Inspection on 03/04/09 for Oaklands

This inspection was carried out on 3rd April 2009.

CQC found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oaklands 03/04/07

Oaklands 27/02/06

Oaklands 16/09/05

Extracts from inspection reports are licensed from CQC, this page was updated on 20/07/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Oaklands 183 Faversham Road Kennington Ashford Kent TN24 9AE     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Paul Stibbons     Date: 0 6 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Oaklands 183 Faversham Road Kennington Ashford Kent TN24 9AE 01233632381 01233632381 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): CareTech Community Services (No.2) Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 4 The maximum number of service users who can be accommodated is: 4 The registererd person may provide the following category of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Learning disability - LD Date of last inspection Brief description of the care home Oaklands is a detached property, which offers care and support to a maximum of 4 service users who have learning disabilities. It is situated in the Kennington area of Ashford; with access to a local shop and pub a few minutes walk away. The town of Ashford is accessible by the public bus service and by using the homes dedicated vehicle. The home is owned and operated by Caretech Community Services Limited. The home is set in its own grounds, with parking for 3 vehicles to the front and a large, secluded garden with patio space to the rear. The home has 2 communal rooms, one Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home lounge and one dining room. A shower room with WC is on the ground floor, and bathroom and WC on the first floor. All bedrooms are registered for single occupancy. The main ethos of the home is the promotion of greater independence in skills and social development. Activities are organised to develop practical skills both within the home and in the community. There is a wide range of leisure opportunities available. Previous reports are available from the home. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection on this service was completed on 3rd April 2007. This unannounced inspection started on 3rd April 2009 but due to no one being in the home was concluded over a period of 2.5 hours on the 6th April 2009. A completed AQAA (Annual Quality Assurance Assessment) was submitted to the commission prior to the visit. Discussions were held with the person in charge of day to day management of the service, members of staff and residents during the visit. Care Homes for Adults (18-65 years) Page 6 of 29 A tour of the premises was carried out and a variety of records and documents were examined. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents have sufficient information on which to base an informed decision as to whether the home can meet their needs. A comprehensive assessment of needs is carried out prior to admission to ensure the home can meet prospective residents needs. People living in the home have the security of an individual written contract of terms and conditions attached to the placement. Evidence: The home provides a statement of purpose that is specific to the individual home and the resident group they care for. It clearly sets out the objectives and philosophy of the service supported by a service users guide. There have been no new admissions to the home for some time but the manager states that admissions are not made to the home until a full needs assessment has been undertaken. Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: The assessment is conducted professionally and sensitively and involves the individual and their family or representative, where appropriate. Where the assessment has been undertaken through care management arrangements the service insists on receiving a summary of the assessment and a copy of the care plan. Prospective residents are given the opportunity to spend time in the home. New residents are provided with a contract detailing terms and conditions. This sets out in detail what is included in the fee, the role and responsibility of the provider, and the rights and obligations of the individual. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home benefit from having an individual plan of care that reflects their assessed and changing needs. People living in the home are consulted and supported in taking risks as part of an independent lifestyle. People living in the home can be confident that information held about them is handled appropriately and their right to confidentiality is upheld. Evidence: The service involves individuals in the planning of care which affects their lifestyle and quality of life. Staff members understand the importance of residents being supported to take control of their own lives and individuals are encouraged to make their own decisions and choices. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: The service knows the preferred communication style of the individual, and uses proven methods that enable the person to lead a full life that promotes independence and choice. These include communication aides such as photographs, pictures, and objects of reference. Care plans are person centred and are agreed with the individual. Plans are written in plain language, are easy to understand and look at all areas of the individuals life, however, plans are far too bulky to be a useful working document. There is a corporate decision to introduce a different format in the near future that addresses this issue. A key worker system allows staff to work on a one-to-one basis and contribute to the care plan for the individual. Care plans viewed included comprehensive risk assessments that are reviewed regularly. The management of risk is positive in addressing safety issues while aiming for improved outcomes for people. The home ensures that residents are consulted regularly through Talk times, resident meetings and reviews to gather information about their satisfaction with the home. Records kept in the home are securely stored. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home have a range of opportunities that will meet their social, leisure and educational needs and their own personal development. People living in the home are supported in maintaining appropriate relationships with friends and family. People living in the home enjoy a healthy and varied diet that is of their choosing. Evidence: The AQAA demonstrates that the service has a strong commitment to enabling residents to develop or maintain their skills, including social, emotional, communication, and independent living skills. Individuals are supported to identify their goals, and work to achieve them. Each resident has a monthly life and leisure Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: plan that records what they would like to do in the coming month and are therefore fully involved in the planning of their lifestyle and quality of care. Residents are involved in daytime activities of their own choice and according to their individual interests, diverse needs and capabilities. Residents were being supported in art work during this visit and they have drawn up a plan for a vegetable patch in the garden. A company day centre is attended on a regular basis by all of the residents. Residents can access and enjoy the opportunities available in their local community, such as the local pub, and local leisure facilities. Residents maintain contact with friends and family and some have home visits. Where appropriate residents are involved in the domestic routines of the home and take responsibility for their own room, menu planning and cooking meals, making sure that they are able to enjoy the food they prefer and like. Two residents spoken with commented on how much they liked living in the home and enjoyed the food in the home. Care Homes for Adults (18-65 years) Page 15 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home receive personal support in the manner they prefer and require, and their physical and emotional needs are met. People living in the home are protected by the homes policies and procedures for dealing with medication. Evidence: People receive personal and healthcare support using a person centred approach with support provided based upon the rights of dignity, equality, fairness, autonomy and respect. Personal healthcare needs are clearly recorded in each health action plan. They give a comprehensive overview of their health needs and act as an indicator of change in health requirements. Residents spoken with said staff treat them with respect and care plans, risk assessments viewed indicated that people are supported and helped to be independent Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: and can take responsibility for their personal care needs. Residents have access to healthcare and remedial services. Staff make sure that those who are fit and well enough are encouraged to be independent, have regular appointments and visit local health care services. The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Medication records are fully completed, contain required entries, and are signed by appropriate staff. Regular management checks are recorded to monitor compliance. Training records confirm that an assessment has been carried out to ensure each member of staff is competent to manage medication properly. Care Homes for Adults (18-65 years) Page 17 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can be confident that their views will be listened to and acted on, and they are protected from abuse and neglect. Evidence: The service has a complaints procedure that is clearly written and easy to understand. The complaints procedure is supplied to everyone living at the home and is displayed on the notice board within the service. Residents and others involved with the home understand how to make a complaint and are clear about what will happen if a complaint is made. The home keeps a full record of complaints and this includes details of the investigation and any actions taken. The policies and procedures for safeguarding adults are available and give clear specific guidance to those using them. Two staff members spoken with demonstrated a good understanding of safeguarding issues and know when incidents need external input and who to refer the incident to. There is a clear system for staff to report concerns about colleagues and managers. Staff that blow the whistle on bad practice are supported by the service. Training of staff in safeguarding is regularly arranged by the Home. Other training Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: around dealing with physical and verbal aggression is also made available to staff as needed. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in an environment with sufficient personal and communal space to meet their needs, however, a lack of maintenance is ongoing and detracts from the visual impact of the home and damp problems have the potential to cause health problems for residents. Evidence: The home provides a physical environment that is appropriate to the specific needs of the people who live there. However, there appears to have been little progress since the last report in addressing maintenance issues. There are hip tiles missing from the roof and other broken tiles, if left this has the potential of causing damp patches in residents rooms and adversely affect their health and living environment. There are also areas where wallpaper is coming away from walls and a skirting board noted to have rot. It is a requirement of this report that maintenance issues are addressed to improve the environment of people who live in the home. All bedrooms were viewed and personal possessions were seen to be on display, one resident spoken with commented on how happy they were with their room. All the homes fixtures and fittings meet the needs of individuals and can be changed if their needs change. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: The shared areas provide a choice of communal space with opportunities to meet relatives and friends in private. The bathrooms and toilets are in sufficient numbers. The home is clean and tidy and staff members have received training in infection control. There is a large garden area and the residents have drawn up plans to develop a vegetable plot. Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are supported by a competent and qualified staff team in sufficient numbers to meet their needs. People living in the home are protected by the services robust recruitment procedures for new employees. Residents individual and joint needs are met by an appropriately trained and supervised staff team. Evidence: At the time of the visit there was enough staff on duty to meet the needs of the people using the service and the staffing structure is based around delivering outcomes for residents and is not led by staff requirements. Training records indicate that all staff members receive relevant training that is focussed on delivering improved outcomes for residents. The home puts a high level of importance on training and staff members spoken with report that they are supported through training to meet the individual needs of people in a person centred way. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: Staff members undertake external qualifications beyond the basic requirements, for example, NVQ qualifications and Learning disability qualifications. Managers encourage and enable this and recognise the benefits of a skilled, trained workforce. There is a good recruitment procedure that clearly defines the process to be followed. This procedure is followed in practice with the home recognising the importance of effective recruitment procedures in the delivery of good quality services and for the protection of individuals. Records viewed confirm that staff meetings and supervision sessions are regular and that staff found them helpful with a focus on improving outcomes for people using the service. Notes and action points are taken of meetings and sessions. Care Homes for Adults (18-65 years) Page 23 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents would benefit from living in a home that is run by a competent and qualified manager and where their rights and best interests are safeguarded. Residents benefit from living in a home where their views underpin all self-monitoring and development of the home. Evidence: The home has no registered manager at present and this is a breach of the Care Standards Act 2000. The home is currently being managed by the registered manager of another company home nearby. The person in charge of day to day management of the service is not registered with the commission for this service and states that the providers are currently looking to recruit a permanent manager. The commission requires an action plan detailing the timescale for recruiting and registering a manager for the home. Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: There is a focus on person centred thinking, with residents shaping service delivery and a strong ethos of being open and transparent in all areas of running of the home. The AQAA would benefit from the inclusion of more information about the service to enable the making of quality judgements by the commission. The data section of the AQAA is accurately and fully completed, however, the AQAA was returned with no name of who completed it or the date of completion. This is a legal document and must be completed fully with accountability by the organisation. Maintenance issues identified in previous inspections had not been addressed by the management of this home. The AQAA and feedback from staff indicates that the manager promotes equal opportunities, has good people skills and understands the importance of person centred care and effective outcomes for people who use the service. The service has sound policies and procedures, which the manager effectively reviews and updates, in line with current thinking and practice. The home has a clear health and safety policy and all staff are fully aware of the policy and are trained to put theory into practice. Safeguarding is given high priority and the home provides a range of policies and guidance to underpin good practice. There is also evidence of organisational monitoring by corporate providers. Records are of a good standard and are routinely completed. The home has access to professional business and financial advice and has all the necessary insurance cover to enable it to fulfil any loss or legal liabilities. Care Homes for Adults (18-65 years) Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 23 23 The premises to be used as the care home are of sound construction and kept in a good state of repair externally and internally. The provider must take action in respect of the broken and missing roof tiles, peeling wallpaper in some areas, evidence of damp patch and rot to skirting boards. An action plan must be drawn up to address these issues in a timely manner and a copy sent to the commission. 17/07/2009 2 37 11 Care Standards Act 2000. Regulation 11 Requirement to register. An action plan is required by the commission detailing the timescale for the recruitment and registration of a manager for the home 18/06/2009 Care Homes for Adults (18-65 years) Page 27 of 29 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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