Inspection on 19/05/05 for Oaklands

This inspection was carried out on 19th May 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oaklands 05/10/06

Oaklands 23/11/04

Oaklands 30/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Oaklands 76/78 Church Road Plymstock Plymouth PL9 9BD Lead Inspector Tina Maddison Announced 19/05/05 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Oaklands D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Oaklands Address 76/78 Church Road, Plymstock, Plymouth, Devon, PL9 9BD Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01752 481166 01752 482790 The Durnford Society Limited Tania Russell Care Home 10 Category(ies) of Learning disability (10), Learning disability over registration, with number 65 years of age (10), Physical disability (10), of places Physical disability over 65 years of age (10) Oaklands D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd November 2004 Brief Description of the Service: Oaklands is part of the Durnford Society group of homes. The Durnford Socitey is a voluntary organisation that provides services for people who have a learning disability. Oaklands care home provides care for up to ten service users that have have learning disabilities and may or may not have physical disabilites. The accommodation is provided in a purpose built bungalow that is set in landscaped gardens. The home is seperated into two units and all bedrooms are single rooms. Most of the service users who live at Oaklands require a high level of care and there are high staffing levels as a consequence. The home has its own transport and the home is near to public transport routes, shops and local services. The home is equipped with various aids and adaptations to enable service users mobility. Oaklands D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out over one day on 19th May 2005. A pre inspection questionnaire was returned by the Manager prior to the inspection, and a number of comment cards from relatives were received. A meal was sampled, and a tour of the building was conducted. Service users are not able to communicate but staff were observed interacting with the service users, and parents of one service user were spoken to at length. Staff were spoken to during the inspection. The homes policies and procedures were available, as were staff records and residents records and care plans. A representative from the Durnford Society visited the home during the inspection. What the service does well: What has improved since the last inspection? A statement of purpose in a format that is accessible to service users has been developed in the form of a video. Oaklands D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Oaklands D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Oaklands D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5. Prospective service users are able to use an appropriate comprehensive service users guide and statement of purpose that helps enable them to be sure that Oaklands will be able to meet their care needs. EVIDENCE: Oaklands has a detailed statement of purpose that is available to all service users and families/representatives. It is available in Braille and video format. Service users and their families are invited to visit prior to admission. There has not been any new admissions to the home for over a year due to the home being fully occupied. The documented procedure for admissions was comprehensive and detailed. Each service user has a comprehensive care plan and detailed risk assessments have been carried out. Each service user has a contract from their funding authority, or statements of terms and conditions. The home requests a contribution from service users towards transport costs. Contracts have been signed by the service user or their representative, and all contracts detailed the room that is occupied. Parents of a service user at the home confirmed that careful consideration and assessment are given to any prospective service user, to ensure that the home is able to meet their needs, and that they will fit in with the other service users at the home. Oaklands D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9. Service users can be assured that staff will enable them to be as independent as possible and be encouraged to safely participate in all aspects of life in the home. Care plans are comprehensive and detailed, and risks and choices are appropriately balanced. EVIDENCE: The care plans contain an individual description of all the personal care services to be provided. Personal likes and dislikes regarding care and moving and handled are detailed. The plans have been drawn up with input from the service users, families, key workers and health and social care professionals. The plan addresses how all aspects of health, social, personal, physical emotional and behavioural needs will be met. Evidence of specialist services and consultations were detailed with recommendations and actions taken. It is recommended that clearer recording of reviews is documented. The Manager confirmed that care plans are regularly reviewed, or amended when any change in needs occurs. Each service user has their own keyworker, and service users have an input into their choice of keyworker. Although many of the service users at Oaklands have very limited communication, every effort is made by staff to enable the service users to make decisions about their lives, Oaklands D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 10 using picture charts and symbols. The home has a comprehensive missing persons procedure. It was observed that staff worked with service users in a respectful and knowledgeable manner, and were aware of service users needs despite their limited communication abilities. Oaklands D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16,17. A variety of social activities that are appropriate to the service users living at Oaklands are available, and inclusive to all service users. Personal development is encouraged, and meals are nutritious and varied. EVIDENCE: Personal development opportunities are encouraged, and details of activities undertaken are recorded in individual care plans. It is recommended that to enable service users to be aware of what is happening each day, a pictorial daily diary is developed for their use. It was evident from discussion with The Manager, staff, and parents of service users that all aspects of independent living skills are encouraged. Service users are able to attend a local church if they wished to. Service users participate in a variety of activities outside of the home, and these include day opportunities, college courses , music therapy and hydrotherapy. In house activities include arts and crafts, pottery, and music evenings. Evidence from care plans showed that service users enjoy individual holidays away from the home to a variety of places, and these holidays are mainly funded by the Durnford Society. The service users have access to a minibus that is owned by Oaklands, and risk assessments and Oaklands D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 12 appropriate insurance are in place for the use of the vehicles. Mealtimes are flexible, and dietry preferences, special diets and nutritional needs are noted. It was observed that service users during a meal were assisted to eat their meal in a sensitive and discreet manner by the staff. Photographs of various foods have been taken and used to assist the service users to make choices about their meals. Service users families confirmed that they are able to visit the home at any reasonable time, and were always made to feel welcome by staff. Oaklands D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20,21 Service users can be assured that staff will treat them with respect, and their personal care needs will be given in the way that they prefer, and their health care needs will be met. EVIDENCE: Staff confirmed that they were aware of individual preferences regarding moving and handling, and these preferences are documented in care plans. Visits from health professionals are held in private, although staff are always on hand to facilitate communication. The home has pressure relieving mattresses and equipment for one service user and the home is able to evidence that it has good working links with physiotherapist, community nurses and district nurses. Staff that dispense medication have received appropriate training. On the day of the inspection not all medication that had been dispensed had been signed for. Parents of a service user confirmed that all health care needs were always met, although sometimes they had to prompt the staff to organise flu jabs for their son. Medication is securely kept, and the Manager has overall responsibility for medication. Oaklands D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Service users can be confident that their concerns will be listened to, taken seriously and acted upon. Oaklands hasa vulnerable adults procedure that is robust, which will ensure the protection of service users. A complaints procedure must be displayed. EVIDENCE: The Registered Manager and pre inspection documentation indicated that the home has not received any complaints since the last inspection. The homes complaints procedure was not displayed on the day of the inspection. Oaklands has a complaints policy and procedure, and the parents of one service user confirmed that they were aware of how to complain should they need to. There is a concerns book, and it is recommended that all concerns and issues be recorded along with actions taken to resolve these. The home has comprehensive policies regarding adult protection, whistle blowing, gifts and legacies. There is a policy relating to aggression towards staff generally, and a policy relating to physical restraint and restriction of liberty. All staff employed at Oaklands have current CRB checks, and POVA checks in place. Oaklands D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29,30. Oaklands is furnished and decorated to a very high standard. It is very clean and warm, the gardens are accessible and pleasant, and overall Oaklands creates a comfortable environment for service users. EVIDENCE: The premises are accessible to all of the service users, and the home was found to be comfortable, very well furnished and decorated, clean and light. There were no offensive odours. Rooms are redecorated and furnishings, fittings and other items are replaced as necessary. The building is owned and maintained by the health authority. The gardens have been redesigned recently and include a well thought out swing area that was requested by one service user and their family. There is a planned maintenance and redecoration programme. Bedroom, toilet and bathroom doors are lockable and can be overridden in an emergency. All rooms meet spatial requirements, and all bedrooms are single rooms and are individually decorated. The home is fitted with aids and adaptations to meet the mobility needs of service users. The home has grab rails fitted, one bathroom has a hydraulic hoist and there are manual hoists available. There is a call bell alarm in the bathroom, and service users have individual aids as recommended by their Physiotherapist. Bedrooms Oaklands D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 16 do not have telephone points, but there is a cordless phone for private telephone calls. All bedrooms consist of low level wash hand basins. There are two large bathrooms and one shower room. The home has six toilets, and two of these are fitted with hand rails. The path in the garden is uneven in some places, and needs attention to ensure it is safe. When staff are sleeping in they have the use of a bedroom with an en suite shower and toilet. Kitchen facilities were found to be satisfactory. Oaklands D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36. Care staff numbers are adequate to meet the care needs of the service users. The home has a robust recruitment procedure, and this offers protection to service users. The staff team are committed, caring and appropriately skilled to provide care to service users. There has been a greater than usual turnover of staff recently. EVIDENCE: All staff receive job descriptions that clearly define their roles and responsibilities. Observation of staff indicated that roles are understood. Policies, procedures and care plans included in the induction process are always available to staff to enable them to fulfil their duties. The home does not employ any volunteers. Robust procedures are in place to ensure that new staff are suitable and are always supervised until they are deemed to be competent. Staffing rotas evidenced adequate numbers of staff employed to meet service users care needs. Most relatives confirmed in feedback cards that they felt that there were always adequate staff on duty, although there had been a number of staff changes in the last six months, which was felt to be disruptive to the residents, and the causes of this high turnover is being investigated by the Durnford Society. Rotas and discussion with the Manager and staff confirmed that staffing levels were as follows: 8am – 8pm – 6 care staff plus a Manager Oaklands D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 18 8pm – 8am – 3 waking night staff 11pm – 7am – 1 sleeping night staff. Staff undertake the cooking and cleaning as part of their duties. The Durnford Society recruitment policy and procedure are extremely thorough and staff records are kept on the premises although there was one staff file that did not contain two references. All staff appointments are subject to a six monthly probationary period. Training opportunities are provided on a variety of subjects, including first aid, food hygiene, health and safety, fire safety and specific training for staff who work with people who have a learning disability. Induction training is given to new staff. Supervision is undertaken on a regular basis. All staff receive five paid training days per year. Oaklands D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,40,41,42,43. The home is managed by a recently appointed and competent manager. There is a clear management structure operating in the home that is clearly effective. EVIDENCE: The recently appointed Registered Manager is working towards the Registered Managers Award. She is a qualified nurse with many years of working in care homes. Parents that were spoken with felt that the new manager was having a positive impact on the home. It is clear staff are encouraged to develop through supervision and meetings. Records are well kept and easily accessible, and all policies and procedures are kept up to date. The Durnford Society is continuing to develop its quality assurance system. Health and safety is a priority in the home, and health and safety practices described and observed were found to be satisfactory. Fire safety checks, and staff training were carried out as required. All staff are trained in emergency procedures, and first aid, and there is usually a first aider on duty. Infection control practices and procedures were found to be satisfactory. Substances Oaklands D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 20 hazardous to health were found to be safely stored. Maintenance records for such equipment as hoists were found to be up to date. Gas, heating and portable electrical equipment were regularly tested. A risk assessment for Legionella had been carried out. Thermostatic valves fitted to water outlets ensured that water temperatures do not exceed 43c. The home has covered all radiators. All accidents had been reported and documented. Detailed risk assessments had been carried out for all safe working practice topics. 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Oaklands Score 3 2 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 4 3 3 3 3 3 D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 21 LIFESTYLES Standard No 11 12 13 14 15 16 17 Score 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 2 3 3 3 3 Oaklands D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 22 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. 4. 5. Standard YA20 YA22 YA24 YA34 YA39 Regulation 12 22 23 18 35 Requirement Medication must be signed for at the point of dispensing. A copy of the complaints procedure must be displayed. The uneven path in the garden must be made safe to prevent possible tripping. Staff records must contain two written references. The home must develop its own quality assurance system to review, monitor and action the quality of care provided at the home. Timescale for action 30/6/05 30/6/05 30/7/05 30/6/05 30/8/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA7 Good Practice Recommendations A pictorial diary should be developed that helps to enable service users what is planned for each day. Oaklands D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Oaklands D52-D04 S3549 Oaklands V214475 100505 Stage 4.doc Version 1.20 Page 24 - 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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