CARE HOME ADULTS 18-65
Oakley Care Home 21 Norton Road Heysham Lancashire LA3 1HA Lead Inspector
Mrs Marie Cordingley Unannounced Inspection 10th August 2007 10:00 Oakley Care Home DS0000069017.V338536.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 Oakley Care Home DS0000069017.V338536.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. Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Oakley Care Home Address 21 Norton Road Heysham Lancashire LA3 1HA 01524 831554 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) Mrs Jane Gilmour Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The registered person may provide the following categories of service only. Care home only - code PC, to service users of the following gender:Either. Whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 3 Date of last inspection 8th March 2007 Brief Description of the Service: Oakley Care Home is a small home registered with the Commission to provide care and accommodation for up to three younger adults with mental health needs. However, at the time of the visit there were only two residents at the home and there were no plans to admit a third person. The home is situated in the Sandylands area of Morecambe close to a number of facilities and amenities. Whilst care is provided on a 24 hour basis, the home is managed in a very informal manner and has a family like environment. Residents health care needs are met by community professionals such as district nurses and doctors. At the time of the inspection fees at this home were £283 weekly. Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection of this home included a site visit which took place over the course of several hours. The visit was unannounced which meant that the manager and residents did not know it would be taking place until we arrived. During the visit we spoke with both the people who live at the home and the manager. We looked at a variety of documents and carried out a tour of the home. Prior to the visit we asked the manager to complete a detailed self assessment form. This gave us a lot of information about how the home is managed and the quality of the service provided. We also sent residents, their families and other professionals such as social workers, questionnaires asking for their views about the home. We received a good response to these surveys. What the service does well:
We received a number of completed surveys prior to our visit and these included very positive responses and comments. Residents told us that they liked living at the home and were able to make every day choices in their lives. Surveys received from family members were also very positive. One relative said the manager ‘’ encourages independence without being too expectant or demanding’’ and also stated that the manager understood the needs of their loved one, communicated well with her and provided companionship and stimulation in pleasant home surroundings. Community professionals who took part in our survey said that the manager respected peoples’ privacy and dignity and responded well to the different needs of people living at the home. When we talked with people who live at the home they told us that they were very satisfied with the service provided. One resident said ‘’I am very happy here with Jane (the manager) we get on very well, I feel safe with her.’’ Residents expressed satisfaction with all aspects of their life at Oakley and were complimentary about areas such as meals and activities. Oakley is a very small home and care is provided in a family like environment. There are no staff employed there so all the care is provided by the manager. This close daily contact means that the manager has a very good understanding of the residents and an in-depth knowledge of their needs. It
Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 6 also enables the manager to quickly identify and act on any concerns in relation to a resident. As Oakley is such a small home, daily routines such as meal times and activities can be very flexible. As such, residents have increased opportunities to make everyday choices. Residents at this home are provided with a good standard of accommodation which is well maintained and nicely furnished. During the visit we found that all areas of the home were clean, warm and comfortable. . What has improved since the last inspection?
The current manager took over this home approximately six months ago and has made a number of positive changes in this time. A number of written policies have been implemented which describe how the manager deals with certain areas, such as assessing risk and ensuring the safety and wellbeing of residents. All records within the home have been reviewed and updated where appropriate. Residents’ care plans have been expanded to include more information and guidance. The manager has changed the way that meals are planned and now holds a weekly meeting with residents to ensure that menus are developed in line with their personal preferences. More activities have been made available and residents have also been given the opportunity to go on holiday. Residents spoke about this during our visit and said that they were very much looking forward to their holiday, which is planned for next year. Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 7 All residents who wish to look after and manage their own medication are now asked to sign a statement confirming that they are fully aware of their rights and responsibilities in this area. In line with a recommendation made following the home’s last inspection, medication administration records have now been improved and contain more information about individual medicines. What they could do better:
It has been difficult for small homes such as this one to adapt to new ways of working which are now required in line with the Care Homes Regulations and National Minimum Standards. The National Minimum Standards require care homes to work in a more formal manner and in line with written policies and procedures, which should be in place for all aspects of the management of the home. The manager has made some good progress in implementing these formal systems but there still remain a small number of policies and procedures that need to be put in place. However, throughout this and previous inspections we have found that this shortfall in relation to paperwork and records does not have a negative impact on the quality of care provided. It is recommended that the manager carries out a review of all written policies, procedures and written records and implements all those which are still outstanding. Medication stores within the home need to be kept in a locked cupboard for security and to ensure the safety and wellbeing of residents. We discussed the area of quality monitoring with the manager and we recommended that the manager implement a formal quality assurance system. The process should ensure that the views of people using the service and their representatives are regularly sought. In discussion, the manager demonstrated a commitment to ensuring that peoples’ rights are upheld and that people should be encouraged to make decisions and express their views. We agreed that people living at the home could benefit from the support of independent advocates to assist them in this area and recommended that the manager research local advocacy groups and make their details available to residents. Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 8 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. Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 9 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 Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager will ensure that she can meet the needs of any prospective resident before offering them a place at the home. EVIDENCE: There is a basic Service User Guide in place which gives details of the service provided and some information about daily life at the home such as activities available. This document is made available to any person who is considering a move to the home and their representatives. Both of the people who live at the home have done so for many years and there are no plans to admit a third person for the foreseeable future. In discussion, the manager told us that she would be very careful to ensure that any new person who came to live at the home would be suitable and compatible with the existing residents. The process of assessment was discussed. The manager was aware of the importance of obtaining thorough information about a prospective resident’s needs, so as to ensure that their needs could be met at the home. In addition, Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 11 obtaining this level of information would enable her to put a detailed plan of care in place before they arrived. Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 12 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 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care is planned in line with peoples’ individual needs and wishes. People are encouraged to make decisions and express their opinions. EVIDENCE: There are individual plans in place for each resident which outline their care needs and how these needs are to be met. One resident we talked to was aware of her plan and told us that she had been involved in its development. Since the last inspection, individual plans have been reviewed and now contain more relevant information to ensure that residents’ changing needs are addressed. In discussion, the manager recognised that residents should be encouraged to make their own decisions and would at times need support to do so. Residents told us that they were encouraged to make their own choices and decisions at
Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 13 all times. We recommended that the manager research local advocacy groups available and make their details available to the people living at the home. The manager demonstrated a good approach to risk taking and recognised that well planned and managed risk taking can be an aid to a resident’s personal growth and development. The manager had systems in place to assess individual risks associated with new activities for instance, and where appropriate, measures were in place to reduce such risks without removing a person’s opportunity for personal development. Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 14 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 good. This judgement has been made using available evidence including a visit to this service. People who live at this home are supported to choose how to spend their time and take part in activities that they enjoy. EVIDENCE: We spoke to both people who live at the home about how they spend their time. They told us about the various activities they carried out on a regular basis. One resident takes part in supported employment several days each week and told us that she enjoyed this very much. In addition, this resident had a number of hobbies and had recently taken up swimming with the support of the manager. Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 15 The other person who lives at the home is retired and has a number of hobbies he enjoys. In particular, he enjoys watching Western movies. The manager had recently assisted him to find some new films to add to his collection. Residents also told us how they enjoyed going out to Heysham Village and with the manager for drives to places such as Blackpool. Both residents were very much looking forward to a holiday planned for next year. The residents had chosen the location themselves after looking though brochures with the manager. People who live at the home were very complimentary about the food provided there. They said that they were happy with the choices provided and the quality and variety of food available. Weekly menus are now developed in conjunction with residents to ensure that their individual choices are taken into account. One resident is becoming increasingly involved with the food preparation and told us that she was enjoying learning these new skills. Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 16 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’ health and well being is closely monitored. Residents are supported to access health care when they need it. EVIDENCE: Oakley is a small home and presently there are only two residents living there. There are no staff employed at the home and all the care is provided by the manager. As such, the manager has a very good knowledge of the residents and their individual needs. One resident told us that the manager was very supportive and described several ways in which she was provided with emotional and practical support on a daily basis. Each resident has an individual plan in place which includes information about their health care needs. Records are also kept to demonstrate that people
Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 17 living at the home are regularly visited by health care professionals such as community psychiatric nurses. We received a written survey from one health care professional who told us that the manager of the home always incorporated any advice she gave in the appropriate resident’s individual plan. She also told us that the manager showed a good understanding of the residents’ needs. There are basic procedures in place which cover the receipt, storage, administration and disposal of medication. We viewed a selection of medication administration records which were in good order with no errors or omissions. One person who lives at the home has chosen to manage her own medication and she has been supported in this decision by the manager. Appropriate risk assessments and a written agreement are in place in relation to this. The storage of medication was discussed. Currently the majority of medication is kept in a locked cupboard. However there are some items which are not locked away. The manager was advised that all medication must be locked away for security purposes and to ensure the safety and wellbeing of residents. Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to voice any concerns they have. There are systems in place to help protect residents from all forms of abuse. EVIDENCE: People who live at this home have close daily contact with the manager and as such, regular opportunity to express views and discuss concerns. However, there is a danger that this close contact may make it more difficult for residents to complain. This issue was discussed with the manager who was well aware of the possible difficulties and told us that to counter this she regularly spent time with residents asking them how they felt about certain aspects of the service. We talked to residents about voicing concerns and they told us that the manager would want to know if anything was worrying them. One resident said ‘’I think Jane would sort it out if I wasn’t happy about something.’’ The home has a complaints book in place. We viewed this and found that there had been no complaints made since the last inspection. In addition, the Commission for Social Care Inspection have not received any complaints about this home since its registration. Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 19 The manager of the home has undertaken training in Safeguarding Adults and is fully aware of the procedures to be followed in the event that an incident of abuse is alleged or suspected. Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 20 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. People who live at this home are provided with comfortable, homely accommodation which is decorated and furnished to a high standard. EVIDENCE: This home is conveniently located in the Heysham area of Morecambe. It is within walking distance of the beach and close to a number of facilities and amenities. At the time of our visit we found the home was clean and comfortable and all areas were nicely decorated and furnished. Both residents have their own lockable bedrooms which are nicely decorated and filled with personal items such as pictures and ornaments. There are a variety of communal areas to use including several lounges and safe outdoor space.
Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 21 There are basic infection control procedures in place which outline the manager’s approach to ensuring that any infection is not spread within the home. Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 22 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): None of the above standards are relevant as there are no staff employed at this home. EVIDENCE: Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 23 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, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Oakley is a well managed home which is run in the best interests of people who live there. EVIDENCE: The current manager of Oakley took over the home approximately six months ago. During this time she has made some positive changes. The manager told us about some of the changes that she has made which include increasing the variety of activities available and ensuring that residents have the opportunity to go on a holiday at least once each year. Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 24 Both residents appeared comfortable and relaxed in the presence of the manager and told us that they were very happy living at the home. The area of quality monitoring was discussed during the site visit. We were able to confirm that the manager has measures in place to ensure that residents have the opportunity to express their views and opinions about the running of the home. However we also recommended that the manager implement a formal quality assurance process. The process should ensure that the views of people using the service and their representatives are regularly sought in a more formal manner. The manager has continued to develop a number of written polices and procedures in line with the Care Homes Regulations and National Minimum Standards. We recommended that she continue this process until all the necessary policies and procedures are in place There are a number of measures in place to help ensure the health and safety of residents including fire safety and infection control procedures. In addition, information completed by the manager confirmed that a number of safety checks are regularly carried out within the home including gas and electric appliances. The manager of this home has completed training in the key health and safety areas including moving and handling and food hygiene. She has plans in place to refresh this training on a regular basis. Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 25 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 3 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 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 N/A 32 N/A 33 N/A 34 N/A 35 N/A 36 N/A 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 2 x 3 x 2 x x 3 x Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 26 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 YA20 Regulation 13 Requirement All medication must be kept in a locked cabinet at all times. Timescale for action 30/09/07 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 YA13 YA40 Good Practice Recommendations Residents rights to vote should be included in the Statement of Purpose. An audit should be carried out against Appendix 3 of the National Minimum Standards to determine which policies and procedures are still outstanding. Those still outstanding should be developed and implemented. Internal quality monitoring systems that are informed by the views of residents and their representatives should be implemented. An accountants letter confirming financial viability should
DS0000069017.V338536.R01.S.doc Version 5.2 Page 27 3. YA39 4. YA43 Oakley Care Home be forwarded to the Commission for Social Care Inspection. 5. 6. 7. YA17 YA37 YA7 An audit should be carried out of all the records in the home to ensure that all records required by the Care Homes Regulations are in place. The manager should complete the registered managers award. The manager should research local advocacy services and make their contact details available to residents. Oakley Care Home DS0000069017.V338536.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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
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