Inspection on 27/04/05 for Oaklands (74)

This inspection was carried out on 27th April 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Oaklands (74) 09/12/08

Oaklands (74) 19/02/07

Oaklands (74) 09/11/05

Oaklands (74) 17/11/04

Oaklands (74) 12/05/04

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 (74) 74 Oaklands Chippenham Wiltshire SN15 1RQ Lead Inspector Elaine Barber Unannounced 27th April 2005 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 (74) D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Oaklands (74) Address 74 Oaklands Chippenham Wiltshire SN15 1RQ 01249 765520 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) United Response Margaret Williams Care Home 4 Category(ies) of 4 Learning Disability registration, with number of places Oaklands (74) D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th November 2004 Brief Description of the Service: 74 Oaklands is a semi-detached house in a residential area on the northern side of Chippenham. Each service user has their own single room. Two service users have rooms on the ground floor and two on the first floor. There is a lounge and a dining room, with a toilet on each floor. There is a large garden at the rear of the property. 74 Oaklands is part of ‘North Wiltshire Community Living’, which is run by the national charity, ‘United Response’. 74 Oaklands is the service users’ permanent home for as long as this remains appropriate to each person’s needs and wishes. The service users receive personal care and support throughout the day from a permanent staff team. There is a member of staff on duty when the service users are in the home. There are two members of staff on duty during evenings and weekends to enable service users to participate in activities. The philosophy of care emphasises the importance of an ordinary home environment and the involvement of people with a learning disability within the wider community. The staff team operates a system of ‘collective team management’. The registered manager is Mrs M. Williams. Oaklands (74) D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection and preparation took five hours. The inspector spoke to all four people living in the home and a member of staff, read records, including care plans and medication records, and looked at the accommodation. What the service does well: What has improved since the last inspection? What they could do better: The arrangements for recording medication were not robust enough to ensure people were protected and must be changed. The support plans for two people should be updated following their next reviews. People’s risk assessment information should be stored separately on their personal files to maintain confidentiality. Oaklands (74) D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 Page 6 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. Oaklands (74) D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 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 (74) D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 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) 2 People’s individual needs and aspirations were fully assessed. EVIDENCE: All the people had moved into the home before the introduction of care management in 1993 so they did not have initial community care assessments. There was in-house assessment information and some people had had reassessments by social workers. There were also assessments by an occupational therapist, physiotherapist and a psychologist. There were copies of social work care plans. Each person had a daily routine, a support plan and two people had revised support plan objectives following a review. Oaklands (74) D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 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, 9 People’s assessed needs were reflected in a support plan and reviewed and changed as necessary. People were supported to make decisions about their lives and to take risks to promote their independence. People could not be confident that information about them was kept confidentially. EVIDENCE: Each person had a weekly routine and plan of activities. There was a recommendation form the last inspection to update support plans when objectives were revised following review, which was partly addressed. Two people had had the objectives from their last review collated into new support plans. Plans were developed at six monthly reviews involving the person, professionals and relatives. Objectives were monitored two monthly. When required there were also behaviour plans developed by the behaviour nurse. People were satisfied with their involvement in decision making in the home including choosing their food, the décor of their rooms and where to go on holiday. One person had been involved in training and staff selection. There was a keyworker system and people were supported and encouraged to make decisions. Risks were identified in social work assessments. People had individual risk assessments e.g. for bathing and going to college alone. Some risk assessments were kept in a health and safety folder and some were kept on Oaklands (74) D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 Page 10 individual files. There was an outstanding recommendation that individual risk assessments should be kept on personal files. Oaklands (74) D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 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, 16, 17 People had opportunities for personal development, to be part of the community and take part in appropriate day time and leisure activities. People’s rights and responsibilities were respected. They had a choice of meals and enjoyed their food. EVIDENCE: The people and the member of staff talked about their lifestyle. Information from these conversations and the personal records showed that people had varied daytime activities including college, a resource centre and work experience. One person had been involved in training staff and selection interviewing and chose to go to church. Staff helped people to manage their money. People participated in the community through work experience and use of community facilities including the shops, church, theatre, cinema, pub, restaurants and the leisure centre. People had a choice of leisure activities inside and outside the home. At home they watched TV and video, listened to music and used a computer. Some people had leisure activities through the Gateway club. Everyone had been for Oaklands (74) D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 Page 12 a long weekend to Butlins a fortnight ago. Individual holidays of choice were also planned. On the evening of the inspection three people were going out for a birthday meal and one had chosen to go to a social club. People were involved in the daily routines. Staff supported them to do their own washing, cleaning, cooking, ironing and money management. People were involved in decisions about their own clothes, food, shopping, decorating and holidays. A previous recommendation about decision making had been addressed. Staff supported people to choose, plan and prepare their own meals and shop for food. People said that they enjoyed cooking and eating their meals. Oaklands (74) D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 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 People were supported in ways they preferred. Their physical and emotional health needs were being met. One person was supported to retain and administer their own medication. The arrangements for recording medication were not robust enough to ensure people were protected. EVIDENCE: People’s preferences for routines and support were recorded in their personal notes. Times for meals and baths were flexible according to people’s choices and activities. People chose their own clothes and hairstyles and their appearance reflected their personality. There was a keyworker system and a consistent staff team who had worked with the people for may years. There were no ‘in-house’ therapies being provided. The people who lived in the home were registered with GPs at a local surgery. Specialist support was being provided through the Community Team for People with a Learning Disability including community nursing, occupational therapy, psychology and psychiatry. People’s individual needs in respect of medical conditions and disabilities were being assessed and recorded. Visits to opticians, dentists and other health care professionals were recorded. Prescribed medication was obtained from a local chemist and there were suitable storage facilities. People received support from staff with the safekeeping and administration of medication. One person was supported to Oaklands (74) D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 Page 14 manage their own diabetes medication and the diabetes nurse had provided advice. All other medication was administered by staff members after they had received training and been assessed as competent. There were administration records, which relied on a numbering system and were not easy to read when there were several items. A clearer system of records must be developed. Oaklands (74) D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 Page 15 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) EVIDENCE: These standards were not assessed. They were met at the last inspection. Oaklands (74) D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 Page 16 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, 27, 28, 29, 30 People lived in a homely, safe, comfortable, clean and hygienic environment Bedrooms suited their needs and lifestyle and promoted their independence. They had sufficient toilets and bathrooms to meet their needs and maintain privacy. Independence was promoted through the provision of aids. EVIDENCE: The location and outlook of the home was in keeping with the stated aims. The property was similar to other houses in the surrounding area. There was a large enclosed garden at the rear of the property. One of the people liked to work in the garden. There was a lounge and a dining room for shared use. Together these rooms provided a total of 20 sq metres communal space (5 sq m per person). The upkeep of the home and on-going maintenance was of a good standard. There were systems for monitoring of health & safety. The accommodation was decorated in a homely and domestic manner. Each person had their own single room. One room that was converted from a garage measured 8.49 sq. metres. This room had been in use before 31.03.03 and has been unchanged since that date. The four people had the use of a bathroom and toilet on the first floor and a toilet on the ground floor. Grab rails were provided in the bathroom to assist Oaklands (74) D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 Page 17 one person. Sleeping-in facilities for staff were provided in a separate room. The home was clean and there were no unpleasant odours. Laundry was carried out in a small utility room. Soiled items were not carried through areas where food was stored cooked or eaten. Guidance on infection control was available to staff. Oaklands (74) D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 Page 18 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) 33, 34 People were supported by an effective staff team and were protected by the home’s recruitment practices. EVIDENCE: There was a staff rota for the month ahead. This took account of the service users’ activities and any special events that were coming up. The manager’s hours were not included on the staff rota. At least one member of staff was on duty whenever the people were at home. A second staff member was being deployed at particular times, depending upon people’s activities and when additional support was needed e.g during the evenings and at weekends. There was an on-call system in operation for making contact with a United Response manager outside office hours. There were regular staff meetings, usually monthly. These covered a range of business items and discussions about people’s needs. Specialist services were provided by the community team. Several of the staff had worked in the home for many years and knew the people from when they were children. There had been no new staff since the previous inspection when the standard about recruitment was met. Oaklands (74) D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 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) EVIDENCE: These standards were not assessed. Oaklands (74) D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score x x 3 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oaklands (74) Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 Page 21 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 20 Regulation 13-2 Requirement The registered person must ensure that the administation records are legible and easily understood. Timescale for action 13/05/05 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. 2. Refer to Standard 6 9 & 10 Good Practice Recommendations It would be good practice to update all the support plans when objectives are revised following a review. It would be good practice to keep information about each person’s risk assessments separate in their personal file to facilitate their access to their records. Oaklands (74) D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 Page 22 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire SN15 2BB 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 (74) D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 Page 23 Oaklands (74) D51_S28216_OAKLANDS(74)_V206175_270405Stage4.doc Version 1.30 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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