CARE HOMES FOR OLDER PEOPLE
Oaklawn 400 Chessington Road West Ewell Surrey KT19 3NB Lead Inspector
Graham Cheney Announced 03 May 2005 16:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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. Oaklawn H58_s13733_Oaklawn_v214747_030505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Oaklawn Address 400 Chessington Road, West Ewell, Surrey, KT19 3NB Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 83936731 EMAS Limited Company Mr Charlie Yong Huat Puah CRH Care Home 3 Category(ies) of LD(E) Learning Disability, 3 registration, with number of places Oaklawn H58_s13733_Oaklawn_v214747_030505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. LD(E) Learning Disability, service users who are over 65 years of age but do not fall within the category of old age. Date of last inspection 14 September 2004 Brief Description of the Service: The home provides accommodation for three service users over the age of 65years with a learning disability. The building is a bungalow, which comprises of a large lounge, small separate dining room, 3 single bedrooms, bathroom, kitchen, small office and a laundry room. There are no en suite facilities, however the bedrooms are all situated near to the bathroom. There are ample gardens to the rear of the property, mainly laid to lawn, with patio area. The garden adjoins with the company’s sister home, Firlawn. There is a parking facility to the front of the property. Oaklawn H58_s13733_Oaklawn_v214747_030505 stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This visit was the home’s first inspection for the year 2005/2006. This was an announced visit, which meant that staff and residents knew that it was due to happen. The inspection started at 16.30 p.m. and the inspector had the opportunity to met both of the current residents. The home currently has one vacancy. This was the first time the inspector had been to Oaklawn and the first part of the visit was taken up with an introduction to both of the residents, one of whom showed the inspector his room. The member of staff on duty was introduced and a tour of the building was completed. The rest of the time was spent observing staff and residents together, looking at records and reports and talking to the manager about how the home was run. One of the residents had some difficulty with verbal communication, but was able to express himself in a variety of ways that staff were able to recognise and respond to appropriately. The inspector was made very welcome and would like to thank the residents and staff. What the service does well:
As stated above one the residents had some difficulties with verbal communication but had a good level of understanding. Observations indicated that the relationship between residents and staff was relaxed and very friendly, creating a warm and homely feel in the home. Residents were encouraged and supported to be as independent as they were able and involved in what was happening in the home. One of the residents helps around the home and on the day of the inspection had helped to prepare the supper meal and make the jelly. The manager said that they had got to know both residents well and understood their likes and dislikes, at the time of the inspection one of the residents was doing some art work, the other was able to show the inspector some of the art work he had done previously and displayed on his bedroom wall. Oaklawn H58_s13733_Oaklawn_v214747_030505 stage 4.doc Version 1.30 Page 6 Residents also go into the local community on a regular basis, which included attending day care, one attended three days a week the other on four days. Other trips included leisure activities, shopping and having meals out. The home has its own transport for residents. Residents had been attending church but the manager said they were now finding the services too long. Church services were watched on television instead. The residents have the opportunity of a joint holiday with the residents in Firlawn next door, which they said they enjoyed. They told the inspector that they were looking forward to going away again this year. 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.
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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) Scoring of Standards Statutory Requirements Identified During the Inspection Oaklawn H58_s13733_Oaklawn_v214747_030505 stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 4, 5 The home was generally operating effectively in respect of these standards. Information about the home was up to date, although more details about the registered manager were required (Please see below). Such information was readily available to residents and provided a good level of detail about the home, which would help prospective residents or their supporters to make an informed choice as to whether the home would be a suitable place to live. EVIDENCE: Sampling of care plans provided evidence that the home has established a sound process of assessing residents’ needs and aspirations Other than adding more information about the registered manager’s experience and qualifications the home’s statement of purpose and service user guide were in line with the Standard and Regulations. The home’s complaints procedure has been looked at and made easier for residents or their supporters to follow if they have a problem. Oaklawn H58_s13733_Oaklawn_v214747_030505 stage 4.doc Version 1.30 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 9, 11 Evidence gathered during this inspection confirmed that the home meets each of the assessed standards. This meant that the home was able to demonstrate that residents’ health and personal care needs were being appropriately met. EVIDENCE: Standard 9 was assessed on this occasion and the practice for administering medication complied with the Royal Pharmaceutical Society’s guidance. On the evidence presented the home was therefore obtaining, storing, administering and recording medication appropriately. It was recommended that the quantities of medication received be recorded on the medication record sheets rather than in a separate book. The home has had to address the issues of bereavement recently with the death of one of the residents in Firlawn. Discussion with the manager suggested that this was well managed with the other residents being appropriately informed of what had happened and supported. Oaklawn H58_s13733_Oaklawn_v214747_030505 stage 4.doc Version 1.30 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14, 15 Evidence gathered during this inspection confirmed that the home meets each of the assessed standards. This meant that the home was able to demonstrate that residents were encouraged and supported to lead as independent and fulfilling life as they were able. EVIDENCE: The manager said that they had got to know both residents well and understood their likes and dislikes, i.e. with meals and their personal interests such as gardening. Both residents go into the local community on a regular basis, which included attending day care, leisure activities, shopping and having meals out. The home has its own transport for residents. One of the residents was very able and enjoyed going out with staff. They had been on a trip to France. The residents have the opportunity of a holiday, which they said they enjoyed very much. Oaklawn H58_s13733_Oaklawn_v214747_030505 stage 4.doc Version 1.30 Page 11 Neither of the residents had been to church recently as they found the services too long. Both were able to watch the Sunday service on television if they wished. Oaklawn H58_s13733_Oaklawn_v214747_030505 stage 4.doc Version 1.30 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Evidence gathered during this inspection confirmed that the home meets the assessed standard. This meant that the home was able to demonstrate that residents’ views were important and acted upon. EVIDENCE: The home’s complaints procedure has been looked at and made easier for residents or their supporters to follow if they have a problem. Observations of the interactions between residents and staff indicated that staff understood the residents well and were able to respond to wishes appropriately. Oaklawn H58_s13733_Oaklawn_v214747_030505 stage 4.doc Version 1.30 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20. 21, 23, 24, 25, 26 Oaklawn was a pre-existing, (before 2002) registered small care home. Given this the evidence gathered during this inspection confirmed that the home meets each of the assessed standards and provides a reasonable level of accommodation appropriate to the needs of the current residents. EVIDENCE: The home was generally operating to a good standard. Having been originally registered as a small care home it did not have to meet the same standards as a larger or more recently registered service, for example washbasins had not been fitted in residents’ rooms. This did not seem to be a problem to the current residents. No health & safety concerns were identified on the day of inspection and the home was very clean, tidy and well maintained. Oaklawn H58_s13733_Oaklawn_v214747_030505 stage 4.doc Version 1.30 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28, 29, 30 Evidence gathered during this inspection confirmed that the home meets each of the assessed standards. Staff appeared to be enthusiastic and committed to supporting residents, with training and development given a priority. EVIDENCE: Training and development of staff has been given priority with staff undertaking a range of training to help them care for and support the residents. The manager of Firlawn was looking to become an assessor for the NVQ. The manager demonstrated that regular supervision sessions with all staff to provide support and guidance had commenced. The observed relationship between residents and staff was good, creating a warm and homely feel in the home. Staff demonstrated a good level of understanding of the residents’ needs and wishes and responded appropriately. All staff were subject to CRB and POVA checks before they commence duty and any issues identified were appropriately managed. The manager was advised that once seen by the inspector CRB checks should be disposed off to ensure compliance with the Data Protection legislation. Oaklawn H58_s13733_Oaklawn_v214747_030505 stage 4.doc Version 1.30 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, 35, 36, 38 Evidence gathered during this inspection confirmed that, the home meets each of the assessed standards and was seen to be well run, with sound and accountable management support. EVIDENCE: The home’s owners have started to carry out checks to make sure that a good quality of service is being provided to the residents. These include quality and health & safety audits. The registered provider acts as appointee for residents in both Oaklawn and Firlawn. All of the residents have their own personal bank or building society account and accurate records of all transaction were maintained. The residents’ accounts were externally audited.
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This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x x 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 3 x 3 3 3 3 STAFFING Standard No Score 27 x 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x 3 3 3 x x 3 Oaklawn H58_s13733_Oaklawn_v214747_030505 stage 4.doc Version 1.30 Page 18 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4 Requirement More information about the registered manager’s experience and qualification must be included in the home’s statement of purpose. Timescale for action 2 Months 03/07/05 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. 2. Refer to Standard OP9 OP29 Good Practice Recommendations It was recommended that the quantities of medication received be recorded on the medication record sheets rather than in a separate book. The manager was advised that once seen by the inspector CRB checks should be disposed off to ensure compliance with the Data Protection legislation. Oaklawn H58_s13733_Oaklawn_v214747_030505 stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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