Inspection on 19/07/05 for Oaklands Leonard Cheshire Foundation

This inspection was carried out on 19th July 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 Leonard Cheshire... 28/10/08

Oaklands Leonard Cheshire... 26/02/07

Oaklands Leonard Cheshire... 13/12/05

Oaklands Leonard Cheshire... 06/01/05

Oaklands Leonard Cheshire... 01/09/04

Oaklands Leonard Cheshire... 27/08/02

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

CARE HOME ADULTS 18-65 Oaklands Leonard Cheshire Foundation Oaklands Dimples Lane, Garstang Preston, Lancashire PR3 1UA Lead Inspector Patrick Rooney Announced 19 July 2005 th 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 Leonard Cheshire Foundation F57 F09 S6067 Oaklands Leonard Cheshire Foundation V229792 190705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Oaklands Leonard Cheshire Foundation Address Oaklands, Dimples Lane, Garstang, Preston, Lancashire, PR3 1UA 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) 01995 602290 01995 600026 Leonard Cheshire Deborah Jane Holmes CRH Care Home 27 Category(ies) of PD Physical Disability 27 registration, with number of places Oaklands Leonard Cheshire Foundation F57 F09 S6067 Oaklands Leonard Cheshire Foundation V229792 190705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The home shall at all times employ a suitably experienced and qualified manager, who is registered with the CSCI Date of last inspection 1st September 2004 Brief Description of the Service: Oaklands is a Leonard Cheshire Foundation home. It is registered by the Commission For Social Care Inspection to provide support for physically disabled adults from the age of 18 to 65. The registration is for 27 persons of either sex needing either nursing or residential care. There are 26 permanent places and one respite place available. Day care is also available on the premises. The home is siuated on the outskirts of Garstang and offers a range of activities and support to meet the individual needs of residents. Residents are encouraged and enabled to maintian links in the community, and a bungalow is available in the grounds where relatives and friends may stay. Oaklands Leonard Cheshire Foundation F57 F09 S6067 Oaklands Leonard Cheshire Foundation V229792 190705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and was carried out by two inspectors over a five-hour period. Information was received from general practitioners serving the home and a pre-inspection questionnaire was completed by the manager. Completed survey forms were received from relatives and from residents. The assessments and care plans of five residents were examined and these residents were interviewed. A tour of the building was carried out and residents were spoken to in the lounges, dining area and their own rooms. The inspectors’ case tracked the care of five residents. Their care records were examined these clearly describe their health needs, including risk assessments. The inspector spoke to these five residents about the care they receive and all felt their care needs are met. They said that staff offer them good care and enable them to do as much as they are able. Care staff were interviewed and staff recruitment records examined. The inspectors also looked at the homes policies and procedures and the staff handbook. The manager assisted the inspection throughout. Feedback from all these sources was positive and gave the picture of contented residents and a staff team dedicated to promoting the health and welfare of residents living in the home. What the service does well: What has improved since the last inspection? The medication administration system has been improved and staff records showed that there has been more training for those administering medication. Residents are being kept in touch with future plans to relocate the home and regular briefing notes regarding this are provided to residents. Oaklands Leonard Cheshire Foundation F57 F09 S6067 Oaklands Leonard Cheshire Foundation V229792 190705 Stage 4.doc Version 1.40 Page 6 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 Leonard Cheshire Foundation F57 F09 S6067 Oaklands Leonard Cheshire Foundation V229792 190705 Stage 4.doc Version 1.40 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 Leonard Cheshire Foundation F57 F09 S6067 Oaklands Leonard Cheshire Foundation V229792 190705 Stage 4.doc Version 1.40 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) 1,2 All residents receive information about the home and are able to visit prior to placement. There is a full needs assessment carried out including a risk assessment. EVIDENCE: Care records for four of the most recently admitted residents were looked at and the inspectors spoke them to individually. Records showed that there was a full assessment carried out by senior staff at the home. The assessment process involves the prospective resident, their representatives and families. Those spoken to confirmed this and the content of files, residents or their representatives sign the files. Residents also confirmed that they receive a service users guide and that they are able to take up the offer of temporary residents in order to help them make their mind up about accepting a permanent place. Oaklands Leonard Cheshire Foundation F57 F09 S6067 Oaklands Leonard Cheshire Foundation V229792 190705 Stage 4.doc Version 1.40 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 and 7 Residents have a care plan, which they are involved in, and which helps them to reach personal goals. Areas of risk are dealt with in care plans and are agreed with the involvement of residents or their representatives. EVIDENCE: The care plans were seen for four residents and the inspectors spoke to them about the care they receive. They said that they receive the right levels of support from staff and are enabled to reach their own goals. All care plans are signed by the resident, or their supporters. Any constraints are discussed and agreed. Care files also showed that residents or their supporters sign the record of information held and have access to their records. Oaklands Leonard Cheshire Foundation F57 F09 S6067 Oaklands Leonard Cheshire Foundation V229792 190705 Stage 4.doc Version 1.40 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) 12,13 and 15 There is encouragement and support to enable resident to take part in a variety of activities; these involve links with the outside community and other support organisations. Residents are able to have private contact with relatives and friends. EVIDENCE: Residents told the inspectors that they are encouraged and enabled to take part in a variety of activities. These include activities in house, snooker, computers and internet, reflexology, music sessions, creative writing, art classes, beautician, massage, college, library, swimming and cinema. An activities coordinator is employed to facilitate leisure activities. One resident has been given space to operate an electrical repair business. Residents’ interests are recorded in their assessments and provide a basis for planning individual activities, outings and holidays. The disabled peoples forum visits and holds meetings at the home. This involves and supports residents in living with disability. Oaklands Leonard Cheshire Foundation F57 F09 S6067 Oaklands Leonard Cheshire Foundation V229792 190705 Stage 4.doc Version 1.40 Page 11 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 and 20 Residents receive the right levels of care that ensures they are involved. All aspects of care including physical and emotional are included in residents care plans. There have been improvements to the administration of medication and full training given to those administering medications. Decisions about selfmedication are taken with residents during their assessments. EVIDENCE: Residents spoke highly of the levels of support they receive and told the inspectors that they are happy with the care they receive. From reading files the inspectors were able to confirm that residents and their representative are involved in the care planning and sign their care plans. From medication policies and procedures and from discussion with staff the inspectors found medication administration had been improved. Only members of staff trained to do so administer medication. Residents are consulted on admission regarding whether they wish to self medicate and sign a form to this effect. Oaklands Leonard Cheshire Foundation F57 F09 S6067 Oaklands Leonard Cheshire Foundation V229792 190705 Stage 4.doc Version 1.40 Page 12 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 The home has good policies and procedures in place which ensure residents concerns are heard and dealt with. EVIDENCE: The inspectors looked at the complaints procedures, these include access to external agencies. All residents are given access to the complaints procedure and receive a copy of it in the service users guide. Residents said that they felt any concerns they have are dealt with and that they were confident in approaching the management of the home. There were no complaints made to the CSCI since the last report. Records seen by the inspectors showed that four complaints made internally had been dealt with appropriately and outcomes recorded. Oaklands Leonard Cheshire Foundation F57 F09 S6067 Oaklands Leonard Cheshire Foundation V229792 190705 Stage 4.doc Version 1.40 Page 13 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 and 25 Within the constraints of an old building the home has created a comfortable and safe environment for residents. Each service user has their own room, which may be personalised according to individual requirements. EVIDENCE: The inspectors toured the building and viewed maintenance records; there is a five-year maintenance plan in operation. New flooring has been laid on some corridors. New windows have been installed at the rear of the building. The fire alarm system has recently been upgraded, as has the emergency call system. Some residents were seen in their own rooms and these contained personal items and had been decorated according to the wishes of individual residents. Residents told the inspectors they are happy with the accommodation provided. Oaklands Leonard Cheshire Foundation F57 F09 S6067 Oaklands Leonard Cheshire Foundation V229792 190705 Stage 4.doc Version 1.40 Page 14 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 and 35 The home provides a good variety of staff, who are trained and are able to provide the right care to residents. EVIDENCE: The inspectors looked at rotas, training records and staff files. There is always a trained nurse on duty. Of the 24 care staff 20 are qualified to at least NVQ 2 in care. Those who do not have this qualification are booked to do it in September. Staff records showed that all staff receive a very comprehensive induction programme which is carried out on one day a week for six weeks. Discussion with staff showed that they are aware of the needs of residents they care for. Oaklands Leonard Cheshire Foundation F57 F09 S6067 Oaklands Leonard Cheshire Foundation V229792 190705 Stage 4.doc Version 1.40 Page 15 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 Residents views are regarded as being important to developments in the home and they are consulted about future plans. EVIDENCE: From discussion with management, staff and residents the inspectors found that a residents action group is promoted, however there have been problems in persuading a resident to chair this. The manager said that the home is committed to pursuing this. One resident is involved in the homes management committee and residents are able to be involved in the appointment of new staff. The home actively promotes the involvement of advocacy services and enable the Disabled Peoples Forum to meet in the home. The Leonard Cheshire Foundation who are the registered providers carry out an annual survey of residents views. Previous surveys were available, however the most recent was not. Oaklands Leonard Cheshire Foundation F57 F09 S6067 Oaklands Leonard Cheshire Foundation V229792 190705 Stage 4.doc Version 1.40 Page 16 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 3 3 x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x x Standard No 31 32 33 34 35 36 Score x 4 x x 4 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oaklands Leonard Cheshire Foundation Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x x x F57 F09 S6067 Oaklands Leonard Cheshire Foundation V229792 190705 Stage 4.doc Version 1.40 Page 17 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 Regulation Requirement Timescale for action 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 Good Practice Recommendations Oaklands Leonard Cheshire Foundation F57 F09 S6067 Oaklands Leonard Cheshire Foundation V229792 190705 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection 2nd Floor, Unit 1 Tustin Court Port Way Preston PR2 2YQ 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. 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