Inspection on 18/05/05 for Oakleigh House

This inspection was carried out on 18th May 2005.

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 13/09/06

Oakleigh House 28/09/05

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 Announced 18 May 2005 th 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 D54-D07 S62352 Oakleigh House V214582 180505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Oakleigh House Address 8 Barn Park Road, Teignmouth, Devon, TQ14 8PN 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) 01626 870331 01626 776715 Oakleigh@carepartnerships.com. Networking Care Partnerships (South West) Limited Mr Christopher Bishop Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Oakleigh House D54-D07 S62352 Oakleigh House V214582 180505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Registered manager must complete his Registered Managers Award and NVQ in Care at Level 4 by November 2006. Date of last inspection N/A Brief Description of the Service: Oakleigh House is registered to provide accommodation and care for a maximum of six people who are between the ages of 18 and 65 and who have learning disabilities. At the time of this inspection there were two residents and four vacancies. Oakleigh House is a large terraced property which is situalted in a residential area of Teignmouth. It is within walking distance of the town, railway station and beach. The bed-sitting rooms are situated on the ground, first and second floors and there is a flight of steps leading to the front door so the home would not be suitable for people with poor mobility. All of the service users bedsitting rooms are single rooms and have en-suite bath or shower facilities and toilets. There is one large lounge/dining room (the second lounge is currently being used as an office), a kitchen, a communal bathroom and a communal toilet. There is a large terrace to the front of the house and private gardens to the back of the house. The home is staffed on a twenty-four hour basis. Oakleigh House D54-D07 S62352 Oakleigh House V214582 180505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Oakleigh House was registered on 8th December 2004 and this is the first inspection to be carried out. The inspection was announced and was carried out by one inspector from 9.50am to 4.00pm on Wednesday, 18th May 2005. The information provided in this report was gained in conversation with two service users, Mrs Ann Balchin (Responsible Individual) and Mr Christopher Bishop (manager) and the Deputy Manager, a Senior Support Worker and a Support Worker, who were all interviewed in private. Additional information was gained from a pre-inspection questionnaire, that had been completed by the manager, the Statement of Purpose and the Service Users’ Guide held on the Commissions files, an inspection of one resident’s written assessment and one resident’s care plan, records of the administration of medicines, the staff rota and a sample of staff files. A physical inspection was carried out of the premises and completed Comment Cards were received from both of the residents and a Case Manager. , What the service does well: Comprehensive assessments of the needs of people applying to live at Oakleigh House are carried out to ensure that the home will be right for them. The care planning system if very detailed and includes risk assessments and guidance for the staff on how to minimise risk. The level of support provided for each of the residents is based on his or her assessed needs. The residents are supported and encouraged to do as much as they can for themselves and to make decisions about their daily lives. The residents are encouraged to choose their own social, recreational and occupational pastimes and are given appropriate staff support. Appropriate family contact is encouraged. The residents have access to the complaints procedure in written, pictorial and audio format to ensure that they will be able to make a complaint if they are not happy with the service provided. Oakleigh House is well maintained, comfortably furnished and clean. The residents are encouraged to personalise their bed-sitting rooms by choosing their own colour schemes and by bringing in their own personal belongings. Oakleigh House D54-D07 S62352 Oakleigh House V214582 180505 Stage 4.doc Version 1.30 Page 6 Each of the residents is helped to write his or her own menu plan, but will be encouraged to eat a healthy, well balanced diet. The staff training programme is regularly reviewed to ensure that the staff will receive the training they need to meet the residents needs. 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 D54-D07 S62352 Oakleigh House V214582 180505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Oakleigh House D54-D07 S62352 Oakleigh House V214582 180505 Stage 4.doc Version 1.30 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 standard(s) 1 & 2 Prospective residents and their representatives have the information they need to make an informed choice about where to live. The initial assessment process is very thorough and identifies prospective residents needs. EVIDENCE: The Statement of Purpose was seen to contain all of the information needed to help prospective residents and their carers to make an informed choice about whether the home is right for them. However, both this document and the Service User’s Guides need to be updated to reflect the change of manager. A resident’s case file was inspected and contained a very comprehensive and well documented needs assessment. Risk assessments had also been carried out and recorded. Oakleigh House D54-D07 S62352 Oakleigh House V214582 180505 Stage 4.doc Version 1.30 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 standard(s) 6, 7, 8 & 9 Detailed care planning and risk management strategies ensure that the residents changing needs and personal goals are identified. Flexible support is provided to enable the residents to make their own decisions about their lives and to take risks as part of their individual lifestyles. EVIDENCE: One of the service users care plans was inspected and found to be very comprehensive. The care plans include clear and detailed risk management strategies, which the staff must sign and date to demonstrate that they have read and understood. There is no evidence that the residents have been directly involved in the care planning process. This was discussed with the manager who said that he was planning to involve the service users when they had become more settled. Each of the residents care plans include a section on ‘routines’ and on the care plan inspected this was blank. The manager explained that there were no routines and that the residents were encouraged to make his own decisions about their daily routines, with flexible support provided by the staff where Oakleigh House D54-D07 S62352 Oakleigh House V214582 180505 Stage 4.doc Version 1.30 Page 10 necessary. An observation of the interaction between the staff and the residents throughout the inspection supported this. The manager said that residents were invited to attend part of the monthly staff meetings and this was confirmed in interviews with the staff. Oakleigh House D54-D07 S62352 Oakleigh House V214582 180505 Stage 4.doc Version 1.30 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 standard(s) 13, 14, 15, 16, 17 The residents can participate in activities of their choice both within and outside their home. Appropriate family contact will be encouraged and facilitated. The residents eat healthy, nutritious and well balanced meals. EVIDENCE: The manager said that the staffing levels were flexible to enable the residents to go out when they choose to. On the day of the inspection there were three staff on duty this confirmed that both residents could have been taken out. One resident was taken shopping in Exeter. One of the residents has signed up for art classes twice a week and regularly attends the local Gateway Club and staff are available to escort him. The residents care plans identified that one of the residents has very close links with his family and that he visits them regularly. Oakleigh House D54-D07 S62352 Oakleigh House V214582 180505 Stage 4.doc Version 1.30 Page 12 There are no fixed routines but there are house rules, which have been written down, discussed and agreed with the residents and inform the residents of their responsibilities. The agreed rules include agreements not to display a range of anti-social behaviours and an agreement by the residents to keep their bed-sitting rooms clean and tidy. One of the residents said that she kept her room clear and tidy and this was seen to be true. Both of the resident’s care plans identify that they have special dietary needs and the menu plans provided demonstrate that they are both encouraged to eat healthy low fat, low sugar foods. The menus also provide evidence of variety and choice. Oakleigh House D54-D07 S62352 Oakleigh House V214582 180505 Stage 4.doc Version 1.30 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 standard(s) 18, 19 & 20 The residents personal support needs are met in a manner that encourages them to retain their independence and their emotional needs are met sensitively and with respect. The resident’s medication is handled conscientiously to minimise the risk of errors. EVIDENCE: The resident’s assessments, care plans and the pre-inspection questionnaire all identify that the residents need very little help with their personal care and that what help is given is done by prompting and encouragement rather than on providing ‘hands on’ support. The care plans also identify that the residents need a lot of emotional and psychological support and that this is provided sensitively. A Comment Card completed by one of the residents Care Manager’s, identified that manager and deputy manager have formed a good working relationship with the Teignbridge Learning Disability Team. Very positive comments were made about the progress that her client had made whilst living at Oakleigh House. Oakleigh House D54-D07 S62352 Oakleigh House V214582 180505 Stage 4.doc Version 1.30 Page 14 The staff training records identified that the resident’s medicines are administered by named staff who have received appropriate training. Both the storage and the records were seen to be satisfactory. No un-prescribed medicines are used. Oakleigh House D54-D07 S62352 Oakleigh House V214582 180505 Stage 4.doc Version 1.30 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 standard(s) 22 & 23 The provision of a written, pictorial and audio complaints procedure ensure that that is accessible to the residents. The residents are protected from abuse, neglect and self-harm. EVIDENCE: The complaints procedure is included in the Statement of Purpose and the Service Users’ Guide. It is available in a written, pictorial and audio format to ensure that it is accessible to the residents. The residents have access to complaints forms, which they can complete and address directly to the manager, to the service provider, to their case manager or to the Commission. Records have been seen of one complaint, which was dealt with appropriately. The homes policies and procedures on staff recruitment ensure that Enhanced CRB and POVA First checks are carried out on all staff. There are also policies and procedures on adult protection and the prevention of abuse. The manager demonstrated that he has a good understanding of adult protection issues, although the provision of training would provide further safeguards for the residents. Oakleigh House D54-D07 S62352 Oakleigh House V214582 180505 Stage 4.doc Version 1.30 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 standard(s) 24, 25, 26, 27 & 30 Oakleigh House provides a clean, comfortable, homely and safe living environment for the residents. EVIDENCE: An inspection of the premises was carried out. The home was seen to be wellpresented and a high standard of cleanliness is maintained. The safety of the residents has been considered and was evidenced through maintenance and associated records. Although there are six bed-sitting rooms with en-suite toilet facilities, one of these is currently being used as a staff sleeping in room. One of the residents invited an inspection of her room, which was seen to be clean and to clearly reflect her interest and lifestyle. Although the bed-sitting rooms had been decorated before the residents were admitted, the manager said that the resident’s rooms would shortly be redecorated according to their tastes. One of the residents said that she had chosen green paint and the other said that he had chosen blue. All of the residents bed-sitting rooms are lockable. Oakleigh House D54-D07 S62352 Oakleigh House V214582 180505 Stage 4.doc Version 1.30 Page 17 All of the residents bed-sitting rooms have en-suite bath or shower facilities and toilets. There is an additional communal bath and an additional communal toilet. The home has a large lounge/dining room. A smaller room was to be used as a quiet lounge when the home was registered but this is currently being used as an office. A second lounge will be needed when the number of residents increases. Oakleigh House D54-D07 S62352 Oakleigh House V214582 180505 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, 35 & 36 The staffing levels ensure that the assessed need of the current residents can be met. The staff are well supervised and supported by the manager and on-going staff training is provided to ensure that the staff are competent and qualified to meet the needs of the residents. The residents are protected by safe recruitment practices. EVIDENCE: From their assessments it has been calculated that each of the two residents needs one to one support during the day within their home environment. One needs one to one support to go out and the other needs two to one support. The manager said that there were at least two support workers on duty at all times and that three support workers were often employed to ensure that the residents could go out when they chose to do so. The staff rota was inspected and confirmed this. The format used to draw up the staff rota is to include six weeks rota on a single sheet of paper (A4) and use a coding system to identify hours worked. Oakleigh House D54-D07 S62352 Oakleigh House V214582 180505 Stage 4.doc Version 1.30 Page 19 These two factors make it very difficult to follow. The manager’s hours are not recorded and the rota can include the hours that the staff have worked at a different home, which is not appropriate. Although this does not effect the scoring of this standard, it is suggested that weekly rotas, showing the name, position and actual hours worked by the manager and each member of staff (excluding any hours worked at other homes) would provide a clear record. A staff training programme and record of staff training were seen and demonstrated that the training needs of the staff are being identified and that training courses are being booked to meet the staffs training needs. A copy of the staff induction training programme was seen and one of the staff interviewed said that she was to complete a six month foundation training course. Several members of staff have hold NVQ qualifications in Care and some are working towards gaining their NVQ’s and/or working towards gaining NVQ’s within the Learning Disability Award Framework. Records were seen of regular staff supervision and staff appraisals. The staff records demonstrated that the homes recruitment practices are satisfactory. Oakleigh House D54-D07 S62352 Oakleigh House V214582 180505 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The health, safety and welfare of the residents are promoted and protected through the homes policies, procedures and practices. EVIDENCE: Most of the required policies and procedures were seen to be in place. The manager is working towards redrafting some of the policies and procedures from the Croner manual to ensure that they all relate specifically to Oakleigh House. A sample of the risk assessments have been carried out all working practices was inspected. Records have been seen to demonstrate that gas appliances and electrical systems have been checked. Records were seen to demonstrate that the staff have received training in fire safety and routine checks are being carried out of the fire safety equipment. Oakleigh House D54-D07 S62352 Oakleigh House V214582 180505 Stage 4.doc Version 1.30 Page 21 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 4 x x x Standard No 22 23 ENVIRONMENT Score 4 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 4 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 x x 3 3 3 3 4 Standard No 31 32 33 34 35 36 Score x x 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oakleigh House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x D54-D07 S62352 Oakleigh House V214582 180505 Stage 4.doc Version 1.30 Page 22 N/A 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 1 Regulation 4&5 Requirement The Statement of Purpose and needs to be updated to reflect the change of management. The Service Users Guides also need to be updated and revised copies must be given to each of the residents. Amended copies of both documents must be sent to the Commission. Timescale for action 18/7/05 2. 3. 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. 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