Inspection on 28/10/08 for Oaklands Leonard Cheshire Foundation

This inspection was carried out on 28th October 2008.

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

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... 26/02/07

Oaklands Leonard Cheshire... 13/12/05

Oaklands Leonard Cheshire... 19/07/05

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 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Oaklands Leonard Cheshire Foundation Oaklands Dimples Lane Garstang Preston Lancashire PR3 1UA     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Susan Dale     Date: 2 8 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Oaklands Leonard Cheshire Foundation Dimples Lane Oaklands Garstang Preston Lancashire PR3 1UA 01995602290 01995600026 tanja.wainford@LCDisability.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Tanja Wajzner Wainford Type of registration: Number of places registered: Leonard Cheshire Disability care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: The registered person may provide the following category of service only: Care Home with Nursing - Code N To Service Users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Physical Disability - Code PD The maximum number of service users who can be accommodated is: 27 Date of last inspection Brief description of the care home Oaklands is a Leonard Cheshire Foundation home providing care and support for physically disabled adults. The home is an adapted property situated on the outskirts of Garstang and is registered to accommodate a maximum of 27 persons of either sex needing nursing or residential care. Day care is also available on the premises. The home offers a range of activities and support to meet the individual needs of residents. The home has a number of lounge areas and a large dining room. There are sufficient toilet and bathing facilities to meet the needs of the residents accommodated. A Care Homes for Adults (18-65 years) Page 4 of 27 27 Over 65 0 Brief description of the care home passenger lift provides access between the ground and first floor and a variety of aids are available around the home to promote independence. Residents are encouraged and enabled to maintain links in the community and a bungalow is available in the grounds where relatives and friends may stay.Written information is given to prospective residents and on admission a copy of the Service User Guide is placed in their bedroom. The written information explains the care service that is offered, the homes aims and objectives and all relevant information that residents need to assist them in making an informed decision about life in Oaklands. Fees are dependent on the assessed needs of the individual service user. Further details over fees can be obtained from the manager of the home. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced site visit was undertaken as part of the homes key Inspection. The site visit commenced at 10:00 am and took place over 6 hours. Prior to the site visit the registered manager completed an Annual Quality Assurance Assessment which is a self assessment form that focuses on how well outcomes are being met for people using the service and it also gives some numerical information about the service. Surveys were sent prior to the visit in order to gain views about how the service is being provided. In total, one survey was returned from a person receiving the service, one completed by a relative and four from staff. Care Homes for Adults (18-65 years) Page 6 of 27 A random selection of records belonging to the people being provided with a service and staffing records were examined. Discussions took place with the registered manager and other staff as well as the people provided with the service and a relative. A tour of the home took place. The last Key inspection on this inspection was completed on the 26th February 2007 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 Care Homes for Adults (18-65 years) Page 8 of 27 240 7535. Care Homes for Adults (18-65 years) Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes admission and assessment procedures are clear to ensure that individual wishes and needs are met. Evidence: Care records were examined and a full assessment is undertaken by the registered manager and care supervisor. Family and friends are involved in the process and the assessment takes into account the goals, wishes and preferred life style of the individual. Any cultural or religious wishes or requirements are taken into consideration. One of the advantages of living at Oaklands is their use of volunteers many of whom are from overseas and provide an opportunity for cultural diversity. Many of the people living in the home have prior knowledge of the care provided by attending day care or visiting the home for respite care. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a clear and consistent care planning system in place, which ensures that individual needs, aspirations and goals are met. Evidence: Individual Service Plans (ISP) record the care needs as well as individual wishes and goals of the individuals concerned. The records seen were comprehensive and include the views of the individuals concerned over their ability to control their own lifestyle in all aspects of daily living. Support and encouragement is provided by staff to enable the people who use the service to meet their goals and aspirations such as attending college, going on holiday abroad or in the United Kingdom, swimming or attending concerts or shopping trips. The people who use the service help in the recruitment of staff and are encouraged to be as independent as possible, taking control of their own medication and or finances following a risk assessment. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: The ISPs were seen to be reviewed on a regular basis with reports recorded on a daily basis; a key worker system is in operation. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Opportunities for development and community participation are addressed in a variety of ways. This ensures that the people who receive the service have a lifestyle that meets their individual needs and expectations. Evidence: The people living within the home confirmed and are provided with a wide variety of activities and are encouraged and supported with their own personal development. Individual interests are recorded at assessment and the activities co-ordinator also undertakes her own assessment and devises a programme of activities that includes all the people within the home including those who have more difficulty because of their disabilities. The activities include Art and Crafts; during the visit preparations were well under way Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: for a Halloween Party. There are also themed days such as the 4th July and a Japanese day where every one dresses up and a special menu is devised. There are two fully adapted mini buses available with one full time and one part time driver available during the week as well as several volunteer drivers available at weekends and some evenings. A staff member made the following comment: I think it does a great job for the people in our home. They regularly have trips out and social functions within the home. There are trips out to the theatre, concerts, shops, public houses, parks. One person has recently been on a trip to Lourdes and another person spoken with had been to America and Prague for holidays. There have been trips to Duxford; currently a trip on a steam train is being planned for Christmas. A Physiotherapist, Occupational Therapist and Reflexologist are available also a Beautician and the home has its own Sensory room for relaxation. The people who use the service are encouraged to continue with their education and are provided with transport to attend college or supported with their religious wishes and are escorted to church. Overseas volunteers are supported to visit the home and recently four Japanese ladies have been participating in the various activities taking place within the home. Meals are provided within a spacious dining room and the menu provides choice and flexible arrangements with regard to individual wishes. A hot beverages machine and a water cooler is available at all times within the dining room for use by the people living in the home and their visitors. A bungalow is available within the grounds available for visitors/family to book into for short periods. Until recently the bungalow was used by one of the people living within the home for private weekends for her partner. Overall there is a warm and homely atmosphere within the home and the staff are welcoming and happy in their roles with good interactions observed between the staff and the people provided with a service. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care is based upon individual need and the principles of respect, dignity and privacy are put into place. Evidence: The assessment takes into account the way each individual prefers personal care to be provided including the preferred gender of staff. A key worker system is in operation. The assessment process takes into account physical and emotional requirements. Staff are taught the importance of privacy and dignity when the commence and staff were observed to carry out their duties in a way that ensured privacy, dignity and independence were met at all times. A staff member made the following comment: Provides individuals with disabilities the opportunity to live life to the full, comfortably, safely and respectfully. Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: The ISPs included a record of all interaction with other health professionals such as General Practitioners, Chiropodists and Speech Therapists. Self medication is encouraged and any risks are examined and a signature obtained from the person concerned. A lockable facility is available within each bedroom for the storage of any medication. Medication assistance is provided by the registered nurses and the records seen were well maintained with a clear method for ensuring accountability with regular audits. The medication is kept within a treatment room which has appropriate storage facilities including a fridge for medication. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements in place for handling complaints ensure that people feel confident that their complaints will be listened to and taken seriously. Procedures for dealing with and reporting abuse were in place to ensure people are adequately protected. Evidence: The home has a details complaints procedure, which includes access to external agencies. The complaints procedure is provided to all the people who are receiving the service within the service users guide. There have been no complaints received by the commission within the last twelve months; a record of complaints is maintained by the home and they have been appropriately dealt with and the outcomes recorded. The staff handbook has a section in which staff are taught how to respond to a complaint and any concerns are quickly picked up by the staff key worker system. There was evidence that all staff and volunteers have been provided with Safeguarding/Abuse training and were aware of how to recognise any possible Abuse and what to do next. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment in this home provides residents with a comfortable and homely place to live. Evidence: The home is a very large adapted property set in large grounds in a rural environment with excellent views of the surrounding areas. A tour of the home confirmed that the bedrooms are individually furnished containing their personal items and decorated according to their wishes. The home has been fully adapted for wheelchair users with access to all areas including outside the home through a lift and ramps. There is a smoking room for the people provided with the service and a separate smoking room for the staff. A sensory room is also provided with coloured lights and music. All areas of the home were warm, clean and tidy and there was a very welcoming, pleasant and homely environment throughout. There are four part time cleaners employed. All staff have received training Health and Safety training and some staff have Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: received specific training including, COSHH, Food Hygiene, Infection Control, Fire Marshall etc. Fire Safety consultants have visited the home to ensure that it meets safe standards. The exterior of the home is in need of some attention and since the last site visit a number of the windows have been made safe and re-pointing taken place on the brickwork. A five year programme of maintenance is now in place and external contractors are currently working on the outside of the building. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are recruited appropriately in order to safeguard the people provided with a service. Staff are supported and trained to a very high standard and work as an effective team for the benefit of the people receiving the service. Evidence: The policies and procedures for the recruitment of staff are robust and provide safeguards for the protection of the people provided with the service. Any volunteer also has to undertake a successful security check before helping at the home The staffing levels were found to be sufficient to meet the needs of the current people in the home with a larger number of staff on duty at certain times of the day. The home is also supported by a large number of volunteers who assist with activities and social interaction. The staffing group is relatively stable with many of the staff having worked at the home for a number of years. There is very relaxed working relationship with the volunteers who voiced their appreciation of helping in the home and being part of a happy team. The training records show that all staff undertake a formal induction process that includes the subjects required by mandatory training. One of the staff provided Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: detailed information about the training received at Induction; Health and Safety; Moving and Handling; Fire Awareness; Infection Control; Food Hygiene; Diversity and Equality; Working in an Empowering Way; Disability Awareness; POVA/POCA. Examples of additional training included, Stoma Care; PEG Feeds; First Aid at Work (4 day); Medicines Awareness and Administration; Mental Capacity Act and IMCA Awareness; Advocacy and Empowerment; Multiple Sclerosis; Fire Marshall. The number of staff with a National Vocational Training (NVQ) in Care is high with 18 staff out of a total of 21 staff having an NVQ qualification at level 2 or above and a further 3 staff in the process of obtaining the qualification. A staff member made the following comments: The home provides relevant courses to make sure that residents get the best care and staff have lote of knowledge and experience to give the best care. Leonard Cheshire Disability is a wonderful organisation to be part of. The service users are valued as individuals and in being valued they are cared for to an extremely high standard holistically. It is very satisfying work we do in caring for people with disabilities. The home is very proud of the fact that they have student placements and a very comprehensive work book is provided as their Personal Development Plan. All staff are also encouraged and assisted to establish and maintain their own Personal Development Portfolios. A large training room is available within the home and there is access to the Internet. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the best interests of the people who use the service. The home has policies and procedures in place to ensure the Health and Safety of the people who use the service and staff. Evidence: The manager has recently been registered with the Commission for Social Care Inspection(CSCI) and has lengthy experience in the provision of Care within the National Health Service and Primary Care Trusts. The manager is qualified as a Registered Nurse and due to undertake the Registered Managers Award in the near future. Staff spoken with felt well supported by the manager and the management team. There were several staff comments: We have a supportive manager who is very knowledgeable and approachable. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: Works well as a team. Supervision takes place every 8 weeks. We communicate verbally through effective handover reports and through appropriate documentation in Individual Service Plans and Communication books. Various methods are employed to gather the views of the people who use the service, relatives and staff as part of the monitoring of quality. Internal and external audits take place that include questionnaires and surveys and regular reports are sent to the commission. Representatives of the people living within the home attend meetings held by the Service Users Networking Association (SUST). The association provides support through Advocacy and Mentoring. An in-house news letter is being developed by volunteers. Policies and procedures are in place to ensure the Health and Safety of the people who use the service, staff and volunteers. Risk assessments are conducted and regular reviews. Staff are well trained and know how to report any accidents/incidents. The management also ensures that all in-house equipment and main line services are checked, serviced and maintained on a regular basis. The people who use the service also expressed their appreciation of the service provided. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!