Inspection on 13/09/06 for Oakleigh House

This inspection was carried out on 13th September 2006.

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 House 20/11/07

Oakleigh House 28/09/05

Oakleigh House 18/05/05

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

CARE HOME ADULTS 18-65 Oakleigh House 8 Barn Park Road Teignmouth Devon TQ14 8PN Lead Inspector Judy Hill Key Unannounced Inspection 13th September 2006 10:00 Oakleigh House DS0000062352.V302841.R02.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 House DS0000062352.V302841.R02.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 House DS0000062352.V302841.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakleigh House Address 8 Barn Park Road Teignmouth Devon TQ14 8PN 01626 870331 01626 776715 oakleigh@carepartnerships.com 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) Networking Care Partnerships (SW) Ltd Miss Amy Charlotte Eastough Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Oakleigh House DS0000062352.V302841.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 6 service users who are Learning Disabled aged from 18 to 65 years may be accommodated at any one time 28th September 2005 Date of last inspection Brief Description of the Service: Oakleigh House is registered to provide accommodation and care for a maximum of six people who are under sixty-five years of age and who have learning disabilities. The home specialises in catering for people with a very high level of need. The home is situated in a residential area of Teignmouth and is within walking distance of the town centre, railway station and beach. Information about the service provided is available from the service provider in a Statement of Purpose and in a Service Users’ Guide. Copies of CSCI inspection reports are also available from the service provider and the CSCI website. The fees are calculated according an individual assessment of each residents needs and at the time of this inspection the weekly fees for the current residents ranged from £800 to £3,000 a week. This covers accommodation, board and care and additional charges are made for professional hairdressing, chiropody, toiletries, other items of a personal nature and some activities. Oakleigh House DS0000062352.V302841.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The information contained in this report was gained in conversation with the registered manager, the operations manager, staff and residents at Oakleigh House. Additional information was gained from a pre-inspection questionnaire, that had been completed by the registered manager, questionnaires completed by one GP and two Social Workers, the Homes Statement of Purpose and Service Users’ Guide, previous inspection reports and records, including the service users needs and risk assessments and care plans and staff records. An inspection of the premises was carried out and both direct and indirect observation was used to assess the interaction between the staff and service users. What the service does well: The resident’s individual needs and risk assessments, care plans and reviews are comprehensive and well documented. The residents are encouraged to exercise choice and make decisions about their lives. However, the manager and staff recognise and record where restrictions are needed to safeguard individual service users. The provision of personal care is tailored to meet the individual needs and abilities of the service users and good links are maintained with Health and Social Care services in the community. The availability of external day care services is limited but where suitable services are available the residents are helped to attend them. The staffing levels maintained enable the service users to receive the occupational support they need within their home environment and to go out. Although the residents are encouraged to eat healthy meals, their individual likes and dislikes are taken into account. The complaints procedure is available in written, visual and audio formats to make it more accessible to the service users. Complaints are taken seriously, dealt with appropriately and recorded. The service providers written policies and procedures, staff training and safe recruitment practices provide protection for the residents from the threat of abuse. The home is very well located, being within a short walking distance of the town centre, train station and beach. Within their home each of the residents has their own bedroom with en-suite bathing and toilet facilities. There is a spacious lounge and dining room and a smaller room that has been equipped as a sensory room for the residents use. The home is kept clean and is well maintained. Oakleigh House DS0000062352.V302841.R02.S.doc Version 5.2 Page 6 Staff training is given a high priority. The staff are well managed and work well as a team. The registered manager is well qualified and has a very good understanding of the needs of the residents. The registered service providers provide strong management oversight. 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. Oakleigh House DS0000062352.V302841.R02.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 House DS0000062352.V302841.R02.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 at least once during a 12 month period. 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. The service users needs are fully and comprehensively assessed prior to admission, or directly following admission if an emergency placement made. EVIDENCE: The needs assessments of two of the five residents were inspected. One of the service users had been placed at the home following a long period of assessment and consultation with other agencies, the other had been admitted as an emergency placement, along with two other service users. Although the assessment of the second service user had been poor at the time of his admission, this had been built upon following admission to provide a full and comprehensive assessment of the service user’s needs. Oakleigh House DS0000062352.V302841.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The quality of care planning and risk assessment is good and boundaries are only set when the decisions of the residents may be detrimental to their wellbeing or the safety of others. EVIDENCE: The care plans of two of the residents were inspected and found to be very detailed and to include comprehensive risk assessments and risk management plans where necessary. The care plans are stored in individual service user case files the office and two of the staff spoken with said that regularly read through the files. Information regarding the service users is shared informally, through the use of daily records, completed by the staff and regular staff meetings and reviews. Records were seen to provide evidence that formal reviews, which can involve joint working with the professional support services, took place. Oakleigh House DS0000062352.V302841.R02.S.doc Version 5.2 Page 10 In addition to inspecting service user records, which provided some evidence of individual choice and autonomy, the ability of the residents to make decisions about their lives was discussed with the manager because four of the five current service users could not respond to direct questions and the fifth chose not to. Some boundaries are set but only where this is necessary to safeguard the residents or to improve their quality of life. One example of this is that the residents are actively encouraged to get up if they do not choose to do so by 9.30am. Evidence of individual decision-making was seen in the presentation of service users’ bedrooms and with regard to their chosen activities within the homes. Oakleigh House DS0000062352.V302841.R02.S.doc Version 5.2 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The residents are given good support to enable them to participate in activities of their choosing both within their home and outside, subject to availability. Continued family contact is encouraged and the right of the residents to exercise choice is encouraged. EVIDENCE: Four of the five service users have very limited communication skills and were unable to respond to direct questioning. The fifth chose not to speak with the inspector. Because of this most of the information gathered about the service users lifestyles was taken from records and from the registered manager, staff and observation. Evidence was seen of the limited use of outside day care services. This was discussed with the manager and staff who agreed that more provision would benefit the service users. However, all of the service users have very profound learning disabilities and/or can display challenging behaviour, which reduces Oakleigh House DS0000062352.V302841.R02.S.doc Version 5.2 Page 12 the number of services that are suited to their needs. The residents do attend social events with Gateway Club and New Horizons, which provides art and music classes. In addition to this the staff take residents shopping and for walks or drives and were seen working on a one to one basis with the residents within their home. For the residents who have families who wish to remain in touch, continued contact is encouraged through regular telephone calls and visits. The residents are helped and encouraged to participate in the running of their home. Examples of this are that they take it in turns to plan meals and will be helped to make drinks and snacks. Healthy eating is encouraged, but not too rigidly. The residents who have special dietary needs are catered for. Oakleigh House DS0000062352.V302841.R02.S.doc Version 5.2 Page 13 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 at least once during a 12 month period. 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 the service. The residents can be confident that personal care will be provided in accordance to their assessed needs and wishes and that timely referrals will be made to the primary and secondary health care and support services as and when necessary. The residents can be confident that their medicines will be handled safely and conscientiously by trained staff. EVIDENCE: The individual assessments, risk assessments, care plans and reviews provide good written records of the personal support needs of the service users. Sufficient staff are employed to ensure that one to one personal support can be provided at a pace and level geared to the residents’ needs. Evidence was seen of good links with the professional support teams provided by the local care trusts and of timely referrals to primary and secondary health care services. Risk assessments have been used to establish that none of the present service users could manage their own medication. The service users’ medication is Oakleigh House DS0000062352.V302841.R02.S.doc Version 5.2 Page 14 stored in a locked cupboard in the room that is currently being used as an office. Separate facilities are provided for medicines requiring refrigeration and for controlled medicines, although neither are currently required. The medication is administered by trained staff and the person administering the medication on the day of the inspection was seen to be wearing a tabard with a message on it advising people not to disturb her because she was administering the medicines. Information about the service users’ medication is recorded in their case files and in an administration record book. The records of administration seen were immaculate. Oakleigh House DS0000062352.V302841.R02.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. The complaints procedure is available in different three formats to make it as accessible as possible for the residents. The residents and others can be confident that their complaints will be dealt with appropriately. Good written policies and procedures and staff training are in place to protect the service users from abuse. EVIDENCE: The homes complaints procedure is available in written, pictorial and audio formats. The pre-inspection questionnaire completed by the registered manager identified that three recent complaints had been made. Each complaint had been properly looked into and dealt with appropriately. Written policies and procedures are in place to protect the service users from the threat of abuse. Records were seen to indicate that training in the Protection of Vulnerable Adults has been provided for all permanent staff. Oakleigh House DS0000062352.V302841.R02.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. The home is ideally located for access to local facilities. The provision of ensuite toilet and bathing facilities for each of the residents and a sensory room raise the quality of the home environment for the residents. A high standard of cleanliness is maintained throughout the home. EVIDENCE: Oakleigh House is situated in a quiet residential area of Teignmouth and is within easy walking distance of the town centre, beach and train station. Access from the road to the front door is by way of a short flight of steps, but there is level access to the home from the back of the house. There is a double garage to the front of the house and on road parking is available. A patio over garage provides a pleasant sitting out area and there is a private enclosed garden to the back of the house. A physical inspection of the premises was carried out. Each of the service users has their own single bedroom with an en-suite bathroom or shower room. The degrees of personalisation of the bedrooms varied, but the rooms Oakleigh House DS0000062352.V302841.R02.S.doc Version 5.2 Page 17 that had been highly personalised very clearly reflected the tastes and choices of the service users using the room. Communal space is provided in the form of a large sitting room, which leads into a spacious dining room. The kitchen is off the dining room. The kitchen is kept locked to prevent the service users using it without staff supervision. Risk assessments have been carried out to justify this arrangement. There are laundry facilities on the ground floor which are accessible to staff and service users. There is a small room on the first floor, which was originally registered as second sitting room but has been converted to provide a sensory room for the residents to relax in. The staff sleeping in room has en-suite toilet and shower facilities and doubles as an office for the Registered Manager. The home was seen to be clean and well maintained. Oakleigh House DS0000062352.V302841.R02.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The staffing levels are high enough to meet the needs of the residents and the staff are well training and well supported. Safe recruitment practices are used to ensure that unsuitable staff are not employed to work with the residents. EVIDENCE: An inspection of the staff rota showed that the staffing levels maintained are at a high enough level to meet the assessed needs of the service users. However, it was observed that that the manager has had to rely heavily on the provision of agency staff to achieve this. This was discussed with the manager who said that she had experienced problems with long-term staff sickness but that the situation had improved as the staff had either returned to work or resigned and two new staff members have recently been appointed, subject to satisfactory CRB checks. Two members of staff were spoken with privately. Both said that they enjoyed working at the home and that the relationships between the staff were very good and supportive. The provision of staff training was discussed and provided evidence that this is given a high priority both by the organisation and by the staff themselves. Records of staff training also provided evidence Oakleigh House DS0000062352.V302841.R02.S.doc Version 5.2 Page 19 of a high level of provision and of a commitment on behalf of the staff and the Company towards gaining NVQ qualifications. Regular staff meetings are held and the registered manager was judged by the staff to be fair and supportive. Staff recruitment records were seen and these showed that safe methods are being used to recruit staff. Oakleigh House DS0000062352.V302841.R02.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. 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 the service. The residents benefit from living in a well managed and safely maintained home. EVIDENCE: The registered manager has the qualifications and experience necessary to manage Oakleigh House competently and demonstrated that she has a very good understanding of the needs of the residents. She is well supported by the Operations Manager. However, the registered manager has resigned from her post and was working out her period of notice at the time of the inspection. A quality assurance system is in place to enable the service users to have an input into the running of their home. Questionnaires that had been completed by the residents, with assistance from the staff, were seen to be in a format that is meaningful to them. Oakleigh House DS0000062352.V302841.R02.S.doc Version 5.2 Page 21 The registered manager is required to complete a very detailed Monthly Home Audit covering all aspects of the service provided and the premises. The completed audit for August was seen and this was provided evidence that the home is well maintained and that any outstanding issues are recognised, reported and dealt with. Oakleigh House DS0000062352.V302841.R02.S.doc Version 5.2 Page 22 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 4 23 3 ENVIRONMENT Standard No Score 24 3 25 4 26 X 27 4 28 4 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 4 X 3 X 3 X X 4 X Oakleigh House DS0000062352.V302841.R02.S.doc Version 5.2 Page 23 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. 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. Refer to Standard Good Practice Recommendations Oakleigh House DS0000062352.V302841.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 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. 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