Inspection on 25/05/05 for Oaklands Grange

This inspection was carried out on 25th May 2005.

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

The inspector 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 Grange 05/09/07

Oaklands Grange 15/11/06

Oaklands Grange 11/01/06

Oaklands Grange 17/11/04

Oaklands Grange 21/06/04

Oaklands Grange 04/03/04

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

CARE HOME ADULTS 18-65 Oaklands Grange 53 Seabank Road Wallasey Wirral CH45 7PA Lead Inspector Peter Cresswell Unannounced 25 May 2005 9:00 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 Grange F52_F02_s18921_OaklandsGrange_v227022_250505_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Oaklands Grange Address 53 Seabank Road Wallasey Wirral CH45 7PA 0151 630 5804 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) Pinpoint Developments Ltd Iris Pamela Carter CRH PC only 15 Category(ies) of MD registration, with number of places Oaklands Grange F52_F02_s18921_OaklandsGrange_v227022_250505_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Only 12 adults (aged 18-64 years) with a mental disorder (excluding Learning disability) may be accommodated. 3 named elderly persons (aged over 65 yrs) with a mental disorder (excluding learning disability and dementia) may be accommodated. Date of last inspection 17 November 2004 Oaklands Grange F52_F02_s18921_OaklandsGrange_v227022_250505_Stage 4.doc Version 1.30 Page 5 Brief Description of the Service: Oaklands Grange provides care for adults who are experiencing mental health problems. The building is a three storey detached house on the main road between New Brighton and Seacombe, within half a mile of Liscard town centre. Shops, a post office and other community facilities are nearby and the riverfront at Egremont promenade is only a short walk away. Buses to New Brighton and Seacombe stop close by. There are four shared bedrooms and five singles. Communal space includes a lounge, lounge/dining room and a rear garden. A small ‘quiet room’ on the first floor can also be used for seeing visitors. There is space for car parking at the rear of the building. The home has a variation in its registration to allow it to care for three older people with a mental disorder though only two are resident at the moment. Oaklands Grange F52_F02_s18921_OaklandsGrange_v227022_250505_Stage 4.doc Version 1.30 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. The inspector spoke to most of the residents who were in the home at the time (nine in total) and also spoke to staff and management. The inspector toured the home, looking at all rooms in the building, examined records, including care plans, and inspected medication procedures. What the service does well: 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 Grange F52_F02_s18921_OaklandsGrange_v227022_250505_Stage 4.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 Grange F52_F02_s18921_OaklandsGrange_v227022_250505_Stage 4.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 Residents are only admitted if their needs have been properly assessed. EVIDENCE: One person has been admitted to the home since the last inspection. He was assessed by Wirral Social Services Department and a copy of the assessment was on file as was a care plan prepared by the Department. The manager was in the process of developing a full care plan as she and the staff got to know the resident better. A review had been held on 31 March 2005 and the meeting was attended by a Consultant Psychiatrist and a Community Psychiatric Nurse. He had not been able to visit the home before being admitted but this was due to factors beyond the home’s control. Prospective residents are normally encouraged to visit the home before making a final decision. Oaklands Grange F52_F02_s18921_OaklandsGrange_v227022_250505_Stage 4.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, 8, 9, 10 Care plans are detailed and reviewed regularly, ensuring that up to date information is available to staff responsible for day to day care. EVIDENCE: All of the residents have detailed care plans which are regularly reviewed. Residents are encouraged to attend the review meetings. Some residents also have life histories at the beginning of the file and these contain a great deal of useful information for the guidance of staff. Life at Oaklands Grange is as informal as possible and the residents are involved in decisions about how the home is run on a day to day basis. All of the residents go out of the home alone and several went on different local expeditions, such as shopping, during the course of the inspection. Residents sign a book to indicate if they are in or out of the home and when they are expected back; they accept this procedure as a sensible precaution. Oaklands Grange F52_F02_s18921_OaklandsGrange_v227022_250505_Stage 4.doc Version 1.30 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16, 17 Daily routines in the home are relaxed and residents take part in everyday activities in the community. The meals in the home offer choice and variety for the residents. EVIDENCE: Residents take part in a wide range of activities in the community, such as shopping and visits to the pub. Residents are supported by staff in these activities when necessary. Some also attend day centres and described the range of activities they take part in, including painting and music lessons. Several residents choose to spend most of their time in the home and said that they are happy to do so. There is not much emphasis on organised or formal activities and little sign that the residents would welcome such an approach. Residents make decisions about their own personal lives and are supported in this by the manager and her staff. Families are encouraged to visit and are welcome at any time but few choose to do so at the moment. There is a small ‘quiet’ room on the first floor which can be used to receive visitors or just to spend time alone. Oaklands Grange F52_F02_s18921_OaklandsGrange_v227022_250505_Stage 4.doc Version 1.30 Page 11 Most service users get their own breakfast whenever they get up and were doing so on the day of the inspection. The main meal of the day is served in the early evening – round about 5 p.m. - and residents say that this arrangement suits them. Those who choose to eat later can do so. Choices are always available and the menu is displayed on a small whiteboard in the dining room so residents are always aware of what is on offer for the day. The residents said that they enjoy the food in the home and they can have alternatives if they want them. Oaklands Grange F52_F02_s18921_OaklandsGrange_v227022_250505_Stage 4.doc Version 1.30 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 standard(s) 18, 19, 20 Medication is reasonably well organised but one or two changes are needed to make sure that an entirely accurate record is kept and controlled drugs are stored safely, in order to best protect the interests of residents. EVIDENCE: Residents do not normally need physical personal support but are given emotional support and encouragement through the home’s keyworker system. The home now has a controlled drug to administer. It is kept securely in a locked box in a locked cupboard but should be kept in an approved Controlled Drugs cabinet. The administration of the drug is witnessed and signed by a second member of staff and the Registered Person has ordered a bound Controlled Drugs Register in which to record administration. Medication is on the whole well organised, using a system of plastic NOMAD cassettes in which each resident’s medication is put in preloaded cassettes by the dispensing pharmacist. However, in several cases where a medicine had not been administered there was no entry on the Medication Administration Record (MAR) sheet to indicate why this had happened. It is important that the MAR sheets carry a detailed and accurate record of exactly what has been administered to each resident. Oaklands Grange F52_F02_s18921_OaklandsGrange_v227022_250505_Stage 4.doc Version 1.30 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23 The home has a satisfactory complaints procedure which residents can use to make their views heard. EVIDENCE: Oaklands Grange has an appropriate complaints procedure. One complaint recorded in the complaints book was made by a member of staff about a resident. This sort of matter must of course be properly investigated and dealt with but the home’s complaints book is not the place to record it. The contact details of the Commission for Social Care Inspection have now been added to the complaints procedure. Most complaints are dealt with informally. Oaklands Grange F52_F02_s18921_OaklandsGrange_v227022_250505_Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 30 The home provides clean, reasonably furnished accommodation which meets the needs of the residents. EVIDENCE: The home was clean and tidy apart from the ground floor shower room, near the kitchen. The shower was out of use but was dirty and needs to be cleaned and repaired. The stair carpet to the first floor was also badly marked and needs to be replaced unless it can be adequately cleaned. Bedrooms are highly personalised in most cases and furniture is being renewed on a rolling programme. The new wardrobes are lockable so residents are able to store personal items securely should they need or wish to do so. The Registered Person has no plans to admit more than the current 13 residents so it is not proposed to use any more rooms for sharing. There are only two residents over the age of 65 at present so the variation in place for a third named person needs to be removed. It may be possible to arrange for a flexible condition of registration which allows for residents over the age of 65 to be admitted from time to time if necessary. Oaklands Grange F52_F02_s18921_OaklandsGrange_v227022_250505_Stage 4.doc Version 1.30 Page 15 The lounge/diner is the most popular room and overlooks the garden, which was well maintained. The Registered Manager said that a new three piece suite has been ordered for the front TV lounge. Oaklands Grange F52_F02_s18921_OaklandsGrange_v227022_250505_Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35, 36 The manager is supported by the newly appointed senior staff in providing leadership to the experienced staff group, providing stability and well planned care to the residents. EVIDENCE: The staff team is stable and two of the existing staff have been made senior care assistants, providing additional management and supervisory back up to the Registered Manager. Relationships between staff and residents are informal and relaxed. Additional domestic staff have been deployed at the weekend in order to ensure that the care staff are free to carry out their main task of caring for the residents. Three new members of staff have been employed since the previous inspection and the proper checks had been carried out before they were allowed to start work. Only four members of the care staff have NVQ2 or above and one of those is studying for NVQ3. A further member of staff is studying for NVQ2, which still leaves the home well short of the target of 50 staff qualified to NVQ2 by the end of 2005. The new weekend cook is doing food hygiene training and six staff are going on Social Services training on Protection Of Vulnerable Adults (POVA) awareness. Oaklands Grange F52_F02_s18921_OaklandsGrange_v227022_250505_Stage 4.doc Version 1.30 Page 17 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) 39, 42 The home is well managed and records are properly and safely kept though care needs to be taken to ensure that all health and safety matters are addressed. EVIDENCE: Quality assurance is managed informally via residents’ meetings and questionnaires. The Registered Person visits the home regularly, completes reports on those visits and forwards them to the Commission for Social Care Inspection in accordance with Regulation 26. Fire safety checks and training were up to date. Gas and electrical safety certificates were in place and the electrical safety certificate expires in October 2005. The lid to a freezer in the kitchen is broken and needs to be replaced or repaired. The temperature of one of the other freezers had not been checked and recorded for several days. One of the residents uses a ‘bedleaver’ bar to help him get out of bed. The Registered Manager said that this had been assessed by an occupational therapist but there was no record of this nor a risk assessment on the file. The Medical Devices Agency has issued advice about these devices and this should Oaklands Grange F52_F02_s18921_OaklandsGrange_v227022_250505_Stage 4.doc Version 1.30 Page 18 be obtained and kept on file with the risk assessment. The Registered Person has decided to not fit radiator guards to protect residents but risk assessments are in place and were last reviewed on 17 September 2004. Oaklands Grange F52_F02_s18921_OaklandsGrange_v227022_250505_Stage 4.doc Version 1.30 Page 19 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 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 2 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oaklands Grange Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 2 x Version 1.30 Page 20 F52_F02_s18921_OaklandsGrange_v227022_250505_Stage 4.doc 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 1 Regulation Care Standards Act 2000 s.15(1)(a) Requirement The Registered Person must apply to the Commission for Social Care Inspection for the variation of the conditions of registration to reflect the fact that only two service users over the age of 65 are now accommodated. The Registered Person must make satisfactory arrangements for the recording and safekeeping of medication in the home and arrange for controlled drugs to be stored in an approved controlled drugs cabinet. The Registered Person must ensure that all Parts of the home are clean and reasonably decorated by cleaning the ground floor shower and either cleaning or replacing the stair carpet to the first floor. The Registered Person must ensure the safety of residents by repairing or replacing the freezer in the kitchen; ensuring that freezer temperatures are checked and recorded daily; cleaning the ground floor shower. Timescale for action 1 September 2005 2. 20 13(2) With immediate effect 3. 30 23(2)(d) 1 August 2005 4. 38 13 1 August 2005 Oaklands Grange F52_F02_s18921_OaklandsGrange_v227022_250505_Stage 4.doc Version 1.30 Page 21 5. 38 13 The Registered Person must ensure the safety of the resident in question by ensuring that appropriate information and risk assessments are in place for the bedleaver bar fitted to one bed. 1 August 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 32 Good Practice Recommendations More staff need to be trained to NVQ2 if the target of 50 qualified care staff is to be met. Oaklands Grange F52_F02_s18921_OaklandsGrange_v227022_250505_Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Liverpool Area Office 3rd Floor 10 Duke Street Liverpool, L1 5AS 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 Grange F52_F02_s18921_OaklandsGrange_v227022_250505_Stage 4.doc Version 1.30 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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