Inspection on 25/10/05 for Oaklodge

This inspection was carried out on 25th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Oaklodge 21/09/06

Oaklodge 09/06/05

Oaklodge 26/10/04

Oaklodge 21/04/04

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Snydale Care Home

Hawkhills

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Ravensworth Lodge

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

CARE HOME ADULTS 18-65 Oaklodge 11 Oak Villas Manningham BRADFORD BD8 7BG Lead Inspector Stevie Allerton Announced 25 October 2005 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. Oaklodge 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Oaklodge Address 11 Oak Villas Manningham BRADFORD BD8 7BG 01274 546 920 01274 546 920 oaklodgecarehome@btopenworld.com Mr Ronald Berry 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) Mr Anthony Cook Care Home 30 Category(ies) of Mental Disorder (25) registration, with number Old Age (5) of places Oaklodge 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The places for OP are for the service users specified in the letter dated 29th April 2004 only. Date of last inspection 09 June 2005 Brief Description of the Service: Oak Lodge provides care and support for up to 30 men and women with mental health needs, for those aged 18 - 65 years of age on admission, although some older service users are accommodated. There are facilities for regular respite care for those living independently who require additional support. The home does not provide nursing care. It is one of a group of homes owned by Mr and Mrs Berry and is managed by Tony Cook on their behalf. Oak Lodge is a large detached property located in the Manningham area of Bradford, close to public transport systems, shops and local community facilities. Bedrooms are on three floors, with communal rooms on the ground and lower ground floors, all accessible by passenger lift. The house stands in its own grounds, with good car parking facilities. Oaklodge 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was arranged in advance and was carried out by one inspector over a full day. It was the second in a cycle of two inspections planned for the year commencing 1st April 2005. The previous visit was unannounced and took place in June. Posters, comment cards and other pre-inspection material were sent out to the home in advance, so that service users, visitors and staff could prepare for the inspection. One comment card was returned, which contained very positive views on the service. The inspector spoke to four of the service users at some length and had contact with more in the dining room. Discussions also took place with the Manager, Deputy and other support staff, including the line manager for the home. Some records were looked at and a tour of the premises was made. What the service does well: What has improved since the last inspection? The external appearance of the home has been tidied up since the last inspection. The dining and living areas on the ground floor have also been redecorated and new furniture provided, giving a much brighter aspect to what had previously been quite a dark area. Oaklodge 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 Page 6 The Manager has become more confident in implementing Adult Protection procedures in order to protect service users’ best interests. 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. Oaklodge 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 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 Oaklodge 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 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) 4 There is a good introduction process for service users referred for admission to the home, which is flexible in response to the person’s needs. EVIDENCE: The inspector had observed an introductory visit during the last inspection; that service user had decided to stay for a trial period of four weeks and had then made a decision to stay for a longer period. There was a vacant place at the time of inspection and a prospective service user assigned to that room, if they wished. The Manager advised that this might be a slow process to get the person admitted, as they had been in hospital for 2 years. They had made one visit to see the vacant room and were due back for a second visit, to spend a bit more time in the home and meet other service users. Oaklodge 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 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) 8 & 10 There are appropriate opportunities for service users to take part in day-to-day decisions about their home, though some choose not to be involved. Staff have a good level of awareness of confidentiality and disclosure issues and appear to manage sensitive information well. EVIDENCE: Four care plans were examined in depth, in relation to Standards 8 & 10; the findings were verified in discussion with service users, where possible, with staff and through observation during the course of the day. Records showed that service users were involved in their own care plan agreements, which were based on assessed levels of risk. Service users also said that they spoke to the staff, on an informal basis mainly, regarding day-to-day decisions around the home; this was echoed by the staff, who had recently involved service users in choosing the new chairs and what colour to decorate the dining room. Oaklodge 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 Page 10 House meetings take place sporadically, the last one held about 3 months ago. Service users said they were aware of the house meetings, but preferred to raise things directly with the Manager as they occur. Service users are aware of records made about them, as seen in the written agreements within the care plans. Staff spoke with knowledge about confidentiality and disclosure issues and the management of sensitive information. Oaklodge 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 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) 12 & 15 Staff could provide greater input in order to motivate and encourage service users to do something positive and useful with their day. House rules regarding visitors are clearly understood, if sometimes broken, and staff are prepared to take action if they feel a situation has become risky. There is clarity within individual care plans regarding permitted contacts with family members. EVIDENCE: Some service users who were spoken to said that they were bored and found it difficult to say what they actually did with their time, other than drink alcohol. Others are well motivated and have friends and interests outside the home, so spend a good deal of time out and about. Asian service users are in the minority and have been encouraged to make contact with an Asian day centre, in order to meet with people who share a similar culture, but many choose not to attend. Contact has also been made with Asian advocacy workers. Oaklodge 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 Page 12 Service users can receive visitors in the home, as long as they do not cause problems for other people; this appears to be clearly understood by service users and staff and there was evidence of night staff making a good judgement call regarding a visitor that they felt was placing a service user at risk. Care plans state whether there are legal arrangements in place and the circumstances in which contact with family members can be had. Oaklodge 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 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) 20 There are proper arrangements in place for the safe storage, handling and recording of medication. Staff have a good level of knowledge about the effects of both prescribed and illicit drugs. EVIDENCE: Medication is stored in a room specifically for that purpose and is currently being dispensed from that room, in response to a recent theft of drugs from the mobile cabinet whilst in use in the dining room. This has prompted the staff team to review storage arrangements and the layout of the medication room is to be altered to increase security. The Deputy Manager went through the process for ordering and receiving prescribed drugs and returning those no longer needed. There is a policy for those service users who can self-medicate, which is assessed for potential risk, and this is clearly recorded. Some service users are prescribed medication on an “as and when necessary” (PRN) basis. This was explored with the staff, who were very clear about how and when this is used. The triggers and the processes were seen, written into the care plans, the staff on duty reaching a joint decision and the senior in charge using their judgement as to whether this needs to be referred to an offduty Manager or external health care professional. Records are kept. Oaklodge 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 Page 14 The home works well with the Assertive Outreach Team, reviewing and adjusting prescribed medication to achieve the optimum balance. There is a good level of knowledge amongst the staff team about the effect of illegal drugs and how they affect prescribed medication. There was clear recording seen when night staff have taken the decision not to give someone their prescribed night-time medication, due to illicit drugs having been taken. There is a clear policy within the home regarding the use of illicit substances on the premises. Oaklodge 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 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) 23 Staff appear to be much clearer about issues of Adult Protection and are using risk assessment as a good tool to protect individuals who may be vulnerable. Adult protection procedures have been used effectively. EVIDENCE: There has been a lot of input to the staff team in the form of Adult Protection training over the past few months. The Manager advised that there had also been discussions with the staff team regarding personal relationships and professional boundaries. The Manager has demonstrated willingness to implement Adult Protection procedures, following a recent incident. Staff and volunteers are vetted appropriately, prior to working with the service users. Oaklodge 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 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, 28 & 30 Service users’ rooms meet their needs and there is a range of communal areas that are well used. The environment does suffer damage and extreme wear and tear, but there is good input from the group’s handyman service. Some of the communal carpeted areas (the stairs in particular) would benefit from thorough cleaning. The kitchen was not clean. The kitchen staff do not appear to be adhering to the established cleaning schedules, nor were they storing food in the pantry appropriately, without prompting. EVIDENCE: A tour of the building took place. Two service users’ bedrooms were seen, along with communal living areas, the laundry and kitchen. The home was found to be reasonably decorated and furnished, some areas having recently been done and others in need of attention. Communal carpeted areas, in particular the stairs, were stained and would benefit from carpet shampooing. The dining & living room on the ground floor had been refurnished and decorated and seemed much brighter than before. Service users had been involved in choosing the furniture and so on. Oaklodge 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 Page 17 One of the bedrooms seem had been redecorated following a fire in that room and was awaiting completion. A bedroom was also seen on the lower ground floor that provided bed-sit type accommodation, having an en-suite bathroom. The service user whose room it is said that he was very pleased with his accommodation and that it provided him with more independence. He had a set day each week when he cleaned it. The small lounge on the lower ground floor that is used by smokers had some areas of damage that needed to be attended to. The service users pointed this out to the Manager, who arranged with the handyman to attend to these right away. They also said that they could not watch TV very well, as the aerial had gone missing. The Manager said that he would get this replaced. There is a large laundry room on the lower ground floor that service users can use, with assistance from staff as necessary. The kitchen is also situated on this floor, meals being delivered to the servery upstairs via “dumb waiter”. On the day of inspection the kitchen was found to be lacking in general cleanliness. There are measures in place to maintain good hygiene, such as disposable aprons for anyone entering the kitchen, fly screens at the window and cleaning schedules; however, these were not effective. The fly screens were in need of cleaning and the items on the cleaning schedule appeared not to be being done routinely. There was a problem with the storage of dry foodstuffs in opened packets in the pantry, instead of in proper containers; this was rectified on the day after it was pointed out. Oaklodge 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 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 Service users are supported by a staff team that has been recruited on their personal attributes and trained for the work that they do. EVIDENCE: The Manager advised that there had been a fair amount of staff turnover during this year, which had had implications for staff training. They had been concentrating on the new staff’s induction training, so had done more informal in-house support for staff, discussions and so on, rather than formal training. Other staff members spoken to confirmed that there was a current shortage of permanent staff, but that the rota was covered by the use of overtime and that the existing staff were a good team. Current vacancies are for a care worker and an activities organiser. The Manager said that recent recruitment efforts had been responded to by a poor calibre of applicant and that he felt it was more important to recruit individuals with the correct attitude. It was noted on this, as on previous inspections, that the handyman is seen very much as part of the staff team. The staffing reflects the cultural spread of service users supported at the home; two workers are bi-lingual or know key words in other Asian languages, which aids in communication with Asian service users. Oaklodge 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 Page 19 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) 39 & 42 Service users are encouraged to express their views and be involved in decisions about their home. There is a suitable mechanism in place for continuous review and development, which should be expanded to monthly visits to satisfy the requirements of the Care Homes Regulations. Health and Safety is taken seriously and risk assessments reflect behaviour and lifestyle issues as well as the safety of the premises. EVIDENCE: The company has an internal audit system, currently done quarterly, which looks at the care, the environment and the people working in the service. This material was looked at during the inspection. It has identified areas to concentrate on and the home’s line manager said that they were in the process of developing a new monthly audit from this, which would satisfy the requirements of Regulation 26. Oaklodge 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 Page 20 There is also a “Customer Comment and Feedback” survey, which again has led to an improvement plan being formulated. Service users’ meetings are held infrequently on an “as and when” basis; service users spoken to said they knew about the meetings, just preferred talking to the Manager about things as they arise. That was evident from exchanges that were observed during the inspection. The Manager is clearly approachable by staff as well as service users; it was seen from the records that night staff had felt able to consult with him out of hours in order to resolve issues. There had been a recent fire at the home, a deliberate ignition started in a service user’s bedroom. A full evacuation was carried out by the staff on duty, who were supported by senior staff within 5 minutes. The Fire Officer who attended was said to have been satisfied with the fire safety measures in place and the actions of the staff. Risk assessments are in place. Staff are due another fire safety update and some other mandatory training has also been identified; dates have been arranged for these to take place. Oaklodge 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 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 x x x 3 x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x 3 x 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x 3 x 2 Standard No 11 12 13 14 15 16 17 x 2 x x 3 x x Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oaklodge Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 Page 22 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. 1. Standard 24 Regulation 23(2)(d) Requirement All parts of home must be kept clean and reasonably decorated (Carpeted staircases are badly stained) The kitchen must be kept to a clean and hygienic standard. All food handlers must have training in Food Hygiene. Timescale for action By 31.1.06 2. 30 23(2)(d) 3. 33 18 Action agreed at the time of inspection. By 31.1.06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 12 Good Practice Recommendations Staff should be encouraged to give more input regarding social and leisure activities. Oaklodge 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 Page 23 Commission for Social Care Inspection Aire House Town Street Rodley LEEDS, LS13 1HP 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. Extracts may not be used or reproduced without the express permission of CSCI Oaklodge 20051025 Oaklodge AN Stage 4 S1314 V205092 J52.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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