Inspection on 06/03/08 for Oaklands

This inspection was carried out on 6th March 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oaklands 24/11/06

Oaklands 29/12/05

Oaklands 18/08/05

Oaklands 09/12/04

Oaklands 21/09/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Oaklands 5 The Green Theale Reading Berkshire RG7 5DR Lead Inspector Helen Dickens Unannounced Inspection 6th March 2008 10:00 Oaklands DS0000011150.V359383.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 Oaklands DS0000011150.V359383.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. Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oaklands Address 5 The Green Theale Reading Berkshire RG7 5DR 0118 930 5288 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) londonroad@tiscali.co.uk Milbury Care Services Ltd Post Vacant Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th November 2006 Brief Description of the Service: Milbury Care Services Ltd is a private company that is registered to provide care and accommodation for up to six adults who have a learning or communication difficulty. The accommodation is provided in Oaklands, a large, older-style detached house that is situated on the outskirts of Theale village. The home is within walking distance of local shops, churches, pubs and cafés. There are bus and rail services from the village to the towns of Reading and Newbury. A private drive at the front of the house provides parking space for several cars and there is a large garden to the rear of the property. Each of the Service Users has an individual bedroom in addition to use of the shared accommodation of the property. At the time of this inspection, the fees at this home ranged from £988 to £1,600 per person per week. Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key inspection was unannounced and took place over 7 hours. The inspection was carried out by Mrs. Helen Dickens, Regulation Inspector. The new home manager represented the establishment. A partial tour of the premises took place and a number of files and documents, including resident’s assessments and care plans, staff recruitment files, quality assurance information, and the annual quality assurance assessment (AQAA) were examined as part of the inspection process. A number of questionnaires were sent out to residents, and health and social care professionals but none were returned in time to write this report. Therefore all residents were spoken with or observed on the day of the inspection, and, in addition to the new manager, two other staff members were interviewed. The inspector would like to thank the residents, staff and the new manager for their time, assistance and hospitality. What the service does well: What has improved since the last inspection? Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 6 There have been a number of improvements since the last inspection, including meeting the single Requirement made at the previous inspection on the recording of medication. In addition, the manager has introduced guidelines for staff on when to administer ‘as required’ medication for individual residents, so that all staff are administering this medication in a consistent way. A number of environmental improvements have taken place including the provision of a prefabricated building to house the new laundry, and some internal decoration and refurbishment for example the replacement of carpets, the provision of a completely new kitchen, and some new garden furniture in memory of a past resident. A ramp has been built, with rails, for the safety and comfort of residents who are moving from the patio area to the lawn. One new shower unit has also been supplied. The manger has been reviewing all resident’s support plans and these are now being transferred into a more user-friendly format with actual photographs of each resident engaged in various activities within them. The manager was commended for the work she has done on resident’s Reviews which are now in a photo and word format which is designed to make the process more inclusive for residents. 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. Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit by having their needs thoroughly assessed prior to and in the early days of admission to Oaklands. EVIDENCE: Six gentlemen live at Oaklands and five of them have been there since the early 1990s. One new resident moved in last year and his file was checked to judge how well the service does in relation to pre-admission assessments. The background information on this resident was very thorough. The social services department funding this placement had carried out an extremely detailed assessment and the home had also sought an assessment from the resident’s previous placement; this too gave a detailed overview of his needs. In addition, a relative had written a detailed social history for staff at Oaklands. This assisted them to see this resident more clearly in the context of his early life and background prior to moving in. Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s benefit by having their assessed and changing needs reflected in their care plans, and they are encouraged to make decisions and take reasonable risks as part of their daily lives. EVIDENCE: Two care plans were checked and both were found to be very detailed. One was complied in the new format which all residents will have in the near future. The new format is much more resident-friendly with pictures and easier words throughout. The new manager should be commended for the work she has done on these care plans and other documents which are now more accessible to the people who live at Oaklands. Even resident’s Reviews are in a picture and word format with photographs of the person taking part in activities both at home, and out and about at social and leisure activities. Staff spoken to were knowledgeable on residents needs. Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 10 As all the people living at this home have difficulty with verbal communication, guidance has been drawn up for staff on how to interpret various expressions and actions which residents use to express themselves; this is detailed in their care plans. There is a key worker system in place which means one member of staff gets to know each resident very well and takes overall responsibility for their care. Risk assessments are in place though some needed a formal review and the most recent resident did not have a fully completed care plan. The manager is aware of this and is working on the final phase. Residents were seen to be encouraged to make decisions and choices, and staff were observed to communicate well with them and anticipate their needs. Care plans detailed likes and dislikes, for example food preferences were noted, as well as preferences about how they would like their personal care delivered. Where choices are limited for safety or other reasons, this is documented on their care plans and risk assessments. Staff support residents with their finances and this is discussed under Standard 23 below. Risk assessments and risk management strategies are in place at Oaklands which aim to limit the freedom of residents as little as possible. A recent review showed that one resident had improved in this respect since moving into the home and staff were pleased with the progress they and the resident had made. Evidence of liaison with day services and other specialists regarding the safety of residents and was noted on each file. Residents are encouraged to take part in activities and further education, and associated risks are assessed and minimised, for example one resident was attending cookery and community awareness sessions. Very detailed information on how residents would like their daily support delivered is on each file; the manager explained that this takes into account how more challenging behaviours can be avoided or reduced. Some risk assessments had not had a documented review for some time and the manager said this was being done as care plans were changed into the new format. Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit by the arrangements made at this home for further education, community activities, and for keeping in touch with their families. Daily routines promote their independence, and mealtimes are an enjoyable experience. EVIDENCE: Resident’s individual support plans identified the activities they engaged in. One resident was gradually being introduced to a wider range of activities and the manager was pleased with his progress. New activities included bowling, cookery, and community awareness arranged by the local further education college. The other file checked showed the resident had activities on four out of five afternoons during the week, and every second weekend they went to stay with relatives. The manager said residents are encouraged to be involved in the garden and a vegetable patch has been set aside to give them an Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 12 opportunity to get involved in growing things. The manager also said residents used to have a cat who was very popular at the home and, since he had gone, they had arranged to have a kitten who would be joining them soon. Service users are encouraged to be part of the local community and there are many photographs on display in the home and on resident’s files showing the activities they engage in. They use local shops and health services, have a regular takeaway meal, and use the garden and craft centre nearby. One resident now has a whiteboard where staff put a photograph of him engaged in his regular activities – this changes daily and acts as a reminder to him about what he will be doing that day. The AQAA states that the staff rota is organised according to resident’s needs so that there is someone available to accompany them to their various activities. On the day of the inspection the manager was ferrying residents to and from local activities in the homes own minibus. She said residents sometimes use public transport though this can be problematic due to some having challenging behaviour. Risk assessments were in place in regard to residents being out and about in the local community. Residents are encouraged to maintain family and friendship links and staff spoken with were knowledgeable about resident’s families. One of the two resident’s files examined showed that relatives had been pleased with his progress since he had moved into Oaklands There was information from one relative about a resident’s social and family backgrounds, and this had helped staff to understand him better. Bedrooms visited showed plenty of photographs and evidence of good family links. Daily routines were observed to promote independence and individual choice for residents. Two staff interviewed during the morning were very knowledgeable on individual residents needs and routines. They said all residents like to sit together for breakfast, except one who likes a lie in. His care plan reflected this and made arrangements to ensure he was ready on time for those days when he was scheduled to attend further education classes. Care plans went into great detail about how residents liked their support to be delivered, worked out over a long period of time and through getting to know the residents well. At the beginning of each care plan there is a record of how the resident prefers to be addressed. It was noticeable how staff were attentive to residents needs and there were no instances of staff speaking exclusively to each other – staff sat with residents in the lounge at various times during the day, and joined them for lunch at the dining table. One resident has a sight impairment and the manager said she is looking at further ways of ensuring he is able to make the same choices as other residents – some options were discussed for further information and she will be following this up. Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 13 Residents and staff were observed to eat together and the manager said this had always been encouraged at Oaklands. Staff showed the inspector a pictorial file which residents used to help identify foods they liked and to help decide what would be on the menu for the following week. The file was particularly well done in that it showed a photograph of an actual plate of food, e.g. beans on toast or baked potato, so that residents could see exactly what they were choosing. There is a regular take-away evening at the home and some residents eat out from time to time, one going to the pub or burger king as part of their community awareness activities. One resident who has been underweight in the past is being closely monitored by staff in this regard. Care plans clearly document what residents do not like and any food allergies they have, as well as identifying what support they need at mealtimes. Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit by receiving personal and healthcare support in the way they prefer and require, and they are protected by the home’s arrangements for administering medication. EVIDENCE: Resident’s support plans contain very detailed information about exactly how residents prefer to be supported with their personal care. Two files were examined and it was carefully documented how each aspect of personal care would be supported by staff. Those staff interviewed were knowledgeable on the personal care needs of residents. There is a key worker system in place. There were even pictures in the new style support plan showing for example a photograph of the shower which is used by this resident. Resident’s healthcare needs are recognised and assessed at this home. Their health is monitored by staff for example in relation to their weight and medication. The health section of each resident’s file contains details of their primary condition, for example some residents are autistic, as well as having Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 15 additional health and mental health concerns such as anxiety or epilepsy. Their records show how their health needs affect them and what support is needed. Resident’s records including care plans, reviews and health plans are all written in the first person, for example ‘I need support at with my medication….’. No residents at this home are able to manage their own medication and the support needed by staff is documented on each resident’s support plan. The manager gave medication on the day of the inspection and was observed to do so in a safe way, whilst being sensitive to resident’s needs. The Requirement made at the last inspection has been met in that there are now no unexplained gaps on the medication records. There is good guidance on file for staff regarding when ‘as required’ medication should be given to residents. One way of assessing the improvement in relation to a resident is the reduced use of anti-psychotic medication. The manager had outlined how one resident who had needed this on a daily basis could now go for weeks without requiring it at all. All staff who administer medication have had training and a competency test to ensure they are administering medication safely. Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s views are sought and acted on and they are protected from abuse. EVIDENCE: No complaints have been received by the service since the last inspection, and none have been received at CSCI. There is a complaints procedure in place though realistically, all residents would need assistance to make a formal complaint. However, resident’s needs and likes and dislikes are carefully documented, and there is written guidance for staff on each resident’s file regarding how they express displeasure, make staff aware when they do not like something, or do not want to do something. All residents also have a care manager or social worker as social services departments fund all the current placements at this home. Some residents also have relatives who could raise any issues about their care. Residents are also encouraged to attend ‘house meetings’. The home has a copy of the local multi-agency vulnerable adults safeguarding procedures as well as their own in-house policy. No safeguarding issues have been reported to CSCI in relation to this home since the last inspection. The home has a system in place to ensure those residents who need help with their finances are protected. The manager and a senior member of staff check all transactions and the operations manager also checks each resident’s records on a monthly basis. Two resident’s record books and cash were checked during the inspection and found to be correct. Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 17 It was noted that the homes own safeguarding adults policy allows up to 24 hours to report any suspected incidents to the local authority. It is recommended that this be confirmed with the local authority, as it is more usual to report any suspected abuse immediately. Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from living in a homely environment, which is generally clean and hygienic, though more work is needed to meet these Standards in full. EVIDENCE: Oaklands offers a homely environment for residents with comfortable communal areas and personalised bedrooms. Since the last inspection a number of improvements have been made including a new pre-fabricated laundry in the garden, internal refurbishment and decoration including carpets, and a completely new kitchen including new flooring. In the garden there is a new table and bench, and a ramp has been built from the paved area down to the grass – rails have been fitted for the safety of residents. Radiators in lounge have been replaced and a new shower unit has been installed. Four bedrooms were visited and found to be personalised with residents having their photographs and themes such as football or favourite colours. Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 19 However, some shortfalls were identified and discussed with the manager – these included: • • • • • • The toilet off the dining room needs decorative attention Mould on a bedroom wall has been treated but now needs redecorating A chair in one bedroom was blocking access to the resident’s hand basin making it unusable. An upstairs bathroom needed decorative attention including repairing cracks and a pipe cover which bends when residents stand on it. There are patches on the stairway walls requiring decoration, and the stair carpet is worn. Whilst it is not dangerous, it detracts from the otherwise homely appears of the main hallway and stairs. The outside of the property needed tidying as there were dead plants and last autumn’s leaves, as well as wooden panels lying on the drive. A Requirement will be made for the manager to review these shortfalls and arrange for them to be remedied in a timely fashion. A new laundry building has been purchased and this is now in the garden. This allows a spacious and separate environment for the laundering of resident’s clothes etc. There is a commercial washing machine with a sluicing facility, and a tumble dryer. The area was clean and tidy and there were good hand washing facilities throughout the home. However, the lock on the laundry door was broken; a risk assessment needed to be carried out and any remedial action taken to safeguard residents. The manager did this whilst the inspector was still on the premises. There was a food freezer in the laundry building – this had some bread defrosting on top. The manager was asked to speak to environmental health about the appropriateness of this arrangement, and to check when the next environmental health officer’s visit is due. A slight odour was also noted in one bedroom and the manager said she would deal with this. Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are supported by competent staff, but more staff need to be qualified to NVQ Level 2. Recruitment policies and practices need further work to fully safeguard residents. Resident’s needs are met by the current staff and training arrangements are well developed. EVIDENCE: Staff on duty on the day of the inspection were observed to be confident and competent when supporting residents. Two staff were interviewed and observed during the morning. They communicated well with residents, and residents were seen to approach staff when they needed support. Staff anticipated resident’s needs at times and were knowledgeable about their likes and dislikes. Though there is a key worker system in place, it was evident that staff were knowledgeable about all the residents, not just those who they supported in a keyworker capacity. More work needs to be done regarding NVQ Level 2 qualifications as currently only 4 out of 11 permanent staff has this qualification. Standard 32 recommends that 50 of care staff should have achieved this qualification by 2005. Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 21 The recruitment files for this service are now kept at their head office and a proforma, identifying which recruitment checks have been carried out and reference numbers for CRBs etc are completed and kept on file at the home. This arrangement was made with CSCI in 2007. The two proformas checked had a number of shortfalls in that it was not clear if one staff member had had a POVA check, i.e. whether they had been checked against the protection of vulnerable adults list to ensure they had not been deemed unsuitable to work with vulnerable people. Other answers to questions were left blank, for example whether or not verification about why the person had left their previous employment had been sought was blank on one. A Requirement is being made regarding recruitment procedures. There is a training and development plan in place and a monthly review of the training matrix showing which staff have completed which training courses. Where refreshers are due, for example some staff needed first aid refresher courses, the manager said she had booked them on the training. It was noted that 72 of staff needed moving and handling refresher training though the manager said no service users currently need assistance with moving. This course is going to be delivered in-house in April. According to the matrix, staff had all done induction training and fire awareness training. The manager also said that only those who are trained to give medication and have had a competency test are allowed to administer medication to residents. Though there were some shortfalls, the manager had identified these and was making arrangements to deal with them. Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well run home though the service does not currently have a manager registered with CSCI. There are good quality assurance processes in place and the health and safety of residents is promoted at this home. EVIDENCE: At the inspection it was discovered that the previous manager who was registered with CSCI had left the home last year and a new manager had been appointed. The new manager was asked to ensure that the company informs CSCI about this change as soon as possible. The new manager has sent off for the application forms to register with CSCI but had not yet had her CRB Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 23 documents checked with the Commission. She said she would make time to do this before the end of March. The new manager said she had settled into her role well and she had found staff to be helpful and supportive. There was a strong staff team spirit at the home and a pleasant atmosphere. The new manager already has an NVQ Level 3 in care, and has applied to do the company’s ‘Management development Programme’. This course lasts for 6 months and she said she plans to do her NVQ Level 4 and the Registered Manager’s Award immediately afterwards. During the last 8 years with this company she has had been a senior care worker for four and a half years, and deputy manager for 18 months before taking up the manager’s post at this home. She has kept up her own level of knowledge and training and during the last twelve months has attended 6 training courses, including moving and handling, food handling and hygiene, and medication administration training. She has overall responsibility for achieving the aims and objectives of the home and had a very positive attitude to the inspection process. The company employs a quality assurance manager who last visited in August 2007 – a report is then given to the home showing what work needs to be done. It was noted that the annual service review highlighted some shortfalls, for example in the bathrooms, which had still not been remedied. The home has ‘House Meetings’ which are for staff but residents are invited as well and the manager said some do join in. Resident’s views are also taken into account at their Reviews, and on a day-to-day basis by their key workers. As all residents at this home have difficulties with communication, it is vital that care plans and records clearly identify resident’s preferences. The manager and staff should be commended for the very detailed information they have recorded in this regard. There are a number of systems in place to promote the health, safety and welfare of residents, staff and visitors to the home. Training records show staff have had relevant training, for example in fire safety. There is a risk assessment and a system in place for the prevention of legionella, and all staff who administer medication have had training and a competency assessment. The annual service review highlights any health and safety shortfalls which need further action. However, on the day of the inspection the manager was asked to ensure that risk assessments were in place for any radiators which did not have covers, and for the laundry room where the door handle was faulty and therefore could not be locked. The lock on one interior cupboard in the laundry building, which contained cleaning materials, was also faulty. The manager spoke with her own manager and it was agreed that the remaining radiators identified as needing covers would have these in place by the end of the first week in April and in the meantime risk assessments would be followed to ensure residents were safe. A Requirement will be made that arrangements for monitoring Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 24 health and safety must be reviewed to ensure any shortfalls, such as those noted above, are quickly identified, and dealt with in a timely fashion. Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 2 X 3 X X 2 X Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 26 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. Standard YA24 Regulation 23(2)(b) Requirement Timescale for action 06/05/08 2. YA34 3. YA42 The shortfalls identified in relation to the environment and listed under Standard 24 of this report must be reviewed and dealt with in a timely fashion. 19 Recruitment practices must Schedule 2 be reviewed in line with the Care Homes Regulations 2001 (as amended) to ensure that all the information required in Schedule 2 is obtained for each staff member. 13(4)(a)(b)(c) Monitoring of health and safety arrangements must be reviewed to ensure any shortfalls are identified and dealt with in a timely fashion. 06/04/08 06/04/08 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. Oaklands Refer to Standard YA16 Good Practice Recommendations It is recommended that the manager take specialist advice DS0000011150.V359383.R01.S.doc Version 5.2 Page 27 2. YA23 3. YA30 on promoting more choice and independence for one resident with a sight impairment. It is recommended that the timescale of 24 hours within which staff must report any alleged safeguarding adults issues be confirmed with the local authority. This is to ensure that the Oaklands policy dovetails with the local authority procedures. There was a food freezer in the laundry building – this had some bread defrosting on top. The manager was asked to speak to environmental health about the appropriateness of this arrangement, and to check when the next environmental health officer’s visit is due. Oaklands DS0000011150.V359383.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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