Inspection on 26/10/05 for Oakmead

This inspection was carried out on 26th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oakmead 20/08/07

Oakmead 30/08/06

Oakmead 22/11/04

Oakmead 05/05/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Oakmead 19 Worlds End Lane Weston Turville Bucks HP22 5SA Lead Inspector Gill Wooldridge Unannounced Inspection 26th October 2005 4:00 Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 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 Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 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. Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Oakmead Address 19 Worlds End Lane Weston Turville Bucks HP22 5SA 01296 615578 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) michelleread@parkside.org.uk Turnstone Support Limited Michelle Elaine Read Care Home 5 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 5 residents between 18 - 65 with a learning disability and/or physical disability 26th May 2005 Date of last inspection Brief Description of the Service: Oakmead is a small home providing care and accommodation for up to five younger residents’ with physical and learning disabilities. The home works with residents’ to ensure that they are as independent as their abilities enable them to be. This may mean that, further to assessments, residents’ could be supported to live independently in their own homes. At the time of this announced inspection, there were five residents, who all happened to be male, residing at Oakmead. The home is situated in the village of Weston Turville, close to the market towns of Wendover and Aylesbury. Residents’ avail themselves of the locally based amenities and are within a short journey of Aylesbury itself. Oakmead is a large detached bungalow, which has five single rooms and communal space situated on the ground floor. There is a dormer area to the bungalow where the office and sleeping in accommodation for staff is situated. The home has its own vehicle to transport residents’ and there are ample parking facilities for approximately a further three vehicles at the front of the property. From the drive way there is easy access into the home and there is an enclosed garden to the rear of the property. Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two visits to the home. The first visit consisted of lengthy discussions with staff and time spent observing the evening meal and discussions with residents, the assessment of some standards and substantiating documentation. The second visit focused on the residual key standards not inspected during the first visit, as outlined within this report and the opportunity to meet with residents again, was taken. All residents and a number of staff members, including the registered manager, were spoken with over the course of the two days. Both visits took place over the course of the late afternoon and early evening of 26th October and 31st October 2005. The manager was not present in the home during the first visit, which was ably facilitated by staff. The registered manager was at the home during the second visit to Oakmead. What the service does well: Residents’ have the opportunity to visit the home prior to admission. There are forums where residents’ can participate in the decision making process of the home. There are risk assessments that outline residents’ assessed vulnerabilities in place. The monthly summaries are updated regularly. Residents’ needs are reviewed annually. Monthly residents’ meetings are convened. The home is visited each month by an independent advocate. Residents’ are encouraged and enabled to be independent. Residents’ are able to access a wide range of social and leisure amenities. There are ample opportunities for social and community inclusion. Visiting is ‘flexible’. The home benefits from good, supportive neighbours. Residents’ are able to invite friends and relatives into the home. Residents’ are enabled to participate in the civic process. Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 Page 6 Residents’ needs are outlined within their individual support plans. Healthcare support for residents’ is good. There is a link worker system in place. Privacy and dignity is promoted within the home. Residents’ bedrooms provide single room accommodation. Staff training is in place and this includes induction training. There are good systems in place for enabling residents’ to make their opinions of the service provided known. Vulnerable residents’ are protected via policies, procedures and staff development. Policies and procedures are updated at regular intervals. Residents’ are confident of their position within the home. Residents’ are well supported by staff. Staff training is current and staff training has a high profile within the home. Oakmead provides residents with a comfortable environment. The home works in line with robust recruitment procedures. Residents’ benefit from well informed staff. There are good procedures in place to ensure that agency staff hold all appropriate clearances. Staff benefit from a supportive manager who recognises the value of personal development. Methods for measuring quality assurance are in place. Systems are in place that are used to ensure that residents’ health, safety and welfare are protected and promoted. Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 Page 7 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. Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 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 Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The opportunity to visit the home prior to admission is an integral part of the admission process, which should mean that residents are orientated to the environment and have met and are familiar with staff and other residents before any admission to the home. EVIDENCE: One new resident has been admitted to the home since the last inspection. Documentation seen indicated that this was a gradual process and the resident described enjoying living at Oakmead. Although the assessment was detailed in parts not all the form was completed and there was no follow through care plan/ support plan. Risk assessments were in place. However, these documents need to be more detailed to reflect the resident’s present situation. The designated care manager had undertaken a separate assessment of needs, along with the home’s own assessment this should enable the staff to develop a care plan. The home’s admission policy does not reflect staff and the manager’s described good practice. This must be developed to support the homes practice. Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 One care plan/support plan was not in place which may not ensure that this resident’s assessed need and personal goals are fully met. There are several forums where residents can participate in the decision making processes of the home. Risk assessments are in place, these need to be developed further to ensure any perceived restriction of liberty, or danger is documented fully and reviewed regularly with residents and their representative. EVIDENCE: Care plans/support plans were in place for four of the five residents. The lack of one care plan is of concern as this resident had been residing at the home since August. The manager must confirm in writing that she has developed a care plan/support plan for this resident within two weeks of receipt of this report. Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 Page 11 The completed care plans in place outline some residents personal goals and guidance as to how the goals can be achieved via staff support. A number of care plans were being updated with pencil written over the typed document. Staff indicated that the care plans were all subject to review and some progress was noted. Care plans viewed showed a lack of residents signatures. The use of some language was noted as inappropriate, the manager confirmed that she had addressed these issues in a recent team meeting. It is strongly recommended that the manager develop and support the process of person cantered planning which should more fully reflect that resident goals are part of the process. Risk assessments identified the perceived hazards to residents and were inclusive of some control measures. Staff confirmed that the risk assessments were also being reviewed. It was confirmed that risk assessments were developed for each resident. The content of these documents did not always reflect the present situation or all the control measures. More frequent updating of these documents was a recommendation at the previous inspection. The use of language and the detail must also be improved as outlined during the inspection. Perceived restrictions of liberty must be discussed and reviewed regularly in a multi disciplinarily forum involving the resident. The risk assessments seen for the most recent admission were completed in June 05 before the residents admission to the home and there was no apparent review to be undertaken before January 06. Forms had been produced to describe residents activities, these were not filled in daily in some residents files. It was not evident that items recorded were followed through for example, feeling unwell. The documentation within the care plan must interrelate. Residents’ are encouraged and enabled to make decisions about the way they live their lives via monthly residents’ meetings, minutes of these meetings were viewed and indicated the activities spoken about by residents. These meetings are chaired by the registered manager and are minuted accordingly. Two residents predominantly manage their own finances. Secure facilities are provided within individual bedrooms so that residents are able to keep their monies and any valuables safely. An independent advocate visits the home at least once a month, but frequently visits more often. Residents hold their own front door and bedroom door keys and those who require support to use them receive it from staff. Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 Page 12 Residents, by virtue of their observed behaviours and verbal confirmation clearly actively participate in the day to day running of the home and take part in the recruitment of staff during the informal stage. The home has an organisation generated Missing Persons Policy which is satisfactory however, it is strongly recommended that staffs described practice is included in the policy. The Missing Persons procedure is supported by the ‘vital information form’ within the care plan documentation. This should be further supported by detailed risk assessments as outlined in the missing person policy. Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13, 14, & 17 Residents’ are able to access a wide range of amenities which meet their social, leisure and spiritual needs. Residents’ are supported to develop their own menus and participate in some cooking tasks, which promotes independence and choice while at the same time reinforcing independent living skills. EVIDENCE: Residents described a number of community activities such as attending college, social activities such as bowling and going to the pub. The residents are supported by a visiting Connect Team at Turnstone Support’s Aylesbury office, which supports the residents in a number of activities. Residents are encouraged and supported to carry out independent living skills activities such as laundering, vacuuming, etc. The Connect allocation for Oakmead is five hours per week and is allocated to individual residents to facilitate their choices such as the multi sensory room at Turnstone and music therapy etc. Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 Page 14 No resident is presently in full time employment however, one resident goes to ‘Job Base’ and participates in some food preparation at County Hall. Residents are presented with opportunities for social inclusion and benefit from being supported to access a wide range of amenities, which indicates that their social, spiritual and leisure needs are met. Residents described social activities including visits to the local pubs, cinemas, library’s and the leisure amenities in Aylesbury. Residents also attend clubs and classes that meet their individual aspirations. The home has its own transport, making access easier. Residents confirmed that they were well supported by staff in accessing community-based amenities and also talked animatedly about their forthcoming trips out and recent holidays. A group of residents have just returned from a holiday in Bognor. It is strongly recommended that the manager assess regularly residents dependency needs and ensures that residents individual social and recreational needs are met by the appropriate deployment of staff. There is a personal relationships and personal boundaries policy in place which has been studied previously. The manager described that good practice and positive reinforcement was discussed in staff meetings. Residents confirmed that they are able to invite friends and relatives into the home. There are no hard and fast rules for the residents although residents are reminded about appointments etc that need to be attended and the right that other residents have to a quiet environment during the course of the late evening and night. With the exception of other bedrooms residents’ have unrestricted access to all areas of the home and garden. The conditions of occupancy are outlined within the service users ’ guide and contracts. The manger described that smoking is not permitted in the house and separate arrangements would be made for individuals who wish to smoke. Alcohol is permitted by residents. Residents plan their own menus and, as part of the independent living skills initiative do undertake some simple cooking tasks. There appeared to be a significant reliance on ready meals during the inspection visits. The manager confirmed that residents were encouraged to eat healthily and at least two residents have there cholesterol level monitored. The manager has continued to request support from the dietician who is now an infrequent visitor. Residents’ generally dine in the lounge/diner. The meal time was relaxed and comfortable. The use of plastic beakers was discussed with the manager. Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 20 Healthcare support for residents is documented, which should mean that their health and well-being is promoted and protected. Medication procedures within the home are robust however staff practice is not consistent which has the potential to place residents at risk. The use of the baby monitor must be supported by a clear protocol to ensure the resident’s privacy. Residents privacy was generally observed to be respected. EVIDENCE: Staff do not directly care for service users but do provide them with encouragement and support to live their lives as independently as possible. Residents are allocated a link worker who supports them to shop for clothing, undertake personal business, assist them with the independent living skills initiative and temper the support given to them in line with personal goals. ‘Front Sheets’ that are integral to individual plans contain information that is pertinent to residents’ such as their preferred forms of address etc. Residents’ accommodation is designed in such a way that privacy is generally promoted. Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 Page 16 Bedrooms provide single room accommodation and, although they are not fitted with en-suite facilities, all are within close proximity of the communal bathrooms and toilets. Any direct care that is required by residents is identified on their individual plans and undertaken within the privacy of their bedrooms or bathrooms. It was noted that the promotion of residents’ independence, individuality and fulfilment was paramount although not knowingly pressed upon them. The manager confirmed that all staff who are new to their posts are inducted to their roles. Further to induction and foundation training staff undertake care practice training and NVQ, which promotes core values, this is encouraged. Records viewed indicated that residents health care needs are met. The medications are securely stored within the home in an appropriate wall mounted cupboard, away from the residents’ living accommodation. Medications are not always administered in line with the organisation’s medication policy. All staff are trained to the organisation’s core medication administration standards and thereafter receive update training regularly. The manager is required to check the competency of staff practice in administering and recording the medication given to residents and maintain records for inspection purposes. The manager must develop an audit system to support the reduction in errors. The manager and staff spoken to confirmed that they had training in administering rectal diazepam. The protocol for rectal diazepam must be developed further and systems be in place to ensure that staffs responsibilities are clear regarding this issues. As at least one staff member is not trained to administer rectal diazepam. It is strongly recommended that the manager develops risk assessments to support residents in the process of self medication. The manager must develop a protocol to protect one residents privacy regarding the use of a baby monitor. Good practice guidelines and discussions with the resident relative and health professional to support this practice must be in place and reviewed regularly. Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 There are some clear systems in place for enabling service users to make their opinions of the service provided at the home known, therefore making them feel valued, promoting their individuality and enhancing their self-esteem. Vulnerable adults should be protected through a range of policies and procedures along with well informed staff, this should mean that residents intrinsic human rights are protected. EVIDENCE: There are separate policies and procedures that cover concerns, compliments and complaints. All were updated in November 2004. The policies have been replicated for residents ease of use using symbols and the contents generally explained. The manger described a recent concern however; there was no documentation in the home to support the described practice. The manger assured the inspector that this would be rectified. No comments or complaints have been received by the home or to the Aylesbury office of the Commission for Social Care Inspection during the past twelve months. There is however, a designated file and system in place to record all comments and complaints made. Discussions with residents indicated that they had clear understanding of their rights and how their opinions could be voiced. Residents stated that they felt well supported by the staff and manager. From observations it is clear that residents are comfortable within Oakmead’s environment and are confident of their positions within the home. It is strongly recommended that Care Line is advertised in the home. Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Oakmead has been refurbished to ensure that residents reside in an environment designed to meet their care and comfort needs. Standards of cleanliness at the home are good meaning that residents live in an environment that is clean and hygienic, which should protect resident’s health, safety and welfare. EVIDENCE: Oakmead is a dormer bungalow situated in a residential area of Weston Turville, which is close to the market towns of Wendover and Aylesbury. The home is set slightly away from the main road and has user-friendly access. The home has a communal lounge/diner, kitchen and laundry. Since the time of the last inspection the home has maintained its environment. With regards to the safety of the home please refer to Standard 42. Residents accommodation, which provides all single room accommodation, is situated on the ground floor. Bedrooms were evident of the individual personalities, hobbies and interests of service users. Residents confirmed that they were happy with the private and communal areas within the home. Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 Page 19 There are two bathrooms, one with a walk in shower facility. All areas on the ground floor are accessed via the large, bright entrance hall. The staff sleep in accommodation and the home’s office are situated in the dormer part of the bungalow, away from residents areas. The home is well furnished throughout. All areas of the home were clean, tidy and free from offensive odours during the course of both visits to the home. As part of the independent skills initiative residents are encouraged to maintain their own bedrooms and undertake their own laundry. The manager confirmed that there is a red bag system in place to segregate soiled laundry from non-soiled laundry. Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32 ,33 & 35 Residents benefit from well informed staff, which should ensure that their care and support needs are appropriately and effectively met. Senior staff induction must incorporate staff’s responsibilities to ensure residents needs are met at all times. EVIDENCE: During the first day of the inspection it was evident that the senior member of staff on duty was not fully aware of her responsibilities to the residents regarding the staffing levels. The senior induction must be developed further to incorporate their responsibilities when in charge if the home. The manager confirmed that she would address this issue. It is acknowledged that the staff on duty were knowledgeable regarding the care of residents and indicated that they were aware of good practice encouraging residents independence and risk taking. Records viewed indicated that not all agency staff used in the home have the appropriate training to meet residents needs. Rotas seen indicated that staffing levels are appropriate to meet residents needs. However, the manager stated that the present staffing levels, which indicate three staff on duty in the evenings are apparently to be reviewed. The manager confirmed that two staff would be appropriate in the evening and that Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 Page 21 this would not effect the residents ability to access the community. Discussions took place regarding the balance between promoting residents independence and self-actualisation and supporting residents and disabling them with too much staff support. As described earlier in the report it is strongly recommended that the manager assess regularly residents dependency needs and ensures that their individual social and recreational needs are met by the appropriate deployment of staff. Records should be maintained for inspection purposes. This will be discussed /reviewed again at the next inspection with residents, staff and the manager. Training and supervision described by staff appears to be given a high priority by the organisation and staff described feeling valued. Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 & 42 There is a relaxed atmosphere in the home which should ensure that residents benefit from a well run home. Health and safety shortfalls have the potential to place residents at risk. EVIDENCE: The manager appears to be supportive of staff and promotes residents independence in an apparent safe environment. This encourages comment and the manager was receptive to ideas, regarding good practice, discussed during the inspection. Turnstone Support has recently developed a formal system of quality assurance which was described in the previous inspection report. Monthly regulation 26 reports must be sent to the Commission. It is acknowledged that the manager copied these documents which had apparently not been sent to the Commission. Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 Page 23 The manager is reminded that she is required to send to the Commission a report of any event that effects the well being of a resident as required under Regulation 37. The home’s accident and emergency records were studied indicated some clear recording. During the first day of the inspection the office door was wedged open. Staff were reminded that this was not acceptable and at the follow up visit the door wedge had been removed. The manager is required to ensure that no fire door is held open except with a device agreed and approved by the fire department. It is strongly recommended that the manager consults with the fire department to seek advice of appropriate devices to hold open the office door. Risk assessments will need to support the use of any device recommended by the fire officer. Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 Page 24 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 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 1 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 2 3 2 x 2 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oakmead Score 2 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 2 X DS0000023075.V262028.R01.S.doc Version 5.0 Page 25 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 YA6 Regulation 15 (1) Requirement A ccre plan for the home’s most recent resident must be developed to support the care provided. The manager must ensure that individual risk assessments and any perceived restrictions of liberty are recorded more fully are developed further, and reviewed regularly as detailed in the evidence. The manager must ensure that staff follow the home’s medication procedure. This must be supported by staff competency checks and developments in the homes quality audit system. The manager must develop a protocol for the use of the baby monitor. The manager must develop further the protocol for rectal diazepam. The manager must ensure that staff used by the home from an agency are appropriately trained to meet residents needs. The manger must ensure that senior staff fully understand their DS0000023075.V262028.R01.S.doc Timescale for action 30/11/05 2 YA9 13 (4) (a) 31/03/06 3 YA20 13 (2) 31/03/06 4 5 6 YA18 YA20 YA35 12 (4) (a) 18 (1) (a) 18 (1) (a) 31/12/05 31/12/05 31/03/06 7 YA31 18 (1) (a) 31/03/06 Oakmead Version 5.0 Page 26 8 YA42 13 (4) (a) responsibilities and are fully inducted to their role. The manager is required to 31/12/05 ensure that no fire door is held open except with a device agreed and approved by the fire department. It is strongly recommended that the manager consults with the fire department to seek advice of appropriate devices and if used these devices must be supported by risk assessments. 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 3 4 5 Refer to Standard YA2 YA6 YA6 A6 YA9 Good Practice Recommendations It is strongly recommended that the manager develops the admissions policy to reflect staffs described practice. It is strongly recommended that all care plans are signed by residents or their representatives. It is strongly recommended that the home develops the care planning process to encompass the good practice of person centred planning. It is strongly recommended that staff use positive language when describing situations in care records. It is strongly recommended that the manager includes staffs described practice as part of the missing persons policy. This document should be supported by individual risk assessments as outlined in the missing person policy. It is strongly recommended that the manager develops risk assessments to support residents in the process of self medication It is strongly recommended that the manager assess regularly residents dependency needs and ensures that their individual social and recreational needs are met by the appropriate deployment of staff. 6 YA20 7 YA33 Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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 Oakmead DS0000023075.V262028.R01.S.doc Version 5.0 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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