Inspection on 02/10/07 for Oakhurst Lodge

This inspection was carried out on 2nd 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

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Dalewood Respite Care

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Treloar College

Kestrel House, St Anne`s Opportunity Centre,

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

CARE HOME ADULTS 18-65 Oakhurst Lodge 137 Lyndhurst Road Ashurst Southampton Hampshire SO40 7AW Lead Inspector Tim Inkson 2 nd Unannounced Inspection October 2007 09:05 Oakhurst Lodge DS0000069789.V347609.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 Oakhurst Lodge DS0000069789.V347609.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. Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakhurst Lodge Address 137 Lyndhurst Road Ashurst Southampton Hampshire SO40 7AW 02380 293589 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) Cambian Autism Services John Caslake Care Home 8 Category(ies) of Learning disability (0), Sensory impairment (0) registration, with number of places Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - (PC) to service users of the following gender: Either Whose primary needs on admission to the home are within the following categories@ Leaning disability (LD) Sensory impairment (SI) of the following age range 16 and 25. The maximum number of service users to be accommodated is 8. 2. Date of last inspection N/A Brief Description of the Service: Oakhurst was originally a large private house that was converted for use t o a care home. Its current owners (Cambian Autism Services) totally refurbished the property before it began operating its service in April 2007. The home provides a service for young adults aged between 16 and 25 years who have autistic spectrum disorders and it can accommodate up to 8 individuals. It is described in its prospectus/ service users guide as “a stepping stone” for among others individuals who were previously students at a 52 week residential school for students with special needs that is also owned by the same company. The building has 2 stories with bedroom accommodation on both floors. All bedrooms are single occupancy and are provided with en-suite showers. The shared accommodation/communal space comprises 2 lounges, a dining room, learning area/activities room, sensory room, kitchen, laundry and 2 bathrooms, one of which is fitted with a Jacuzzi/spa bath. There is a large enclosed garden at the back of the building and an enclosed tarmac area at the front. The establishment is located in a small rural community on the edge of the New Forest within easy reach of Southampton and readily accessible by public transport. Amenities in the immediate locality included several shops, restaurants and pubs. The towns of Totton and Lyndhurst are both within a few minutes drive of the home and in the former a range of amenities normally associated with a large town are available e.g. library, leisure centre, college, supermarkets, churches, etc. Arrangements for people to live in the home are all made through local authority social services department and where relevant education authorities. The individual concerned and their relatives and representatives can obtain information about the service from the website of the company that owns the home on www.hillhouseschool.org and will be provided with a prospectus. This Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 5 prospectus will be specifically designed for the individual taking into consideration their specific needs which may result in the use of symbols and pictures to describe the home and its facilities. A copy of a report of the most recent inspection of the service will be made readily available for all interested parties. At the time of the site visit to the establishment on 2nd October 2007 the fees depended on a number of variables, including whether among other things, the individual concerned was post 19, or still in fulltime education. Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This site visit was part of the process of the first key inspection of the home that was registered in April 2007. It was unannounced and took place on 2nd October 2007, starting at 09:05 and finishing at 17:25 hours. During the visit accommodation was viewed including bedrooms, communal/shared areas and the home’s kitchen and laundry. Documents and records were examined and staff working practice was observed where this was possible without being intrusive. Due to the limited communication of most of the people living in the home only one person was spoken to in order to obtain their perception of the service the home provided. Several staff were spoken to about their perceptions, the training they received, what it was like to work in the home and its management. Relatives of people living in the home were contacted by telephone in order to obtain their views about the establishment. At the time of the inspection the home was accommodating 5 people, 3 males and 2 females and their ages were raged from 17 to 19 years, none was from a minority ethnic group. The communication needs of the people living in the home ranged from individuals who were literate and able to read and write and communicate reasonably well verbally to others without such skills able only to understand a one word instruction. The abilities and level of understanding of all individuals could vary and depend on things such as their “mood”. Because of the specific nature of the autistic spectrum disorder of the people living in the home each persons days required significant structure and consistency but there was evidence that this was always tailored to an individuals particular needs. Routine, structure, occupation and consistency were considered essential because without these an individuals behaviour and abilities could deteriorate and consequently their welfare could be compromised. Staff who were present during the visit and able to provide assistance and information when required included, a teacher, assistant team managers and the home’s registered manager. People living in the home were canvassed for their views about the home using questionnaires, before the site visit took place. Their responses had been obtained with the support of staff were made available at the time of the site visit and were taken into consideration when producing this report. Other matters that influenced this report included: An Annual Quality Assurance Assessment completed by the registered manager in which he set out how he believed the home met and planned to exceed the National Minimum Standards (NMS) for Care Homes for Adults (18 –65) and evidence to support this. A “dataset” containing information about the home’s staff team, and some of its managements systems and procedures. The evidence set out in this report would usually result in an overall quality rating of excellent for a service. However as this report is of the first key inspection of the home and it had only been operational 6 months there was Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 7 not a sustained “track record” of high performance essential to achieve such an overall rating. What the service does well: 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. The summary of this inspection report can be made available in other formats on request. Oakhurst Lodge DS0000069789.V347609.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 Oakhurst Lodge DS0000069789.V347609.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, 3, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had systems and procedure in place to enable people that intend to live there to make an informed choice about whether to do so and inform them of ther rights and responsibilities. The help individuals needed was identified before they moved in to ensure that the home could properly provide it. EVIDENCE: At the time of the site visit all the people living in the home had moved into it from a residential school owned by the same company and at which a considerable number of the staff working in the home had also been employed. It was apparent from documentation examined, the responses in questionnaires completed by the people living in the home with staff support and discussion with the relatives of individuals that the move into the home for all concerned had been carefully planned. Everyone had been provided with information about the establishment and its facilities and had made several visits to the premises before they moved into their accommodation. It was also clear from the documents seen and discussion that the level and type of support that individuals’ required was identified in great detail before they moved in. The company that owned the home and school from where the individuals’ had moved employed a range of specialist staff including psychologists, speech and language therapist and teachers that all contributed to identifying the specific needs of the persons concerned. The fact that some of the staff knew the individuals at the school helped provided some consistency and reassurance for the persons concerned. Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 10 Relatives that were contacted all confirmed that they had been provided with a lot of information about the home and had been able to visit with their respective relative. There was some discussion about how the needs of individuals would be identified who moved into the home from somewhere other than from another service owned by the company that also owned the care home. It was stated that the registered manager and the head of the residential school owned by the company would assess an individual’s needs in partnership with any sponsoring local authority and in the process use the expertise of the staff referred to above. The staff group working in the home a range of experience and training. A considerable number had worked with the people living in the home and consequently knew them very well and what type of support and help they required. Other staff that had been employed since the home started operating had all completed 2 weeks induction training period at the residential school referred to, during which they covered a range of matters including the following: • Health and safety • SCIP (Strategies for Crisis Intervention and Prevention) • Valuing People • First Aid • Intimate Care • Understanding Autistic Spectrum Disorder • Child Protection • Shadowing experienced staff • Site induction at Oakhurst Lodge An examination of the training records of staff and discussion with some individuals on duty at the time of the site visit indicated that the training that the care staff working in the home had attended and/or completed included formal qualifications such as; National Vocational Qualifications (NVQ); teaching qualifications; and diplomas in caring services. Other training included the following areas/subjects; Protecting Those Around You; Rights and Responsibilities; Fire Safety; Signing; Medication; Food Hygiene; Visual Impairment; Epilepsy; and Communication. Individuals living in the home had not been given licence agreements setting out their terms of occupancy this was because they had all moved into the home through care management arrangements the home had formal contracts for each person living in the home with their respective sponsoring/funding local authority. There were “student agreements” that had been made with all individuals that set out a persons rights and responsibilities. Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 11 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 and 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living in the home were involved in planning the care and support that they received and risks they took and were able to exercise choices about dayto-day life in the home. Sensitive information about them was looked after properly. EVIDENCE: Documents examined during the site visit included very detailed and comprehensive plans setting out the support and help that each person living in the home needed and how it was to be provided. The plans included clear strategies for achieving each objective that had been agreed with the individual and/or their representative and there was evidence that achievement and progress was monitored daily using a chart i.e. “individual learning plan”. Each person living in the home had a key worker /personal tutor who among other things who ensured that documentation was completed for goals that had been agreed for/with the individual. Also that the person concerned had adequate supplies of clothes, toiletries, personal belonings and encouraged them to pursue pastimes and activities. Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 12 The plans were supplemented by other information such as detailed and specific communication profiles about the person describing how a person may use body language to convey information or indicate how they were in pain or wanted to leave a situation. Discussion with one person indicated that he and his parents were involved in developing and agreeing his plan of care and also regular reviews of the plan. Some aspects of the care and support plans (Information pack for Household skills) were produced in a format suitable for the person concerned e.g. pictures and symbols. A number of relatives of people living in the home were contacted and all confirmed that they were closely involved in the plans of care that were developed for their respective relative and regular reviews of those plans. They also all said that the home was particularly good at maintaining contact with them about any concerns. The documentation for each person included assessments that identified a range of possible risks arising from activities they may be involved in or undertake in the home and the community and set out the actions/interventions to be taken reduce the danger of harm. There was evidence from observation, discussion and documents examined including minutes of weekly house meetings, that individuals were encouraged and supported to make informed decisions about a range of everyday matters. These included activities they wished to pursue and food to be eaten. Minutes of house meetings and the decisions made were recorded in a symbol and picture format. The home had policies and procedures about confidentiality and sensitive information about individuals living in the home was kept securely in the staff office. Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 13 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): 12, 13, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home promoted the right of people living in the home and supported them to take part in social, educational and recreational activities and to develop life skills. People living in the home were able to enjoy their food preferences as well as a nutritious and health menu. EVIDENCE: The home’s prospectus, statement of purpose and service users guide indicated that the ethos of the establishment was to “maintain individual learning through experience” with the aim of being able to support a person to “achieve independence” and reach “their full potential”. The staff group at the home included an experienced teacher and teaching assistants and their presence and involvement reflected the purpose of the establishment to teach the people living there “the skills necessary to equip them for the transition to adult life”. The home consequently operated what was described as an “open curriculum” using among other things normal day to day activities as opportunities for individuals to learn an develop. Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 14 The home had a learning area/activities room that was provided with computer equipment, an interactive white board and projector. Individuals participated an accredited learning scheme “Towards Independence” that included a range of subjects including; water skills/swimming; photography; pottery; performing arts; relationships; meal preparation; sports studies: and money. There was evidence form documentation and pictures, observation and discussion. Some limited work experience had been arranged for people living in the home and this included a placement for 2 at an outdoor centre, litter picking and a paper round. Staff were actively looking for other such opportunities for other individuals. On the day of the site visit people were taking part in a range of activities at different times including swimming session at a local leisure centre, preparing meals; walking in the New Forest, household tasks; personal leisure interests. They were supported in theses by either care staff or teaching staff depending on the type and purpose of the activity. There was evidence that individuals had been encouraged and supported when they indicated a particular wish or interest such as going to the theatre music or watching a local football team. The home maintained links with the residential school where all the people living at the home at the time of the site visit had moved from and ther were some joint some social events arranged with the school. Some individuals also attended music sessions at another service owned by the company that owned the home. Comments from relatives spoken to about educational and work opportunities that the home organised or arranged for people living there included: • “... She is now learning more life skills as well as education …”. • “… There is more opportunity for him to be independent …”. • “… The education team is superb …”. One senior member of the home’s staff said because of the special needs of the people living in the home there was a very structured programme for each individual to ensure consistency and occupation. Another said “if they are occupied there are less behavioural problems and it is also about individuals’ quality of life”. People living in the home and their relatives indicated that the home promoted the right of individuals to maintain contact with their families and friends. A record was maintained of contact between individuals and their relatives and parents were provided with information in a weekly news sheet i.e. Weekly Parental Contact. Comments from relatives about this particular aspect included the following: Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 15 • “ … They always have him ready when we are going to collect him, with his medication and anything else that he needs… he comes home every third weekend …”. The home was seeking to arrange individual bank accounts for people living in the home to enable them to be supported to manage their own finances. At the time of the site visit the home’s registered manager said these were being frustrated by the regulations imposed on the banking industry to prevent money laundering and the accounting procedures of some of the authorities sponsoring/funding some individuals living at the home. Each month the home was visited by individuals appointed by, but independent of ownership of the home who could conduct their visits at any time. They examined documents, spoke to staff and people living there, inspected the premises and completed a written report about the outcome of their visit. Details of these independent visitors and their role monitoring the home and safeguarding and promoting the interests of people living were prominently displayed in the entrance hall of the home and in an alternative format i.e. symbols. The home promoted healthy eating. There was fresh fruit readily available. The home employed a part time cook who was on duty at the time of the site visit. She indicated how she attempted to get individuals to eat vegetables. Part of each persons learning plan and routine was to be involved in household tasks including meal preparation at some time. One person was observed being supported to prepare vegetables for a casserole to be eaten that day. Information about individuals’ food preferences were recorded in their documentation and records were kept of what each person ate. There was evidence from records of weekly meetings and from discussions that people living in the home were consulted about the menus and the food provided by the home. Relatives spoken to indicated that that people living there were able to exercise choice about what they wanted to do. • “ … There is more opportunity for him to be independent … He gets a say in what he wants to do … “. The menus indicated that the food provided was varied, and nutritious and included the opportunity for people to enjoy and experience occasional take away meals. One individual who was spoken to said that the food was nice. Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health and personal care that people in the home received was based on their individual needs and their medication was managed safely. EVIDENCE: Care plans examined set out in detail how the help and support an individual needed was to be provided (see also section about “Individual Needs and Choices” above”). Staff spoken to were able to describe the needs of the individuals in the home and how they were met in accordance with the plans. Thee home had a written policy and procedure about the provision of “intimate care” and it included the following statements: • “When providing intimate care for residents, staff shall have due regard to the dignity and rights of the individual …”. • “Residents should, wherever possible and appropriate, be assisted with personal and intimate care by staff members of the same gender”. At the time of the site visit the gender mix of the home’s care staff team was 13 females and 6 males. There was access to and the home could use the expertise of specialist staff employed and used by a residential school that was owned by the same Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 17 company that also owned the home e.g. psychologist; language and speech therapist; occupational therapist; child psychiatrist; nurse. People living in the home were supported to use local medical services and visit them for appointments as required. A registered nurse employed at the residential school referred to above visited the home once a week to monitor the health of the people living there and provide support and advice to the home’s staff team. There was evidence from documentation and discussion that regular health checks were arranged for individuals with among others; dentists; and if necessary, paediatricians and opticians. The home had written policies and procedures about the management of medication. Medicines were kept in a suitable locked metal cabinet and most medication was given out from their original containers and the medication for one individual was provided in a compliance aid/monitored dosage system made up by a local pharmacist. Records were kept of the receipt into the home of medicines, the giving out and also the disposal of unwanted items. All were accurate and up to date. There were clear instructions for medicine that was prescribed PRN (“when needed”) for one individual. There was evidence from documents examined and discussion with staff that those with responsibility for giving out medication had received training and been assessed as competent to do so. In the AQQA (see section - “Summary – above) submitted by the home’s registered manager it stated that the home intended over the next 12 months to establish a clear procedure for self-medication in order to promote individual’s independence. One good practice matter that was noted was a record of sample signatures of the staff that gave out medication. Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home had access to a complaints procedure that would enable the home to address their concerns. There was a system in place in the home to protect vulnerable adults from harm. The home was committed to promoting the rights of people living there. EVIDENCE: The home had a written complaints procedure and there was no alternative version on display with pictures and symbols for individuals who could understand that format. There was also information on display about the details of and how “independent persons” appointed by the company that owned the home could be contacted. The registered manager agreed to seek information about other independent advocacy services in the locality. In discussion staff acknowledged that some people living in the home would have trouble understanding the concept of complaining. There was however a clear commitment expressed to help and encourage individuals to find more ways to voice their needs, wants and concerns. The home had a system for keeping records of complaints and had received none since it started operating in April 2007. “The Commission” had received no complaints about the home during the same period. There were written procedures readily available in the home for the guidance of staff, about safeguarding children and vulnerable adults. These included copies of the local authority’s relevant protection procedures. Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 19 Staff had received training in the subject of child and adult protection and those spoken to knew what action to take if they suspected or knew that abuse had occurred. All staff working in the home had received accredited training in physical intervention to ensure that they could support individuals who exhibited behaviours that were challenging in a positive, safe and supportive way, avoiding as far as reasonably possible the use of restraint. No person living in the home managed their own finances and relatives of individuals sent or provided sums of money to be looked after by the home on their behalf. Records were kept of these monies. The home was attempting to organise bank accounts for individuals and involve them in managing their own finances. They were however experiencing difficulty because of banking regulations that have been implemented in order to prevent “money laundering”. In the AQAA (see section - “Summary – above) submitted by the home’s registered manager it stated that the home intended over the next 12 months intended to set up bank accounts for individuals as well as understand the use of the home’ complaints procedures. Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home’s environment was comfortable safe, and well maintained for the benefit of the people living and working in it. EVIDENCE: At the time of the visit the exterior and interior of the home was in good decorative order and its furnishings and fittings were in good repair. The premises were clean and hygienic and there was evidence that there were systems in place to ensure a regular and routine cleaning schedule was implemented. The company that owned the home also had other services in the area and a maintenance operative employed by them visited the establishment at least once a week in order to check fire safety systems and water temperatures and also to do any minor repairs that were required. The accommodation was spacious and all people living in the home had their own bedrooms with an en-suite shower/wet room. There were bedrooms on the ground and first floor of the building. Bedrooms viewed during a tour of the premises had been personalised for or by the individual concerned and they were able to decide on their own colour scheme in their bedrooms. Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 21 One individual spoken to said, “I Like my bedroom”. Apart form one of 2 bathrooms all communal/shared space was on the ground floor and comprised: • 2 lounges • Large dining room • Sizeable kitchen • Laundry room • WC suitable for people with disabilities • Bathroom with Jacuzzi/spa fittings • Sensory room • Learning area/activities room There was a good-sized secluded and enclosed rear garden with easy access and a rage of garden furniture and equipment At the front of the building there was an enclosed tarmac area that provided car parking space and there was a ramp as well as steps to the main entrance. There were written policies and procedures in place concerned with “infection control” and all staff had received relevant training. Protective clothing was available for use when required and in accordance with best practice communal WCs were provided with liquid soap and paper towels. Comments about the environment from relatives of people living in the home that were contacted included the following: • • • “ … The environment is very good … “. “ … The facilities are superb, it is hugely impressive …”. “ … It is a lot better for her because it is smaller … it is more like a home … she has freedom now that she did not have before …”. Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 22 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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The recruitment, training, support for, deployment level and skill mix of staff ensured the complex needs of people living in the home were met and their safety was promoted. EVIDENCE: At the time of the site visit the level of care staff on duty was in accordance with the its published rota i.e. 07:00 to 15:00 5 13:00 to 21:45 5 20:00 to 08:00 1 sleep and 2 wakeful Each shift in the home was lead by an assistant team manager and the home’s registered manager was supernumerary. In addition to the care staff the home employed a teacher and teaching assistants who worked from 08:00 to 17:00 for from Monday to Friday. One of these staff also worked during the week outside term times in order to provide a continuous activity programme and “move away from and educational ethos”. Other staff working in the home included: • Part time cook i.e. 3 days a week • Part time cleaner Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 23 • Part time gardener/grounds person It was stressed that when the home was fully occupied that the staff numbers would be increased proportionally with up to 8 care staff on duty on each of the 2 day shifts. It was apparent form observation and discussion that although all the staff worked as a team they were ware of their specific roles and responsibilities and lines of accountability were clear. The home was able to utilise specialist and other staff at the residential school from which all the people accommodated at the time of the site visit had moved (see reference to this elsewhere in the report – above). This included some one with responsibility for human resource issues, including staff recruitment. The home’s prospectus/service uses guide included the following statement: “All staff are checked prior to appointment through the enhanced level of the Criminal records Bureau to ensure they are fit persons to work … this together with rigorous selection procedure ensures that only those who suitable to work with our very special young people are permitted to do so”. Staff spoken to confirmed that they were unable to begin work until satisfactory “police checks” had been completed and references had been “taken up”. There was however no documentary evidence at the home to support these claims because all such records were kept at “head office” i.e. the residential school referred to above. The home’s registered manager agreed to obtain copies of all relevant documentation or alternatively written confirmation that such checks had been completed. This would then be kept at the home in and available for inspection order to provide evidence of compliance with Regulation 19 of the Care Homes Regulations 2001. There was evidence from documents examined and discussion with staff of the home’s and organisations commitment to staff development and training. The staff group working in the home a range of experience and training. New staff that had been employed since the home started operating had all completed 2 weeks induction training period at the residential school referred to during which they covered a range of matters including the following: • Health and safety • SCIP (Strategies for Crisis Intervention and Prevention) • Valuing People • First Aid • Intimate Care • Understanding Autistic Spectrum Disorder • Child Protection • Shadowing experienced staff Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 24 • Site induction at Oakhurst Lodge An examination of the training records of staff and discussion with some individuals on duty at the time of the site visit indicated that the training that the care staff working in the home had attended and/or completed included formal qualifications such as; National Vocational Qualifications (NVQ); teaching qualifications; and diplomas in caring services. Other training included the following areas/subjects; Protecting Those Around You; Rights and Responsibilities; Fire Safety; Signing; Medication; Food Hygiene; Visual Impairment; Epilepsy; and Communication. Although the percentage of care staff employed with a qualification equivalent to at least level 2 in a relevant NVQ was less than 50 the range of other qualifications and experience individuals had and the comprehensive induction and foundation training new staff received ensured that they were able to meet the needs of individuals. Comments from relatives of people living in the home illustrated this: • “… The care team are really superb ….”. • “ … They understand how he communicates …”. • “ … I have seen an improvement since he has been there …”. The home’s prospectus /service users guide included the following statements about staff training: “The value placed upon the important role played by staff is possibly best reflected by our ongoing achievement of the nationally recognised “Investor in People” award … on appointment all new staff whatever their experience or qualifications, undergo foundation and induction training … all staff undergo NVQ 3 as part of their job role … a comprehensive programme for staff development provides a framework for identifying and addressing development needs of all staff …”. The organisation that owned the home employed a staff development coordinator that visited the home regularly to support the staff team. Staff spoken to were enthusiastic about working in the home, the training opportunities that they had and confirmed that they received regular supervision and appraisals. Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 25 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, 40, 41 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s registered manager provided effective leadership There were systems and procedures in place for monitoring and maintaining the quality of the service provided and also for promoting the safety and welfare of everyone living and working in the home. EVIDENCE: The home’s registered manager had several years experience of working with young people with autistic spectrum disorders and in various roles and in supervisory and management posts. He had obtained several relevant qualifications and was working towards a recognised and appropriate management qualification. From discussion with the registered manager, and from observation and discussion with staff, people living in the home and comments from people whose views were canvassed about the management of the home. It was apparent that the registered manager was; highly motivated; enthusiastic; Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 26 sensitive to and understanding of the needs of both the home’s staff team and the individuals accommodated there. Comments about his management approach and qualities included the following: • “I like him as a manager”. • “I find him very approachable”. • “He gives us feedback about our performance”. The home had a range of systems in place to monitor the quality of the service that it provided including; the use of independent persons (referred to elsewhere in the report i.e. sections “Lifestyle” and “Concerns, Complaints and Protection” - above); assistant psychologist to review behavioural programmes; a staff support co-ordinator to check on supervision and staff appraisal; regular reviews of individuals needs involving relatives at which the person could, “comment about the service they received and what they would like to happen in the future”. Documentation was also used to record events and incidents. There was evidence that people living in the home were involved in weekly meetings at which they were asked about the about what they wanted or liked. As the service had only been operational since April 2007 it had not implemented a formal system for taking into account the views of people living in the home and other interested parties in order to inform an annual development plan. The home had a range of policies and procedures available that were readily accessible to staff that they said informed their working practice. They included among the following: • Sex and relationships • Intimate care • Whistle blowing • Medication All the statutorily required records that the home was keeping that were examined were accurate and up to date. The AQAA (see - section “Summary” - above) submitted by the home’s registered manager before the site visit took place indicated that the home did among other things the following in order to promote equality and diversity: “… The celebration of a range of festivals and cultures in different ways through mediums such as music, food, dress and language … we explore different faiths encouraging young people to experience a wide range of religious and community experiences … ”. During the visit one person living in the home said that he was attending a harvest festival at a local church at the weekend. Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 27 Records seen and discussion with staff indicated that comprehensive risk assessments had been completed and safe working practices were promoted in the home. Also that fire safety and other systems and equipment in the home were properly serviced and tested and staff had received relevant health and safety training. Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 28 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 4 3 4 4 4 5 3 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 3 25 3 26 4 27 4 28 4 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 4 34 3 35 4 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 4 4 3 LIFESTYLES Standard No Score 11 4 12 4 13 3 14 3 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 4 X 3 3 3 3 3 4 X Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 29 N/A 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Oakhurst Lodge DS0000069789.V347609.R01.S.doc Version 5.2 Page 31 - 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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