House DS0000016973.V345276.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? YES, NUMBER 2 IN PART. 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 YA20 Regulation 13(2) Requirement Ensure all medications and creams are appropriately labelled so that people are not put at risk of being given the wrong medication. A schedule for all the repairs and redecoration work as identified in the Environmental Standards of this report must be completed so that people live in a nice environment. A copy of the planned schedule must be forwarded to the CSCI. Hallways and stairwayspaintwork requires repainting. (Some work has been undertaken) Outstanding requirement from 30/04/06. Ensure dining area carpet cleaned to remove stains, or replaced if stains cannot be removed. Outstanding from 30/11/06. Employment application forms must be obtained for prospective new staff to ensure there is enough information about the person for the DS0000016973.V345276.R01.S.doc Timescale for action 30/11/07 2 YA24 23(2) 30/11/07 3 YA34 19 30/11/07 Oakfield House Version 5.2 Page 27 employer to make a decision about their suitability to work with vulnerable people. 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 Refer to Standard YA1 YA6 Good Practice Recommendations It would be useful to the reader if the Statement of Purpose and service User Guide were dated on production so that they could see when they were last updated. Review behaviour management guidelines for individual who has excessive amounts of paper in their room so that staff have clear information about the support they need to clean their room and are consistent in their approach. Review individuals care records to ensure they comply with the Data Protection Act and written information about people is stored in a way that respects people’s privacy. Health action plans would be further improved if there was more information in them where people are trying to lose weight regarding dietary information and people’s weight goal. The numbers of relief staff on duty should not exceed the numbers of permanent staff to ensure that people are always supported by an effective staff team who know their needs well. Arrange diversity training for staff so that staff have more knowledge about meeting people’s diversity needs. The development plan for the home would be improved further if a tracking system is added to record progress made towards objectives. 3 4 YA10 YA19 5 YA33 6 7 YA35 YA39 Oakfield House DS0000016973.V345276.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.V345276.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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