Inspection on 10/01/07 for Oaklands Road, 82

This inspection was carried out on 10th January 2007.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oaklands Road, 82 05/09/07

Oaklands Road, 82 04/01/06

Oaklands Road, 82 09/08/05

Oaklands Road, 82 01/02/05

Oaklands Road, 82 09/09/04

Oaklands Road, 82 24/02/04

Oaklands Road, 82 15/07/03

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Oaklands Road, 82 Hanwell London W7 2DU Lead Inspector Sarah Middleton Unannounced Inspection 10th January 2007 09:50 Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 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 Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 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 Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oaklands Road, 82 Address Hanwell London W7 2DU 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) 0208 840 5996 82oakland@ealing.org.uk Ealing Consortium Limited Allyson Clancy Care Home 3 Category(ies) of Learning disability (0), Learning disability over registration, with number 65 years of age (0), Mental disorder, excluding of places learning disability or dementia (0), Mental Disorder, excluding learning disability or dementia - over 65 years of age (0) Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th January 2006 Brief Description of the Service: 82 Oaklands Road is a registered home for three people with learning disabilities and/or mental health needs. The home is registered to take service users over sixty-five years old if their needs can be met. There is currently one service user over sixty-five years old. The home is managed by Ealing Consortium and owned by Catalyst, formerly known as Ealing Family Housing Association. It is located in a terraced house in a quiet residential road. It is close to local amenities, including shops in Boston Manor Road. There are transport links on the Uxbridge Road in Hanwell, which lead to larger towns such as Ealing Broadway. There are leisure facilities available in the local area. There are three single bedrooms, one on the ground floor and two on the first floor. There is one lounge, a dining room with adjacent kitchen and a small laundry area on the ground floor. The first floor has a bathroom/toilet and separate toilet with an office/sleeping in room. There is a garden to the rear, where there is decking leading off from the kitchen and a patio area with gravel, plants and shrubs. There is a small garden to the front and parking is on the street. Fees range from: £425.37-£450.74 per service user, per week, with added weekly contributions on top of this fee made by the individual service user. Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the regulatory process. The Inspection took place between 9.50am-4.35pm. The Inspector viewed a sample of service users files, staff employment file and maintenance records. The Inspector spoke with one service user and two support workers. Two relative comments were completed, one commenting positively on the home and staff. There were no service user or staff vacancies in the home. A support worker and the Service Manager assisted with the inspection process. There were no visitors at the time of the inspection, other than a Regulation 26 visit that took place during the inspection. The Registered Manager is currently on Maternity leave and is expected to return to the home in five months time. The Service Manager has made every attempt to place an interim Manager into the home, as there has been no Manager in the home for the past three months. However, so far, the search has been unsuccessful. The staff team is small and there are no senior members of staff working in the home. The Service Manager has been liaising with an employment agency to try and find a suitable person to manage the home on a day-to-day basis. The Inspector is in regular contact with the Service Manager to ascertain the Management arrangements, (See Standard 39 for further information on Management). Overall the home is managing and the service users needs are being met. What the service does well: The home continues to provide a high standard of care to the service users. The staff team has been consistent, with the last member of staff to join the team just over a year ago. The staff team know and work to meet the needs of the service users. Service users often receive one to one support and time with a member of staff. Activities are provided to suit the preferences and abilities of the service users. Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 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 Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users would be assessed prior to an admission taking place, thus determining whether the home could meet their specific needs. EVIDENCE: There have been no admissions for several years. Systems are in place for the home to assess the needs of any prospective service user. The Inspector viewed the current pre-admission assessment used and this contained information such as the service users physical and mental health needs, communication needs and social interests. The Inspector was satisfied that prospective service users would be considered carefully before any decisions were made. Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Individual care plans indicate service users needs and how these are to be met. To enable staff to support service users appropriately, further work is needed regarding daily records as they need to clearly indicate significant events and action taken. Service users are encouraged and promoted to make every day decisions. The shortfalls in completing risk assessments on any potential risk needs to be addressed, in order to safeguard and protect service users. EVIDENCE: The Inspector viewed a sample of care plans and found these to be up to date and detailed. Care plans are reviewed on a six-month basis. The care plans look at the aims and objectives for the service user and any specific needs, such as physical or mental health needs, activities and communication needs. Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 10 Service users preferences are considered when developing the care plan and where possible service users and their representative’s views are included. Personal care plans are completed and outline where service users need assistance with specific areas of care. Where appropriate guidelines are written and these aim to inform staff about supporting service users. The Inspector viewed one and this detailed certain behaviours to be aware of, however it did not contain a potential risk or behaviour that could occur, when the service users is out in the community. In addition the document was not signed or dated. The Inspector spoke with the support worker, who said they had just completed these guidelines and would make the amendments accordingly. A requirement was made for any document written about a service user, must have all the important information about the service users individual needs, along with signatures and dates to ensure it is up to date and relevant. Keyworkers also complete monthly summaries. The Inspector viewed a sample of daily records, in particular those records relating to the service user who had bruising a few months earlier (See Standard 23 for further information regarding this incident). The daily records did not clearly indicate action taken, other than a body chart being completed. These records are important, as they need to show important information about the service user, such as their mood, activities and any significant events and action taken by the member of staff. A requirement was made for all members of staff to carefully consider what is deemed important to document in order for there to be a clear cross reference if or when completing other necessary documents, such as incident forms and/or updating risk assessments. The Inspector noted that the sample of service users files viewed had different contents in the each file. Some of the information was easier to locate than in other files. It is strongly recommended for all service users files to contain the same, consistent documents so that it is easy to refer to, update and locate important documents. In addition the Inspector noticed that although risk assessments and personal care assessments had been signed to suggest these documents had been reviewed and amended, where necessary, some of these documents had originally been written six or seven years ago. The Inspector recommended for these documents to be re-written on a regular basis, for example, annually, to ensure every consideration has been made as to whether the information recorded is an accurate assessment of the individual service user needs. All of the above findings were fed back to the support worker and Service Manager. Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 11 One service user has an advocate and the support worker stated that every attempt has been made to obtain advocates for the two other service users. The service user, with an advocate has regular contact and goes out with them. The staff team aim to encourage and promote service users to make choices and decisions for themselves. Two of the service users are non-verbal, however they are able to communicate to staff their preferences, such as pointing to pictures of meals they would like to eat or getting the clothes they would like to wear. Overall risk assessments were in place and covered a wide range of areas relevant to the individual service users life, for example crossing the road, moving and handling and taking a bath. Discussions took place with the support worker regarding a service user, who is reluctant to attend some health appointments such as Optician and the GP for a smear. The Inspector made a requirement that risk assessments need to be completed on any identified potential risk. Staff must be aware of any risk and work in a consistent way to support and promote the well being of the service user. The support worker explained that they are looking into providing more visual aids when supporting this particular service user, such as pictures of the road, traffic lights and pictures of the GP/Nurse to try and talk through the procedures and to ease some of the possible anxieties of the service user, who might have difficulties imagining what staff are talking to them about. The Inspector felt this would be good practice and could enable the service user to see what is expected of them. Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are able to take part in activities both in the home and in the community, that meet their individual interests. Social relationships are encouraged and service users are encouraged and supported to maintain these relationships. The rights of the service users are recognised and promoted in their every day life. Service users benefit from the meals offered, that provide them with a balanced and healthy diet, taking into account any health needs along with food preferences. Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 13 EVIDENCE: The Inspector was informed that service users often have one to one time with a member of staff. This is usually when at least one service user is out at the day centre, leaving two members of staff to work with the remaining two service users. Two service users attend a local day centre twice a week and another service user has an aromatherapy session once a week. All the service users are aware of the activities planned for the week and are informed if these are not taking place. At the inspection the member of staff working a day shift was off sick and so the remaining support worker had to juggle and re-arrange a health appointment, which also meant the service user missed attending the day centre. This is a rare occasion and the support worker made arrangements for an agency member of staff to work so that some of the planned activities such as shopping and going to the cinema could take place. Staff discuss in team meetings individual service users and look to review resources that are used to ensure these activities continue to meet the needs of the service users. An evening club used to be attended, but as service users did not seem to benefit from going, this was stopped and instead they now go to the local pub for a drink. Day trips, along with holidays, are organised, and service users use public transport for many of the places they visit. One service user attends church weekly and this is supported by a member of staff. All of the service users have some family and contact with family members varies. Where family members can, they attend reviews and are kept informed about the service user. Some family members visit the home and sometimes the service users will spend time with family at the family’s own home. The Inspector was informed that, if they wanted to, service users could lock their own bedrooms. One service user had a chain on their door for added privacy. The service users cannot read but the Inspector heard a support worker reading the service users personal mail to them. Staff often work alone with the service users and so interacting with them occurs throughout much of day and evening. Service users are able to be alone when they so choose or spend time with the other service users or members of staff. Due to the varied abilities of the service users, some are able to carry out small tasks in the kitchen, such as putting their plates in the sink or cutting up vegetables. Generally the staff team prepare and cook the meals for the service users. The Inspector viewed samples of menus and these showed variation and healthy options. Service users participate in choosing the weekly menu and staff are aware of promoting healthy meals for all service users, in particular for one service user who has a high cholesterol level. The home was having the main food shopping on the day of the inspection. Fresh fruit and vegetables were seen at the time of the inspection. Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 14 Food that had been opened had been wrapped with the date of opening written on it. Fridge and freezer temperatures are taken on a daily basis and were within an appropriate range. Overall the kitchen area was clean and tidy and the end part of lunch was observed, which was relaxed and unhurried. The dining room table is located in the kitchen area, enabling mealtimes to be a social activity. Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive support in a respectful and sensitive way. Service users physical and health needs are identified and were being met. Medication systems are robust and aim to protect the health and safety of the service users. EVIDENCE: The staff team comprises of female support workers who support the three female service users living in the home. All of the service users require some level of guidance or supervision with regards to their personal care needs. It is outlined on individual service users personal care plans how staff need to support the service user, including details of bathing routines, where for example a service user might hold out their hand for the shampoo or pull out the plug when they are ready to get out of the bath. Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 16 The Inspector was informed that service users indicate in different ways when they are ready to go to bed, such as asking for medication or indicating yes or no when they are ready for sleep. The service users go to hair salons for their haircuts. A service user showed the Inspector their jewellery that they like to wear and staff stated that all the service users choose the clothes they wish to wear. Service users health needs are recorded on care plans, along with any action that needs to be taken. Medical appointments are recorded onto forms detailing if there is any outcome or treatment following on from the visit. Service users all have a GP and other health professionals are available, such as the Community Nurse, who carries out health checks, Opticians and Chiropodists. The Inspector viewed the medication systems. All liquid medicines had dates of opening written on them and loose medication is counted recorded on a daily basis. The Inspector counted one service users loose medication and found this to be correct. The medication cabinet temperature is taken on a daily basis. The Inspector viewed a sample of medication administration records and these had been completed correctly. There are no controlled drugs in the home and service users are not able to self medicate. Staff receive training on medication, although this is not necessarily offered as refresher training, (see Standard 35 for further details on training.) Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users views and complaints would be listened to by staff. Systems are in place to safeguard service users. EVIDENCE: There have been no complaints made about the home. There is a complaints procedure available and located in the kitchen, however service users living in the home do not read or write and so it is difficult to ascertain how they would know to make a complaint. However, the Inspector was satisfied that should a service user make a complaint to a member of staff then this would be listened to and Management would be informed and act accordingly. There has been one safeguarding adults investigation since the last inspection. The appropriate professionals were informed, such as the CSCI and the local safeguarding adults co-ordinator. A Registered Manager from a different service carried out the investigation, taking statements from members of staff. However no conclusions were drawn, due to the lack of witnesses and the delay in knowing exactly when the bruises could have occurred. A report was completed and recommendations were made once the investigation had finished. Risk assessments were completed following on from the investigation. The service user’s family members were made aware of the investigation and the outcomes were discussed in the service users review. Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 18 Overall the Inspector was satisfied that appropriate procedures were followed. Discussions took place during the inspection with members of staff to ensure they are fully aware of the processes to follow if there is a possible safeguarding adults incident or allegation. Staff had received training on the protection of vulnerable adults. Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall the home is welcoming, bright and homely. Service users would benefit from the bathroom being finished to a higher standard. Service users bedrooms are personalised, spacious and provide privacy. Service users benefit from a clean and odour free home. EVIDENCE: The Inspector carried out a tour of the home. Overall the home offers service users a pleasant place to live in. The bath has been replaced and the cracked tiles had been replaced. However the paint on the skirting board and bath panel was flaking and the shelving unit was rusty in places. A requirement was made for this shortfall to be addressed. Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 20 A service user showed the Inspector their bedroom. This had been decorated and was spacious and had the service users personal items in it. The service user said they were happy with the home and the bedroom they had. The laundry facilities are stored in a small cupboard and staff support service users to do their own personal laundry. Service users laundry is washed separately. The home was clean and odour free at the time of the inspection. Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by a qualified and experienced staff team. Service users would benefit from a staff team working together and solving any issues that arise between members of staff. Recruitment procedures are robust and aim to safeguard service users. Service users would benefit if staff receive up to date training and refresher training within the necessary timescales. Service users can be confident that staff receive ongoing informal and formal supervision that aims to guide, support and advise staff. Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 22 EVIDENCE: The home has a staff team who have completed NVQ’s, or equivalent. The staff team is small and the support workers are familiar with the needs of the service users. Those asked could explain the different preferences and routines of the service users. As mentioned earlier, two service users use pointing, gestures and pictures as part of their communication to others. Staff have the skills to know or to make every effort to understand what service users are trying to communicate to them. Support workers work closely with speech and language therapists and community nurses in order to meet the individual service users needs. The Inspector was informed that regular staff meetings take place and that once a year the staff team reviews the work that has been carried out and decides on future aims and objectives. Feedback relating to how the staff team are working together was mixed. The Inspector was informed that there have been ongoing issues between members of staff, but all agreed this did not affect professional working relationships and the work needed to be done on a daily basis within the home continued to be carried out without problems. The Service Manager also spoke with the Inspector regarding some of the issues within the staff team. Although the Inspector was satisfied that at this stage, the problems are not having a negative impact on the service users and that all those concerned are aware that the issues need to be addressed, a requirement was made for these to be addressed as soon as possible to enable the staff team to work together in a more consistent and effective way. There were no staff vacancies, however agency staff do have to be used, where possible, regular agency staff are requested when needing shifts covered. On the day of the inspection, the support worker had a new agency member of staff working with them. The support worker gave written information to this new agency member of staff in order for them to support the service user they were working with safely and appropriately. No new staff have joined the team since the last inspection. The Inspector viewed a staff employment file of the most recent member of staff to join the team. This contained the necessary information, such as CRB disclosure number and photograph. The head office holds the original documentation on all employees. Individual training files were viewed. The training needs for the members of staff had not been updated and so it was not easy to identify the training courses that individual members of staff needed to attend. Refresher training on moving and handling was out of date for some members of staff and refresher medication training had not been offered for some time. The Inspector discussed these shortfalls with the Service Manager and a requirement was made for this to be addressed. Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 23 Since the Registered Manager has been on Maternity leave, the support workers have had one to one formal supervision once. The Service Manager aims to book further appointments in the next few weeks. Those support workers asked stated they were happy with the support they received and that they could always seek advice or guidance whenever they needed to. Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Currently the home is without a manager, however service users continue to benefit from a well-run service. Service users views are considered when carrying out reviews of the quality of the care provided. Service users benefit from the robust health and safety checks and reviews carried out in the home. Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 25 EVIDENCE: The Registered Manager has been on Maternity Leave for three months and is expected to return in five months time. In the meantime, the Service Manager has been actively seeking an Interim Manager to be at the home managing the day-to-day running of it. Unfortunately so far the search has proved unsuccessful. Therefore the Service Manager has had a more visible presence in the home and where possible has been attending the fortnightly staff meetings. In addition, nearby there is another registered small group and the Registered Manager from this home has been made available and has regular contact with the home in order to provide support to staff and service users. Overall the lack of a Manager in the home has not had a direct impact on the service users, however the Service Manager is fully aware of the stress and issues that can arise if there is no one in charge on a day-to-day basis. The Inspector did not make a requirement at this inspection for there to be in place a Manager, as clearly every attempt has been made to identify a suitable person and for them to agree to the short-term position. The Inspector has been kept informed of any progress and is satisfied that the Service Manager will continue to look for an Interim Manager. The Inspector received mixed responses from staff regarding the absence of a Manager. Comments included that the home is running well, as all staff know the daily routines of the home, whilst others suggested that the staffing issues might have been addressed more quickly and effectively if there had been an Interim Manager in the home. The Service Manager is aware that individual staff might have a different outlook on how the home is coping without a Manager. Various systems are in place to review the care provided in the home. Recently customer satisfaction surveys were carried out to obtain service users views about the care and support they receive. Monthly Regulation 26 visits take place and reports are forwarded on to the CSCI. Finally monthly quality assurance reports are completed and these look areas such as, staffing, health and safety and service users. The Inspector discussed with the Service Manager about developing an overall summary of the work that has been carried out within the home and look at the future aims and objectives. The Service Manager will explore developing this document to ensure it is available for the CSCI and service users. The Inspector viewed a sample of health and safety records. Water temperatures are taken of all areas of the home on a regular basis. These were within an appropriate range. Fire drills had been held at different times and with various members of staff. The fire risk assessment is due for review next month and the Service Manager was informed of this. Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 26 The Inspector spoke with the Support worker, who is the fire officer, and suggested they consider contacting the London Fire and Emergency Planning Officer, as new fire regulations came into force the latter part of 2006. The home was visited by this department in July 2005, however in light of changes to legislation, the home might want to consider asking for another visit. The last food hygiene inspection was carried out in October 2006, with no issues arising from this visit. Portable Appliance Testing, testing for Legionella and the Gas Safety checks were all up to date. Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 27 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 Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 3 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 2 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 2 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 28 YES 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 YA6 Regulation Schedule 3 Requirement Daily records must be detailed to incorporate details of incidents/events, action taken and any treatment needed following the incident/event. (Previous timescale 04/01/06 not met). Timescale for action 10/01/07 2. YA6 3. YA9 12(1)(b)13(4) Guidelines/or information (c ) detailing the support a service user needs must clearly indicate all possible behaviours/risks to ensure staff working with the service user are aware of their assessed needs. 13(4)(c) Risk assessments must be completed on any potential risk, e.g. where a service user is reluctant or refuses health appointments/medical intervention. 06/02/07 06/02/07 Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 29 4. YA24 23(2)(b)(d) The bathroom must be made good. This is in relation to flaking paint on the bath panel and paintwork on skirting boards. The shelving that has rust on the metal parts must also be replaced. (Partial re-stated requirement). All staff must be willing and able to work as part of the staff team so as to provide a consistent and high standard of care and support to the service users. Training, including refresher training, must be available for staff, e.g. moving and handling refresher training & medication. 28/04/07 5. YA33 12(1)(a)(5) 28/02/07 6. YA35 18(1)(a)(c)(i) 28/04/07 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 YA6 YA9 Good Practice Recommendations It is strongly recommended that documents relating to service users, such as personal care assessments and risk assessments be re-written and reviewed on a regular basis. It is recommended that all service user files contain the same consistent information, to avoid confusion and duplication. 2. YA6 YA9 Oaklands Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection West London Area Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE National Enquiry Line: 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 © 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 Road, 82 DS0000027737.V322652.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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