Inspection on 09/11/05 for Oaklands (74)

This inspection was carried out on 9th November 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oaklands (74) 09/12/08

Oaklands (74) 19/02/07

Oaklands (74) 27/04/05

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 Inspection 9th November and 1st December 2005 01:10 Oaklands (74) DS0000028216.V270255.R01.S.doc Version 5.0 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 (74) DS0000028216.V270255.R01.S.doc Version 5.0 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 (74) DS0000028216.V270255.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Oaklands (74) Address 74 Oaklands Chippenham Wiltshire SN15 1RQ 01249 765520 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) www.unitedresponse.org.uk United Response Mrs Margaret Williams Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Oaklands (74) DS0000028216.V270255.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th April 2005 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 registered manager is Mrs M. Williams. Oaklands (74) DS0000028216.V270255.R01.S.doc Version 5.0 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 three members of staff, read records, including care plans and medication records, and looked at the accommodation. What the service does well: People’s individual needs and aspirations were fully assessed. Their assessed needs were reflected in a support plan and reviewed and changed as necessary to ensure that their needs were met. People were supported to make decisions about their lives and to take risks to promote their independence. They were supported to keep in contact with family and friends and they had appropriate personal and family relationships. Personal information was stored in separate files in locked cupboards and they could be confident that information about them was kept confidentially. People had access to a range of health professionals and 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 ensured people were protected. There was a process for managing complaints and people’s views were listened to and acted upon. There were policies and procedures about dealing with allegations of abuse and managing people’s money so that people were protected from all forms of abuse, neglect and self harm. People were supported by an effective staff team of competent and qualified staff who were appropriately trained. They were also supported and protected by the home’s recruitment policies and practices. The manager and staff were appropriately qualified and experienced so people were benefiting from a well run home. There was a range of health and safety procedures and measures to ensure that people’s health, safety and welfare was promoted and protected. Oaklands (74) DS0000028216.V270255.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Oaklands (74) DS0000028216.V270255.R01.S.doc Version 5.0 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 (74) DS0000028216.V270255.R01.S.doc Version 5.0 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 the following 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 each person had revised support plan objectives following a review. Oaklands (74) DS0000028216.V270255.R01.S.doc Version 5.0 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 the following standard(s): 6, 7, 9, 10 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 be confident that information about them was kept confidentially. EVIDENCE: Each person had a weekly routine and plan of activities. There was a recommendation from the last inspection to update support plans when objectives were revised following review. Each person now had a summary of their objectives following their review and a plan of how these objectives would be met. The objectives were monitored every two months. Plans were developed at six monthly reviews involving the person, professionals and relatives. 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 Oaklands (74) DS0000028216.V270255.R01.S.doc Version 5.0 Page 10 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 for example for bathing and going to college alone. There was a recommendation at the last inspection that individual risk assessments should be kept on personal files. This had been addressed. There was a policy statement about confidentiality. This stated that information given in confidence was not shared with family and friends without permission. Information about each person was kept separately to facilitate access to their records. Records were kept in a locked cupboard. Oaklands (74) DS0000028216.V270255.R01.S.doc Version 5.0 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 the following standard(s): 15 People had appropriate personal and family relationships. EVIDENCE: There was information in each person’s file about how they kept in contact with their family and friends. One person talked about maintaining a personal relationship and staff talked about how they supported the person with this. People had opportunities to meet people and make friends through their day placements, work experience, college and visits to the pub. Oaklands (74) DS0000028216.V270255.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 19, 20 People’s physical and emotional health needs were being met. One person was supported to retain and administer their own medication. The arrangements for recording medication had been improved since the last inspection to ensure people were protected. EVIDENCE: 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. People had recently had appointments with the dentist. There was a requirement at the last inspection that there must be a clearer system of recording the administration of medication. New arrangements for medication had been introduced. Prescribed medication was obtained from a local chemist in a monitored dosage system and there were suitable storage facilities. People received support from staff with the safekeeping and administration of medication. One person was supported to manage their own Oaklands (74) DS0000028216.V270255.R01.S.doc Version 5.0 Page 13 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. Medication administration record sheets, provided with the monitored dosage system, were being used to record medication received, administered, returned and destroyed. A list of current medication for each person was kept in their file. During the inspection the pharmacist visited to inspect the medication and was satisfied with the arrangements. A new homely remedies policy had been developed. Each person had a list of homely remedies, such as paracetamol and cough mixture, which they could take in agreement with the GP. Oaklands (74) DS0000028216.V270255.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): People’s views were listened to and acted upon. People were protected from abuse, neglect and self harm. EVIDENCE: No complaints about the home had been received during the last year. There was a detailed complaints procedure. A more pictorial and ‘user friendly’ version was available for service users and each service user had a copy. When asked, one of the people said that they knew how to make a complaint. United Response had produced a range of relevant policies and written guidance for staff members. These included procedures covering the prevention of harm, responding to allegations of abuse, responding to challenging behaviour, dealing with service users’ money and challenging bad practice at work (whistle blowing). Copies of the guidance booklet, ‘No Secrets’ were available to staff. Some staff had received training in the prevention of harm. A referral had been made to the vulnerable adults unit and had been dealt with appropriately. People were supported to manage their own money and had their own cash boxes. There were cash records for people’s money detailing income and outgoings, reasons for purchases and receipts. Oaklands (74) DS0000028216.V270255.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed. They were met at the last inspection. EVIDENCE: Oaklands (74) DS0000028216.V270255.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 People were supported by an effective team of competent and qualified staff. People were supported and protected by the home’s recruitment policies and practices. People’s individual and joint needs were met by appropriately trained staff. EVIDENCE: Relationships between service users and staff members during the inspection appeared to be friendly and positive. United Response had produced a ‘Getting it Right’ manual that provided staff members with comprehensive guidance on good practice in their support for people. Staff had received a wide range of relevant training to enable them to develop the skills to meet the needs of the service users. Several of the staff had worked with the people, who lived in the home, for many years and were familiar with their needs. There were seven members of staff. Two members of staff had completed NVQ at level 2 and two more were working towards NVQ Level 2. There were no trainees or volunteers working in the home. 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 deployed at particular times, depending upon people’s activities and when Oaklands (74) DS0000028216.V270255.R01.S.doc Version 5.0 Page 17 additional support was needed, for example, duing the evenings and at weekends. One member of staff slept in at night. There was an on-call system 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. There had been one new member of staff recruited since the last inspection. They had copies of their certificates of training and qualifications. They already had an NVQ Level 2 and NVQ level 3 in care. They had a copy of their passport as proof of identity and all the appropriate checks had been made, including a Criminal Records Bureau check and Protection of Vulnerable Adults List check, two written references and a declaration that they had no offences. There was an annual training plan for the Western Area of United Response. All staff had training in food hygiene, first aid, health and safety, manual handling. prevention of harm and ‘The way we work’, a course about the ethos of the organisation Training needs were identified in supervision and appraisal. Several staff had been in post many years and had a wide range of training. The training records showed that they kept their training up to date. The new member of staff was undertaking Learning Disability Award Framework training. Oaklands (74) DS0000028216.V270255.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 People were benefiting from a well run home. People’s health, safety and welfare was promoted and protected. Oaklands (74) DS0000028216.V270255.R01.S.doc Version 5.0 Page 19 EVIDENCE: The manager has responsibility for a number of homes that are run by United Response in the North Wiltshire area. The manager has a Registered Nursing qualification, a diploma in management studies and a qualification in the care of people with a learning disability. She keeps her training updated. There was a ‘Getting it Right’ manual which was a quality assurance manual with policies and procedures to ensure that a range of standards were met. A staff member reported that there were no quality assurance visits by a manager but the area manager did conduct the monthly visits under Regulation 26 of the Care Homes Regulations. There was a two year corporate plan for United Response. There were annual reviews and monitoring of objectives to demonstrate year on year development for each person. The manager reported that at present there were only monthly monitoring visits to assure quality. However, they were developing a questionnaire to send to a range of stakeholders to obtain their views of the service. These had not yet been sent and there was no report of findings. A number of risk assessments and safe working procedures had been recorded. These included a fire risk assessment and risk assessments about unrestricted windows. A risk management manual had been produced by United Response. Arrangements were in place for the training of staff in moving and handling, fire safety, first aid, food hygiene and infection control. A monthly safety inspection of the home was being carried out by staff. Hot water temperature regulators had been fitted to all outlets. These were serviced in April and May 2005. There was a health and safety policy and a health and safety handbook was available to the staff team. This detailed the action to be taken in order to comply with the relevant regulations. There were COSHH assessments and a range of safety checks. These included portable appliance testing, servicing of the boiler, taking of hot water temperatures, fire safety checks and cleaning the shower head. Oaklands (74) DS0000028216.V270255.R01.S.doc Version 5.0 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 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oaklands (74) Score X 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 2 X X 3 X DS0000028216.V270255.R01.S.doc Version 5.0 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 YA39 Regulation 24 Requirement The registered person must develop a system for reviewing and improving the quality of the care provided based on consultation with service users and their representatives. The registered person must supply a copy of the report of any review to CSCI and make a copy available to service users. Timescale for action 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Oaklands (74) DS0000028216.V270255.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham 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) DS0000028216.V270255.R01.S.doc Version 5.0 Page 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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