Inspection on 08/03/07 for Oakley Care Home

This inspection was carried out on 8th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oakley Care Home 10/08/07

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

CARE HOME ADULTS 18-65 Oakley Care Home 21 Norton Road Heysham Lancashire LA3 1HA Lead Inspector Mrs Marie Cordingley Unannounced Inspection 8th March 2007 10:00 Oakley Care Home DS0000069017.V333738.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.V333738.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.V333738.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.V333738.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 19th December 2005 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. Oakley Care Home DS0000069017.V333738.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. As part of the inspection process information was gathered from a number of sources. The manager was sent a very detailed questionnaire asking questions about the written guidance in place for a number of areas such as health and safety and employment. The questionnaire also asked for details of safety checks on equipment such as fire alarms and gas appliances. In addition, surveys were sent to the two residents and visiting health care professionals about their opinions of standards of care in the home. Whilst the residents did not return the surveys the inspector was able to talk to them about their opinions during the site visit. As part of the inspection, a site visit was carried out. This was an unannounced visit which meant that the manager and residents did not know it would be taking place. During the site visit the inspector spent a long time talking to residents and the new manager of the home. Some documents were viewed and the inspector did a tour of the home viewing the private and communal areas. Following this inspection the home continues to be assessed as a good home. The current scale of charges for this home are £283 weekly. What the service does well: This is a very small, family like care home and currently there are only two residents living there. There are no staff employed at the home and all the care is provided by the registered manager. The manager has a very good knowledge of the residents and their needs and is able to quickly recognise and address any issue that should arise. The close contact that the manager has with the residents on a daily basis enables them to voice any concerns they may have. The small size of this home means that the two residents have a lot of opportunities to exercise choice in their daily lives. Bedtimes and mealtimes for instance, can be very flexible due to the fact that there are only two residents living there. Oakley Care Home DS0000069017.V333738.R01.S.doc Version 5.2 Page 6 At the time of the inspection the two residents appeared relaxed and happy. They both said that they got along very well with the manager and liked living at Norton Road. The residents were complimentary about the food provided and were also happy with the activities available within the home. Accommodation at Norton Road is provided to a very high standard and at the time of the visit, the home was found to be warm and comfortable. All areas of the home were nicely furnished, decorated and clean throughout What has improved since the last inspection? What they could do better: It has been a difficult task for family like homes such as this one to adapt to new ways of working since the introduction of National Minimum Standards. The National Minimum Standards require care homes to work in a formal manner and in line with written polices and procedures which they should have in place for all aspects of the home’s management. In addition, the standards require that a number of different records are kept, such as daily records of all food served to residents. Whilst the home has made some progress in implementing these formal systems, there are still a number of records and policies and procedures which need to be put in place. However the inspector has found during this and previous inspections that these shortfalls in relation to paperwork and records do not have any negative impact on residents’ care. Oakley Care Home DS0000069017.V333738.R01.S.doc Version 5.2 Page 7 All medication within the home needs to be locked away to ensure the safety and wellbeing of residents. Residents who are managing their own medication should be requested to sign a written statement confirming that they are fully aware of their rights and responsibilities in this area. 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.V333738.R01.S.doc Version 5.2 Page 8 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.V333738.R01.S.doc Version 5.2 Page 9 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 admitting them to the home. EVIDENCE: There is a basic Statement of Purpose and Service User Guide in place that give details about the home and the services offered there. There have been no new residents admitted to the home for several years and at the present time there are no plans to admit a third resident. However, in discussion the manager demonstrated a good understanding of the importance of ensuring that any new resident admitted is compatible with the existing group. The manager was also aware of the importance of gaining enough information about a prospective resident and their needs, to ensure that they could be cared for properly in the home and that a thorough plan of care could be put in place before their arrival. Oakley Care Home DS0000069017.V333738.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 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are carefully considered when developing their care plan. Residents are encouraged to make decisions and live as independently as possible. EVIDENCE: There are basic written care plans in place for each resident. These plans describe the residents’ needs and what the manager must do to meet these needs. The care plans cover areas such as personal care and socialising and are written in a user-friendly manner. Oakley Care Home DS0000069017.V333738.R01.S.doc Version 5.2 Page 11 Residents are encouraged to try new experiences. Sometimes this may mean that an element of risk is involved and if so, written risk assessments are completed to make sure the residents have all the help they need. It was confirmed that all residents’ personal information is kept in a locked cabinet that only the manager has access to. Oakley Care Home DS0000069017.V333738.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 good. This judgement has been made using available evidence including a visit to this service. Residents are able to choose how they spend their time and are supported to engage in activities they enjoy. EVIDENCE: One of the residents at the home takes part in supported employment several days each week. In discussion with the inspector she said that she enjoyed this activity and especially liked spending time with her friends at work. The resident also told of how she enjoyed spending her free time venturing into Heysham Village, to do a bit of shopping and visit cafes. The other resident is now retired and has a number of hobbies including western movies. He spoke of how he liked to watch a western film every day and how the manager helped him find a suitable film and put it on at the correct time. Oakley Care Home DS0000069017.V333738.R01.S.doc Version 5.2 Page 13 In discussion, both the residents commented on how they enjoyed spending time together and told of how they often went on shopping trips and café visits as a couple. Heysham village is a manageable walk from the home and sometimes the residents take the bus for a change. The new manager has a car and both residents have already enjoyed drives out with her. During the site visit, the manager explained that she had spent some time with both of the residents asking them which places they would like to visit. As a result, plans to visit places such as Blackpool and Cleveleys had been agreed. In discussion with one resident it was evident that she received support from the manager to maintain contact with her parents. She spoke of how she telephoned them every evening and also said how much she enjoyed spending weekends with them. She also confirmed in discussion that she would feel happy to invite her friends to her home at any time. Both residents were complimentary about the food provided at the home. One resident said ‘’Jayne (the manager) is a very good cook, she always makes nice food.’’ The other resident said ‘’I like everything here, there’s nothing I don’t like.’’ Records of meals served confirmed that residents are provided with an appealing, varied and nutritious diet. Both residents confirmed that they were able to choose what they wanted to eat and have snacks or drinks whenever they felt like them. However, to further improve in this area the inspector recommended that the manager develop menus on a weekly basis in conjunction with the residents therefore giving them the opportunity to choose the meals for the week. Oakley Care Home DS0000069017.V333738.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’ health and general wellbeing is closely monitored and advice is sought promptly when issues are identified. EVIDENCE: This is a very small home and there are no staff employed there. The manager provides all the care herself and has very close daily contact with both residents. As such she has an extremely good knowledge of the residents and their likes and preferences. Both residents appeared to be very relaxed and happy in their surroundings and both commented that they got along very well with the manager of the home. Care plans are in place for both residents and in discussion it was confirmed that these are reviewed on a regular basis and always after any significant events. It was also confirmed that care plans contained good information about residents’ daily care needs, likes and dislikes. Oakley Care Home DS0000069017.V333738.R01.S.doc Version 5.2 Page 15 Residents at the home receive health care from a number of visiting professionals, including a general practitioner and community psychiatric nurse. One nurse completed a survey for the Commission in which she confirmed that the manager had a good understanding of residents’ needs, communicated effectively and always incorporated any advice given in relation to a specific resident in their care plans. There are basic medication procedures in place that outline how the manager will ensure the safe ordering, storage, administration and disposal of medication. Medication Administration Records were viewed and found to be appropriately completed with no errors or omissions. However, some medication stock was found to be stored in a cupboard which was not locked. The manager was advised to ensure that medication is kept in a locked cupboard at all times. A recommendation was also made to include names of individual medications on Medication Administration Record sheets to avoid any confusion and reduce the risk of errors in administering tablets. One of the residents who lives at the home takes care of her own medication and in discussion it was confirmed that the appropriate risk assessments had been carried out in relation to this. However, it was recommended that a signed disclaimer be obtained from the resident to demonstrate that she is full aware of her rights and responsibilities. Oakley Care Home DS0000069017.V333738.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. Any concerns raised by residents are dealt with appropriately. The manager of the home is aware of her responsibilities to protect residents from all forms of abuse. EVIDENCE: Due to the small size of the home the residents have very close contact with the manager on a daily basis, and lots of opportunity to discuss their views and opinions or express any concerns. In discussion, the manager recognised that it may be difficult for residents to make complaints and to help in this area she explained that she regularly talked to the residents asking them if they had any concerns or complaints. Residents appeared very relaxed in the company of the manager and in discussion, one resident confirmed that she would be comfortable in raising any issue that she had. She said ‘’I am sure Jayne ‘the manager’ would want to know and sort it out if I was upset about anything.’’ There is a complaints book in place which confirmed that there have been no complaints made since the home’s registration in 2002. In addition, the Commission have not received any concerns or complaints about the home. Oakley Care Home DS0000069017.V333738.R01.S.doc Version 5.2 Page 17 In discussion the manager demonstrated a good understanding of safeguarding adult procedures and also confirmed that she had received training in this area in her previous employment. It was confirmed that there was a copy of the Department of Health Guidance ‘No Secrets’ in the home which outlines the processes that should be followed in the event that an incident of abuse has occurred. Oakley Care Home DS0000069017.V333738.R01.S.doc Version 5.2 Page 18 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. Residents at this home live in a comfortable, clean home which is decorated and furnished to a high standard. EVIDENCE: Oakley Care Home is conveniently located in the Heysham area of Morecambe. It is close to the beach and within easy reach of a number of facilities and amenities. The home is very well maintained and furnished to a high standard. At the time of the unannounced site visit it was found to be clean, warm and comfortable. Both residents have their own bedrooms and there are a variety of communal areas for them to access including two lounges and well kept, safe outdoor space. Oakley Care Home DS0000069017.V333738.R01.S.doc Version 5.2 Page 19 The manager has implemented basic infection control procedures which describe what she will do in the event that there is an outbreak in the home. She has obtained the necessary equipment including gloves, aprons and dispersible laundry bags. She also confirmed that she had received training in this area in her previous employment. Oakley Care Home DS0000069017.V333738.R01.S.doc Version 5.2 Page 20 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): There are no staff employed at this home therefore the standards in this section are not applicable. EVIDENCE: Oakley Care Home DS0000069017.V333738.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, 39, 40, 41 & 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is managed well and in the best interest of residents. EVIDENCE: In discussion the newly registered manager described how she carefully considered the impact her arrival at the home would have on the residents. The previous manager had worked at the home for over twenty years and had developed very close relationships with the residents. To help the residents cope with the change, the new manager spent time with them, and their families, discussing their concerns prior to her arrival. It was apparent that the residents had coped very well and both stated that they felt happy and settled with the new manager. Oakley Care Home DS0000069017.V333738.R01.S.doc Version 5.2 Page 22 The manager has many years experience in the care sector and has also completed a National Vocational Qualification in care at level 3. In discussion, she demonstrated a good understanding of her role and the needs of the residents. The area of health and safety was discussed and it was confirmed that the manager has completed training in all five mandatory areas, ie. moving and handling, fire safety, infection control, food hygiene and first aid. In addition, the manager has made arrangements to receive refresher training when this is due. There are no formal quality assurance systems in place. However, the manager is able to closely monitor all aspects of the service due to the size of the home and the regular contact she maintains with the residents. The manager has implemented some written policies and records since her arrival at the home including infection control and records of food served. However, to fully comply with the National Minimum Standards there are some additional policies and records that should be implemented. Despite this fact, the inspector was satisfied that the absence of some records and policies did not have a detrimental effect on the wellbeing of service users. Oakley Care Home DS0000069017.V333738.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 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 2 X 2 X X 2 X Oakley Care Home DS0000069017.V333738.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? yes 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. 2. 3. Standard YA41 YA20 YA20 Regulation 17 13 13 Requirement Timescale for action 30/06/07 All records as stated in the Care Homes Regulations 2001 must be maintained within the home. All residents’ medication must be 15/03/07 kept in a locked cabinet at all times. A signature should be obtained 15/03/07 from all self-medicating residents confirming that they are all fully aware of their rights and responsibilities. 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 DS0000069017.V333738.R01.S.doc Version 5.2 Page 25 3. YA39 Oakley Care Home 4. 5. 6. 7. YA43 YA17 YA37 YA20 implemented. An accountants letter confirming financial viability should be forwarded to the Commission for Social Care Inspection. Weekly menus should be devised in conjunction with residents. The registered manager should complete the registered managers award. Names of individual medications should be included on the Medication Administration Records. Oakley Care Home DS0000069017.V333738.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way 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 © 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 Oakley Care Home DS0000069017.V333738.R01.S.doc Version 5.2 Page 27 - 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. 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