Inspection on 19/11/08 for Oaklawn

This inspection was carried out on 19th November 2008.

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

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

Other inspections for this house

Oaklawn 27/11/06

Oaklawn 02/11/05

Oaklawn 03/05/05

Oaklawn 14/09/04

Oaklawn 05/05/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Oaklawn Oaklawn 400 Chessington Road West Ewell Epsom Surrey KT19 9EG     The quality rating for this care home is:   two star good 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: Lisa Johnson     Date: 1 9 1 1 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 Older People 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 Older People 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 Older People Page 3 of 27 Information about the care home Name of care home: Address: Oaklawn 400 Chessington Road Oaklawn West Ewell Epsom Surrey KT19 9EG 02083936731 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Charlie Yong Huat Puah Type of registration: Number of places registered: EMAS Ltd care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - LD Date of last inspection Brief description of the care home The home provides accommodation for four people over the age of 65years with a learning disability. The building is a bungalow, which comprises of a large lounge, small separate dining room, 4 single bedrooms, bathroom, kitchen, small office and a laundry room. One bedroom is provided with ensuite facilities. There are ample gardens to the rear of the property, mainly laid to lawn, with patio area. The garden adjoins with the companys sister home, Firlawn. There is a parking facility to the front Care Homes for Older People Page 4 of 27 Over 65 0 4 Brief description of the care home of the property. The cost per person per week is #884.00 and holidays and personal items, one to one support, and complementary therapies are extra. Care Homes for Older People 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Information was provided to us by the service prior to this visit in the Annual Quality assurance assessment(AQAA). This is a self assessment that focuses on how well outcomes are being met for people using the service. Reference is made to this document throughout this report. During this visit we spoke to one people who lives the service. Some of the people living in this service have limited verbal communication therefore feedback has been obtained through observation. We received surveys from three people who live in the service who hadbeen provided support. We also received surveys from four health care professionals and spoke to three members of staff during this visit. Care Homes for Older People Page 6 of 27 During this visit we conducted a full tour of the premises, looked at care plans, risk assessments, staff personnel and training records and policies and procedures. The inspector would like to thank the people living in the service, their representatives, managers and staff for their time, assistance and hospitality during this inspection. What the care home does well: What has improved since the last inspection? What they could do better: The General Social Care Code conduct (GSCC)must be brought to the attention of staff ensuring that they are aware of their responsibilities working in a social care setting. Three good practice recommendation have also been made as a result of this visit. 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. Care Homes for Older People Page 8 of 27 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 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. Peoples needs are assessed prior to admission to the service to ensure that it is able to meet their needs. This home does not support people for intermediate care. Evidence: Since our previous visit two new people have moved into the home. The home carries out pre admission assessments prior to any person being admitted ensuring that the service can meet their needs. During this visit assessments were were sampled for two people, which had been completed by the registered manager. The assessment covered health, personal and social needs. Further information had also been gained about peoples likes, dislikes and preferences. A community care assessment, reports from other professionals and previous placements had been obtained. People and their representatives are able to visit the home and spend time there. A Care Homes for Older People Page 11 of 27 Evidence: person surveyed sad, I was invited for tea and went for lunch and to join in with other service users. Care Homes for Older People Page 12 of 27 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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. Each person is provided with a plan of care and their personal and health care needs are met. Peoples right to privacy is respected and they are protected by the homes medication practices. Evidence: Each person has a completed care plan in place. During this visit three out of four care plans were sampled. Care plans covered health, personal, psychological, communication and social needs. Care plans have been enhanced and made accessible with the introduction of person centered and health action plans that have been formulated with pictures. Care plans were detailed, comprehensive and they are reguarly reviewed. Peoples likes, dislikes and preferences are recorded including their preferred name of address. Clear objectives and goals were recorded and how support was to be provided including advice received from health care specialists. One persons care plan was supported by a communication profile which recorded their means of communication. Staff demonstrated that they were aware of this by ensuring that that they took time to allow this person to lipread and use makaton sign language. This Care Homes for Older People Page 13 of 27 Evidence: person also recieves support and encouragement from staff in undertaking leg exercises. The home operates a key worker system and staff spoken with stated that are made aware of and they are involved with care plan reviews. A persons care plan identified that they require a specialist mattress on their bed for pressure relief, a hoist , specialist bed and the use of a bath chair which were in place. A health care professional surveyed said, care staff follow guidelines and care plans in order to meet peoples health needs and This service provides care that meets my clients assessed needs appropriately. People are supported to access a range of health care specialists such as General Practitioner, dentist, continence adviser, dietitian, optician, psychology , physiotherapy and district nurses where this is required. All health screen checks and appointments were recorded in each persons care plan as well as regular weight monitoring. Another health professional said, There is good communication with regard to the clients physiotherapy needs. Moving and handling assessments had been completed and one person was identified as having a range of emotional needs. This persons care plan was supported by risk and behavioral support plans. This person was also identified at risk of weight loss due their hyperactivity and risk of choking and therefore requires regular monitoring, needs a well balanced diet and requires food thickeners. During this visit staff were observed to respect peoples privacy and dignity. A member of staff was observed knocking on the bedroom door of a person before entering and the shut the bathroom door. Three health care specialists also confirm that staff respect peoples privacy and dignity. Due to the emotional needs of one person and the risk of obstructing their bedroom door a full bedroom door is not in place. This person also refuses to maintain curtains, however the service has installed French windows to the outside window and en suite facilities to maintain their privacy and dignity when receiving personal care. The homes medication practices were examined. Medication was stored in a locked cupboard in the office. Medication is administered using the Medidose system (MDS). A list was in place for all staff who are trained to administer medication, although the home was advised to ensure that this is up to date. We were informed that staff attend an external training course. All medication administration records sampled were appropriately recorded, although a medication card for one person had been recorded by staff, which had not been checked or signed by two members of staff. This was brought to the attention of the person in charge Care Homes for Older People Page 14 of 27 Evidence: who completed this during this visit. Information was recorded about any allergies that people may have. Care Homes for Older People Page 15 of 27 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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. People living in the service are supported to access a range of recreational and leisure activities which meet their needs and preferences. People are supported to maintain links with their families and friends and the local community and they are provided with well balanced and attractive meals. Evidence: Care plans contained individual activity plans which were formulated in pictures which enhances communication with people. During this visit one person left the home to attend day services. Peoples activities are based on their preferences and interests . One person attends day services twice weekly and told us that they like going swimming. where they receive hydrotherapy. There are opportunities to go shopping , visit the pub, eat out at restaurants and visiting places of interest. People living in the service have all been away on holidays. A person surveyed who had been supported to complete their questionnaire said, I enjoy doing puzzles and i like my hands massaged , going to day services and going out A health care professional surveyed said, Schedules are adapted and arranged to suit individuals likes and dislikes. Therapeutic activities are provided as well,including Care Homes for Older People Page 16 of 27 Evidence: foot spas, massage and aromatherapy. One persons activity plan identified that they enjoyed doing table top games which they were enjoying with a member of staff. Activities attended by people are recorded and the manager has stated in the AQAA that they intend to promote further opportunities to expand the range of activities. People are supported to maintain links with their families and friends and peoples person centered plans identified the people that were important in their lives. People are supported to make decisions and choices about their daily lives which was seen in information provided in peoples care plans. One persons care plan identified that they like to choose their clothes. During this visit we were informed that one person likes to spend time on their own which was see to be respected by staff. Throughout this visit good relationships were observed between people living in the service and staff who were interacting in a positive way. A health care professional surveyed said. Since my client has moved in to the home my client has improved in many aspects of their life and the home are keen to promote Independence and the package is very client centered. The home provides a four weekly menus, which were varied and well balanced and based on peoples preferences which were recorded in their care plan . During this visit the main meal was served at lunchtime which was lasagne and fresh vegetables and desert which was attractively presented. Good assistance and supervision was provided by staff who had a good knowledge of peoples dietary needs and any identified needs such as being at risk of choking. One person requires a purred diet which was well presented. People were provided with appropriate equipment such as specialist spoons and plate guards to maintain their independence. The meal time was unhurried and relaxed making this an enjoyable experience for people. Care Homes for Older People Page 17 of 27 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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 home has a complaints procedure in place and people are protected from abuse. Evidence: The home has a complaints procedure in place, that has been set out in a user friendly format using symbols which is provided to each person. The home maintains a complaints register, although since our our previous visit there have been no complaints received by the home and none have been brought to the attention of the commission. Three health care professionals surveyed said, the service has responded appropriately, although one person said that have never had any concerns and that people always appear happy and content. Another health care professional said, Staff always comply with the reporting procedures. The service has local safeguarding vulnerable adults from abuse procedures, which make reference to the local authority procedures and they have obtained the most up to date version. Three staff training files sampled confirmed that staff have received appropriate training. Two members of care staff spoken with during this visit were clear about their responsibilities should they witness or made aware of any incident where the safety of people is compromised. Care Homes for Older People 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, 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. 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. People stay in a safe and well maintained home that is homely, clean, pleasant and hygienic Evidence: The home is single storey and provides provides a spacious,well maintained, comfortable and homely environment. There is a comfortable sitting room and separate dining area. Bedrooms are single occupancy and one bedroom has en suite facilities. Bedrooms were comfortable , colour coordinated and reflected peoples gender. Due the needs of one person their bedroom has had to have adjustments made to it for their safety and risk assessments have been implemented, although it was observed that a window restricter is required. (refer to standard 38) The home has a well maintained garden and patio area which is accessible to people in wheelchairs by a ramp. There is a summer house which is shared by the sister home next door and garden furniture is provided for people to use and enjoy during the summer months and when the home holds barbecues. Since our previous visit new non slip flooring has been installed in the bathroom and has been decorated providing a modern, bright and comfortable facility for people to use. Specialist equipment is provided including beds and pressure relieving Care Homes for Older People Page 19 of 27 Evidence: mattresses, bath chair and a hoist. The home was cleaned to a high standard and was hygenic. Appropriate handwashing facilities and equipment was available and staff were provided with protective aprons and gloves when carrying out personal care. Care Homes for Older People 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. People living in the service are supported by sufficient numbers of staff . People are in the main supported by trained and competent staff and they are protected by the homes recruitment practices. Evidence: At the time of this visit there were two members of staff on duty. There were three people present . Four people live in the home and we were informed that there are always two members of staff on duty during the day and on a number of days there is three which was confirmed by the staff rota. At night time people are supported by one member of waking night staff. We were informed that the manager is always on call should the need arise. Staff spoken with said that they thought the current staffing levels were sufficient numbers of staff to meets peoples needs. There has been minimal staff turnover since our last inspection. Information supplied in the AQAA indicates that the eight care staff have obtained National Vocational Qualifications (Level 2) or above. Some staff are qualified learning disability nurses. New staff receive induction and information seen indicated that they had attended some external induction training although it is recommended that the homes induction programme should follow the skills for care core induction standards Care Homes for Older People Page 21 of 27 Evidence: The training files for three members of staff were sampled. A schedule was maintained for each person. Information was available that indicated that staff have received up to date statutory training which takes place internally and externally in moving and handling, safeguarding vulnerable adults from abuse, food hygiene,fire awareness, infection control and first aid, although it was observed that one person needs up to date refresher training in first aid. A file was examined for a registered nurse who had completed a range of specialist training including challenging behavior and dementia awareness. The personal files were sampled for three members of staff which included two for most recently recruited staff . Files contained the required the information including a full application form. a protection of vulnerable adults check (POVA) and an enhanced criminal Records Bureau check (CRB). The manager must ensure that all staff are provide with the General Social Care Code of conduct (GSCC) ensuring that they are aware of their responsibilities when working in a social care setting. Care Homes for Older People Page 22 of 27 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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 an experienced registered manager in place and the home is run in the best interests of people living there. Peoples financial interests are protected and peoples health, safety and welfare is in the main protected. Evidence: The registered manager is also the owner of the home and is a qualified learning disability nurse. The manager also holds a National Vocational qualification (Level 4) in management. The manager was not present during this visit and the home was being run by the deputy manager who is also a qualified learning disability nurse. Two members of staff spoken with said that they felt well supported by the manager and that there was good team work. Staff meetings are regularly conducted which was supported by written records. Since our previous visit quality assurance systems have been developed including carrying out feedback surveys which have been provided to people using the service Care Homes for Older People Page 23 of 27 Evidence: and/or their representatives and included some positive responses. The manager has also developed some internal quality assurance audits. The home conducts meetings with people who live in the service to gain their views which were recorded The manager carries out monthly health and safety audits. During a tour of the home a number of the radiators have been supplied with radiator protectors, but some bedrooms have not. Risk assessments have been completed, although these should be discussed with the environmental health department. We were informed that this matter is in process and that contact has already been made with the enviromental health department Discussion took place with staff about one persons bedroom which is situated on the ground floor that did not have a window restricter applied . The homes fire records were examined which indicated that regular fire drills, equipment and alarms checks are conducted. Records are maintained of water temperatures in the home. We were informed that the utility room is always kept locked. Substances hazardous to health were appropriately stored and locked away. Information supplied in the AQQA indicated that all servicing and maintenance of equipment is up to date. Care Homes for Older People 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 Older People 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 1 27 18 The registered person must ensure that staff are provided with a copy of the General Social Care Code of conduct This is to ensure that staff are aware of their responsibilities working in a social care setting 21/01/2009 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 1 2 3 28 30 35 It is reccomended that the staff induction programme follows the skills for care core induction standards. It is reccomended that the manager makes arrangements for staff to recieve up to date first aid refresher training. It is recommended that where people require support with handling their monies, this is recorded in their care plan Care Homes for Older People 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 Older People 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!