Inspection on 30/08/07 for Oakleigh

This inspection was carried out on 30th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Oakleigh 04/10/06

Oakleigh 08/11/05

Oakleigh 03/05/05

Oakleigh 30/11/04

Oakleigh 30/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Oakleigh Shutterton Lane Dawlish Warren Dawlish Devon EX7 0PD Lead Inspector Susan Samways Unannounced Inspection 30th August 2007 11:00 Oakleigh DS0000003763.V342838.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 Oakleigh DS0000003763.V342838.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. Oakleigh DS0000003763.V342838.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakleigh Address Shutterton Lane Dawlish Warren Dawlish Devon EX7 0PD 01626 866740 01626 864771 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) Mr Tony England Mrs Pamela England Mrs Pamela England Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Oakleigh DS0000003763.V342838.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Staffing levels will reflect the increase in numbers at the home and will meet Care Homes Act 2000 requirements. 4th October 2006 Date of last inspection Brief Description of the Service: Oakleigh is a large extended property situated on the outskirts of the seaside resort town of Dawlish. The home is registered for six Service Users of either gender who are below the age of 65. Oakleigh provides specialised residential care to Service Users who have learning difficulties with associated challenging behaviour. The Registered Providers state that rehabilitation at the home is based on gentle teaching principles within the framework of a social learning programme. The home is arranged over two levels, which can be accessed by stairs. Each Service User has their own bedroom with nearby bathroom. The home is set in over three acres of land, which is used for activities such as gardening and tending to the home’s many chickens, geese and ducks. The home also has ferrets and a cat. Activities arranged by the home include; keep fit, gymnasium, karaoke, gardening, cooking, sport and arts and crafts. Communal areas of the home include a lounge, a large kitchen, games room, gymnasium and an additional kitchen/multi purpose area. Oakleigh DS0000003763.V342838.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a short notice inspection which enabled the registered manager to prepare one of the residents for the inspection. The inspection took seven hours. All the residents were seen and spoken to and two were interviewed in private. All had completed Service User surveys. The registered manager was present throughout the inspection. A member of staff was spoken to and various records and documents examined. The Annual Quality Assurance Assessment had been received prior to the inspection. What the service does well: The residents spoken to and those who had completed questionnaires expressed a high level of satisfaction with the home, the staff and the providers. They said that they liked living there, they enjoy the activities and have choice in how they spend their time. They also said that the staff listen to and act on what they say and that they can call a residents meeting at any time. They commented on the cleanliness of the home and that they help to keep it that way. They are involved in the running of the home and are consulted about any proposed changes. The home is spacious and has extensive grounds which are well used. Staff were observed to work alongside residents encouraging them to make decisions for themselves. The detailed, individualised care plans are developed over a period of time to ensure that all the residents’ needs are clearly identified and risk assessments completed. These are regularly reviewed and are signed by the resident concerned. The residents’ behaviour is understood by the staff and well managed. The residents are encouraged to lead a healthy life style. They grow their own fruit and vegetables and keep animals such as chickens. The produce is then used by the residents for their meals. The residents are also involved in a wide range of physical activities such as running, swimming, cycling and walking as well as using the home’s well-equipped gym. This approach has enabled at least one resident to lose weight. There is a good staff recruitment procedure and the staff are well trained. Oakleigh DS0000003763.V342838.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. Oakleigh DS0000003763.V342838.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 Oakleigh DS0000003763.V342838.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): 1,2,4,5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The comprehensive assessment made of prospective residents and the detailed statement of purpose, provide sufficient information to enable all those concerned to make the decision as to whether Oakleigh is an appropriate home for them. EVIDENCE: There have been no new admissions since the last inspection. However, the most recent resident to be admitted confirmed that he had been given information about the home prior to visiting. A copy of the Service Users Guide was seen displayed on the home’s notice board. The file for the new resident was examined. A comprehensive assessment had been completed including areas such as assistance required with personal care, dietary needs, behaviour, sleep patterns, interests, likes and dislikes and religious beliefs. The file also included a report from the previous placement and a copy of the home’s contract with the resident signed by him. The manager stated that the resident had been invited to visit the home for lunch and then for tea at a later date and this was confirmed by the resident. He stated that this had given him the opportunity to meet the other residents and the staff, view the room he Oakleigh DS0000003763.V342838.R01.S.doc Version 5.2 Page 9 would occupy and to ask questions. This gave everyone concerned time to see whether the home could meet his needs. He stated that he had been asked if he would like to live at Oakleigh. The Service Users’ Guide is currently being revised a draft of which was seen during the inspection. The residents have been asked for their contributions to this and these were also seen. Oakleigh DS0000003763.V342838.R01.S.doc Version 5.2 Page 10 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): 6,7,8,9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their care plans clearly identify their needs and how they will be met. EVIDENCE: The files for two of the residents were examined one of which was for the most recent admission. Both were found to be comprehensive. At the last inspection the care plan for the new admission was still being developed. The manager had explained that they had found it takes several months to get to know the resident and fully ascertain their needs. This care plan was now found to be very detailed, focusing on what the resident can do and what assistance is required from staff e.g. good at cycling, staff need to be aware of poor road sense. The other care plan seen had been reviewed in March. Both Oakleigh DS0000003763.V342838.R01.S.doc Version 5.2 Page 11 care plans had been signed and dated by the staff involved in compiling them and by the resident concerned. Risk assessments were also found to be in place with evidence that they had been regularly reviewed and signed and dated by the staff. They had also been signed by the resident ensuring that they were fully aware of what action the staff needed to take in various situations. The files also contained letters and assessments from other health care professionals and agreements with residents regarding behaviour management and minimising risks. On examining previous records it was obvious that there had been a high degree of success in managing very challenging behaviour while enabling the residents to remain living in a homely environment in the community. Oakleigh DS0000003763.V342838.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. The residents’ health and well-being is promoted by the provision of a healthy diet and active lifestyle. EVIDENCE: The residents spoken to stated that they are involved in the day-to-day running of the home. They said that they are expected to keep their rooms clean and tidy, help with housework, take turns to choose, prepare and cook the evening meal for everyone and to help in the vegetable garden and with looking after the home’s many animals. They also said that the staff listen to them and take notice of what they say and that they can call residents meetings whenever they want. Oakleigh DS0000003763.V342838.R01.S.doc Version 5.2 Page 13 During the inspection residents were observed doing housework, ironing their clothes and preparing the evening meal. One resident led a tour of the extensive vegetable garden and greenhouses, talking enthusiastically of the crops grown and cooked. They also showed the area where the chickens, ducks and other animals are kept. The ethos of the home is to maintain a healthy lifestyle. In addition to the healthy diet the residents benefit from the home’s well-equipped gym and from other activities such as cycling, swimming, running and going for long walks. One resident said how much they had benefited from this regime. They had lost weight and felt much fitter and better in themselves. The home also has a games room which has a pool table, darts board and karaoke machine as well as table games and arts and crafts materials. Time is also spent on improving literacy and numeracy skills. The residents make good use of community facilities and activities such as going to football matches, the cinema and discos. The residents are encouraged and supported to maintain contact with friends and relatives and this was confirmed by the residents spoken to. Oakleigh DS0000003763.V342838.R01.S.doc Version 5.2 Page 14 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. Residents receive personal care and support in the way they prefer and which promotes privacy, dignity and independence. EVIDENCE: The home operates a key worker system which ensures that each resident’s individual needs are identified and met. Residents are encouraged to be as independent as possible with personal care and at present minimal assistance is required e.g. help with hair washing. This was confirmed by the residents spoken to who said that they would seek help when required from the person with whom they felt most comfortable. One resident requires help with bathing and shaving and the manager ensures that staff of the same gender as the resident provides that assistance. All contact with health care professionals is recorded in the residents’ files. The manager stated that staff support is provided for all residents to attend Oakleigh DS0000003763.V342838.R01.S.doc Version 5.2 Page 15 appointments and that staff will go in with the resident for the consultation if requested or if a risk assessment indicates that this is required. The manager said that they have a good relationship with the local GP. The manager stated that they have worked hard with the residents and the relevant medical staff to reduce the amount of medication they are taking. They have had a high degree of success and only three of the residents take any medication. This is dispensed by the pharmacist in bubble packs and two of the residents are encouraged, with staff supervision, to remove the medication from the packs themselves. Medication records were seen to be correct and up to date. Oakleigh DS0000003763.V342838.R01.S.doc Version 5.2 Page 16 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. Residents are protected by their knowledge of the complaints procedure and staff training in recognising abuse. EVIDENCE: All the residents had completed a Service User Survey prior to the inspection. Through those they all stated that the staff listened to them and acted on what they said, that they knew who to speak to if they were not happy and that they knew how to make a complaint. Each of them has their own copy of the Service Users’ Guide which contains a copy of the complaints procedure. Oakleigh has received no formal complaints and no complaints about the service have been received by the Commission for Social Care Inspection. The manager stated that issues around recognising abuse are discussed periodically at residents meetings. All staff except the newest recruit have had training in the protection of vulnerable adults. Records of residents’ money were found to be in order. Oakleigh DS0000003763.V342838.R01.S.doc Version 5.2 Page 17 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): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Oakleigh provides residents with a homely, comfortable and safe environment in which to live. EVIDENCE: All areas of the home seen during the inspection were found to be clean, tidy and free from offensive odours. The residents all said that the home was clean and that they all helped to keep it that way. The residents spoken to stated that they chose the way in which their rooms were decorated and furnished which reflected their own taste and accommodated their particular needs. They also said that they are consulted about how the rest of the home is decorated. The home is light, airy and spacious throughout with plenty of room for the residents to spend time together or be on their own if they wish. Oakleigh DS0000003763.V342838.R01.S.doc Version 5.2 Page 18 The home has considerable communal space. There are two large kitchen areas with dining space, a comfortable and homely lounge, games room and gym. The grounds are extensive with areas for leisure activities as well as the large vegetable garden and the enclosures for the animals. Oakleigh DS0000003763.V342838.R01.S.doc Version 5.2 Page 19 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): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home employs sufficient staff who have the skills, training and understanding to meet the needs of the residents. Residents are protected by good staff recruitment procedures. EVIDENCE: The files for two of the staff were examined and found to have all the necessary documentation. These included a completed application form, two references, proof of identity and police checks check. The files also included the training records. Induction training for new staff is phased over a six month period with a checklist to be signed off as it is completed to ensure that all areas are covered. Of the six staff one has NVQ level 2 in care with two others currently doing it, two members of staff have achieved NVQ level 3 and another has started the Registered Managers Award. Other recent training has included food hygiene and safe handling and restraint. Oakleigh DS0000003763.V342838.R01.S.doc Version 5.2 Page 20 During the inspection staff were observed to be working alongside residents encouraging them to make decisions for themselves rather than telling them what to do. The residents all said that the staff treat them well and one said that the staff are very respectful. Some commented that they like doing activities with the staff. In discussion with the member of staff on duty during the inspection it was clear that there was a good understanding of each of the residents’ behaviour, which can be very challenging, and how this should be managed. Oakleigh DS0000003763.V342838.R01.S.doc Version 5.2 Page 21 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): 37,38,39,42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents can be confident that the home is well run and that their views will be taken into consideration in the plans for the home. EVIDENCE: The registered manager is also one of the registered providers. She and the other provider have provided the service for over 16 years and two of the residents have been with them for that period of time. The manager has NVQ level 4 and the registered Managers Award and another member of staff is undertaking it. Residents spoken to were very appreciative of the support they receive from the manager. They said the she was easy to talk to and took Oakleigh DS0000003763.V342838.R01.S.doc Version 5.2 Page 22 notice of what they said. During the inspection it was observed that both the residents and the staff approached the manager with confidence and were well received. The staff clearly knew what was expected of them and appeared happy working with the residents. The residents said that their views are listened to by the staff. Residents meetings are held at their request or if a matter needs to be raised with them. If a meeting hasn’t been held for three months then the manager will call one. Residents are always asked at those meetings if they are happy with the care provided. They are also encouraged to complete questionnaires about life in the home. Since the last inspection surveys have been sent to residents’ relatives and professionals. There was a good response to these and the forms used are being revised in light of the responses received. The manager has written an annual development plan covering all areas of the national minimum standards and includes proposed changes to the environment and plans for further staff training. The home encourages safe working practices by ensuring that staff have training in manual handling, infection control, fire safety, first aid and food hygiene. They also have training in techniques for managing challenging behaviour. Risk assessments have been completed for the environment and for the different aspects of residents’ behaviour. The required policies and procedures are in place and regular fire and other safety checks are made and recorded. The manager is planning a health and safety course in the next twelve months for all the staff and is hoping to encourage as many of the residents to attend as well. Accidents and incidents were seen to have been recorded appropriately. The manager is intending to include discussion of any incidents that have occurred at staff meetings. Oakleigh DS0000003763.V342838.R01.S.doc Version 5.2 Page 23 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 4 2 4 3 x 4 3 5 3 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 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 4 x LIFESTYLES Standard No Score 11 x 12 3 13 4 14 x 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 4 3 x x 4 x Oakleigh DS0000003763.V342838.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA39 Good Practice Recommendations The Registered Provider should continue to develop and implement quality monitoring systems. Oakleigh DS0000003763.V342838.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Oakleigh DS0000003763.V342838.R01.S.doc Version 5.2 Page 26 - 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. 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