Inspection on 01/05/08 for Oakmount

This inspection was carried out on 1st May 2008.

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 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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oakmount 29/04/09

Oakmount 11/07/07

Oakmount 21/06/06

Oakmount 23/03/06

Oakmount 22/09/05

Oakmount 30/03/05

Oakmount 29/12/04

Oakmount 25/03/04

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Oakmount 68 -70 Westgate Burnley Lancashire BB11 1RY Lead Inspector Mrs Pat White Unannounced Inspection 1st May 2008 10:00 Oakmount DS0000044999.V360175.R02.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 Oakmount DS0000044999.V360175.R02.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. Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakmount Address 68 -70 Westgate Burnley Lancashire BB11 1RY 01282 458463 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) oakmount68west@msn.com Emmanuel Tendaiwo Dangare Mrs Eunice Dangare Mrs Susan Burnett Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (9) of places Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home will accommodate up to 9 adults up to the age of 65 years who have mental health problems The staffing levels must be maintained at those agreed for registration. Date of last inspection 11th July 2007 Brief Description of the Service: Oakmount is a care home for 9 adults with a mental illness. The house is of the older type situated close to the town centre. Accommodation consists of kitchen, dining room, 2 lounges, a games/smoke room, utility room, a communal room, 5 single bedrooms and 2 double bedrooms. There was a staff room and office on the upper floor. There was a small yard and patio at the back of the building. The owner of the home is a registered mental health nurse. Mrs Susan Burnett is the registered manager of Oakmount. She has relevant experience and the Registered Managers Award. The scale of fees was £400 - £600 per week, with additional charges for some transport and leisure activities. The home had a Statement of Purpose and Service User Guide providing information about the care provided, the qualifications and experience of the owner and staff and the services residents can expect if they choose to live at the home. Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 Star. This means that people who use the service experience adequate outcomes. This inspection site visit, carried out on the 1st May 2008, was part of a Key inspection to determine an overall assessment on the quality of the services provided by the home. This included checking important areas of life in the home that should be checked against the National Minimum Standards for Adults (18 – 65 years), and checking the progress made on the matters that needed improving from the previous inspection. The inspection included talking to residents, touring the premises, looking at service users’ care records and other documents, discussion with a member of staff and discussion with the manager, Mrs Susan Burnett. Survey questionnaires from the Commission were sent to the home for residents, relatives and staff to complete. At the time of writing the report 2 residents and 5 members of staff had returned a completed questionnaire. There were none from relatives. Three residents were spoken with in some depth, and there views are included in the report. Others were spoken to but did not specifically give their views about the home. In addition the home provided the Commission with written information about the residents, staff and services provided, and some of this is also included in the report. What the service does well: The support workers worked hard to meet the needs of the service users. Relationships between staff and residents always seem positive, and supportive towards residents. The support workers assisted and encouraged residents to be as independent as possible and to make choices about their routines and lives. Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 Page 6 The residents were encouraged and assisted to take part in activities. These included going to “Greenspace”, day centres and doing leisure activities. The food was varied, nutritious and tasty and most residents said they enjoyed the meals. The residents were well looked after and they had all the necessary medical attention and treatment they needed for both physical illnesses and mental health support. Most of the residents were linked to the mental health services and had contact with either a social worker or a community psychiatric nurse or both. This helped them have all the necessary support to keep well. The manager had been in post for a number of years and there was a relatively low turn over of staff. This benefited residents as they had continuity of care, and were looked after and supported by people who knew them. What has improved since the last inspection? The way people were admitted to Oakmount had improved, and people were now being gradually introduced to the home. This meant that their needs could be properly assessed and right decisions made about whether or not the home is right for them. Some of the residents who had lived in the home for some time had also had their needs re assessed so there was more up to date information about how needs had changed and what the current needs were. Some work had been done to the premises and a bedroom en suite had been repaired and was being used again (see below). Some parts of the written care plans had improved and there were more useful details about the support that staff, and other people, needed to provide (see below). Some more risks involved with service users’ lives had been assessed to try and make people safer (see below). The staff at Oakmount showed that they listened to the residents and made changes according to what residents said, such as looking into the possibility of taking smaller groups away on holiday rather than altogether. This is so that more residents have more choice and flexibility about where to go. Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Oakmount DS0000044999.V360175.R02.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 Oakmount DS0000044999.V360175.R02.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): 2, 3 & 4 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home’s admission procedures would assist prospective users to make a choice about whether or not Oakmount could meet their needs and aspirations. However this is not supported by a detailed written assessment of mental health needs and these needs are not always clearly identified. EVIDENCE: Since the previous inspection the home’s admission procedures had been developed. The records of a person recently admitted, and discussion with those involved, showed that these procedures had been followed. This person had a gradual introduction to the home during which time an assessment was undertaken and assessments obtained from the hospital and the social worker. The resident had made several visits to the home to see if it was suitable. The resident confirmed in conversation that she had visited the home prior to moving in and that she liked it. This helped the staff team and the prospective resident to make a decision about whether or not the home could meet the needs. However the in house assessment still did not include a comprehensive assessment of mental health matters and needs. In addition there was no evidence in the records that the assessment and placement of a resident admitted as an emergency some time ago, had been reviewed with the placing Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 Page 10 authority. The manager stated that there had been telephone conversations with the placing authority but there was no evidence of this. In addition the viewing of another resident’s records showed that the assessment of need had been updated as recommended at the previous inspection but that this assessment did not include an assessment of mental health issues and needs. However talking to the manager, residents and staff and looking at care plans. showed that, in spite of the gaps in this documentation, people’s needs were being addressed. Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 Page 11 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, 8 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Not all the care plans fully reflected the complexity and changing nature of individual needs. Residents were supported in making decisions about their lives and had choices in their everyday lives but these decisions were not supported by written evidence of how decisions had been made or satisfactory supporting risk assessments. EVIDENCE: All residents had care plans that contained details of what staff needed to do to support people in some relevant areas of their lives. This included a plan for a new resident admitted to the home a few weeks prior to the site visit. The care plans included some mental health issues and related matters. There was evidence that the care plans were reviewed and updated, and they showed some improvement from the previous inspection in terms of including more current information. The key worker system was in operation to assist the process of reviewing and writing care plans. Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 Page 12 However the care plans viewed did not contain the details of support needed in all relevant matters. One of the residents whose records were viewed had needs associated with learning disability. This was not referred to on the care plan, neither were mental health matters. The risk associated with some residents was assessed prior to admission, and risk assessments had been developed in the in house care plans. The risk assessments covered a number of different areas of life such as risks associated with hot water, mobility problems and drinking alcohol. However some of the risk assessments viewed had not been completed satisfactorily and were not all person centred or with a satisfactory “management of risk plan”. Therefore it was not clear how staff minimised or eliminated the risks. Residents were assisted to make choices regarding their routines, and activities throughout the week. However for the residents whose records were viewed there was no written evidence of how decisions had been made regarding what could be seen as restrictions on freedom, for example the restrictions on the consumption of alcohol and smoking, and whether or not the multi disciplinary team had been involved. However the 2 residents who completed questionnaires stated that felt they had sufficient choices in what to do in their everyday lives. There were frequent service users meetings, and one to one meetings with key workers. These were opportunities for residents to discuss choices and preferences. The meals served in the home, trips out and changes to holiday arrangements had been discussed throughout the year. All residents were expected to assist in the cleaning of their bedrooms and other parts of the house. There was a rota in operation and this had helped improve the cleanliness in some areas of the home. Some residents assisted in cooking, and making meals for the others. Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 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 were encouraged to take part in a wide range of suitable fulfilling activities that promoted personal development and encouraged links with the local community, families and friends. The homes routines and terms and conditions promoted independence and choice. The meals served were in accordance with service users’ preferences, and needs, and the principles of healthy eating. EVIDENCE: Residents were encouraged to become more independent and develop their potential. Since the previous inspection one resident had moved into a supported flat. Residents were encouraged to take part in fulfilling activities, both educational and leisure, and all had a weekly plan of activities. Some residents attended a therapeutic work centre. Another resident attended a day centre. Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 Page 14 Residents were encouraged to be part of the local community and this was reflected in the activities and daily routines, such as being encouraged to use the local facilities, for example the swimming baths, pubs and meals out. Two residents had visited London and all residents were given the opportunity to go out on trips with their key worker. It was clear that staff were trying to find different things to interest and motivate people, including encouraging and supporting them to take regular exercise. A five - day holiday is included in the fees paid and since the last inspection residents had enjoyed a caravan holiday. However based on consultation with residents the holiday may be organised differently in the future, with residents going away in smaller groups. Residents were supported in forming and maintaining relationships. They were encouraged to have contact with relatives and friends, and several residents had regular meetings with members of their families. One resident confirmed that her 60th birthday had been celebrated in the home with a party for family and friends. Service users rights to choice and independence were respected. There were appropriate locks on the bedroom doors. Rules on alcohol and smoking were stated in the terms and conditions. Residents were strongly encouraged to join in the activities but could choose not to, so that their right to choose their own lifestyle was maintained. However for the residents whose records were viewed there was no written evidence of how decisions had been made in matters that could be seen as a restriction on freedom of choice, such as smoking and consumption of alcohol (see above). The food served was healthy and suited the service users’ preferences. Residents helped to plan the menus and there was a greater emphasis on healthy eating as a way of enhancing people’s physical and emotional well being. Residents spoke positively about the food served. Breakfast and lunch - time meals were flexible around the service users routines and they were responsible for their own meals at these times. Residents ate the main meal together in the evening and sometimes helped staff to prepare and cook it. Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Appropriate personal support was provided to residents, and in such a way as to promote independence. However some residents were not protected by the home’s medication practices and there were insufficient checks. EVIDENCE: Residents were provided with the level of personal support and the prompting required. Residents were expected to take some responsibility for keeping their rooms clean and doing their washing in order to promote independence and maintain life skills. Residents were encouraged to choose their own clothes and styles etc. Continuity of support was facilitated by the key worker system. The service users physical and mental health care needs were promoted, and there were many examples of residents having the health care that they needed. The records kept in the home confirmed this and also showed that appropriate referrals to health care professionals were being made. Most of the residents had ongoing contact with the mental health services or will have Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 Page 16 in the near future. Records and talking to people showed that residents’ had appropriate contact with their GP’s, community psychiatric nurses and specialist services for any physical health problems, such as diabetes. Staff who completed the questionnaire surveys felt that they provided the right support in the right way, and such as to promote independence. Medication policies and procedures had been checked at previous inspections and found to be satisfactory. There were some areas of good practice such as the prescriptions were checked for mistakes, at the home, prior to dispensing. Some residents were supported to manage all or part of their medication and risk assessments had been developed for these people, including those applying creams. However when people were administering some medicines this was not always written on the Medication Administration Record Sheets (MARs). Some previous matters had been improved and for one resident there was more useful information about “when required” medication. The MARs looked at were generally up to date and signed appropriately which showed that medication was being administered according to the prescriber’s instructions. However there was one example on the day of the site visit of a medicine being signed as given on the MAR before it was due to be given. There were a number of other concerns. Medication received into the home was recorded in a specific book and it was noted that the date of receipt was not always recorded. New medication had been received into the home the day before the site visit but it had not been booked in and therefore had not been checked for mistakes or damage (see below). Also one resident had recently been admitted to the home from hospital and had brought medication with them. There was no record of this medication coming into the home. For two out of 3 residents whose medication was looked at, a medication tray had been damaged. For one resident one compartment was broken but the tablet was not lost. For another resident, 3 compartments in a tray were damaged, and one tablet was lost. This had not been noticed so staff had not taken action on this. For another resident individually wrapped tablets were taken from the original box and placed in a dosette box without labels (secondary dispensing). This was done on a weekly basis and the reason given for this was that medication sometimes had to be given quickly to this person when staff were under pressure. The way this practice was carried out was felt to be unsafe because there was no way of identifying the medicines that were being given, and the medication given was not being checked against the MARs. Therefore staff could not be sure they were giving the correct medication and the resident was potentially at risk from receiving incorrect medicines. Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 Page 17 Though staff administering medication had completed appropriate training the manager was not formally assessing their competence or regular auditing the medicines to identify errors. Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ views were listened to and acted upon and they were protected from abuse and harm by the home’s policies and procedures. EVIDENCE: The way the home deals with complaints had improved and the home now records all the matters that are raised by residents that need to be looked into. Records and information provided to us prior to the inspection showed that 3 “complaints” had been recorded and resolved since the last key inspection. Residents had a number of ways to express their views about the home, including concerns and grumbles. They had a complaints procedure as part of the service user guide, frequent residents meetings and frequent one to one meetings with their key worker. No complaints about the home have been referred to the Commission. There have been no recent recorded allegations or suspicions of abuse and policies and procedures to protect the residents have been checked at past inspections and found to be satisfactory. Staff had undertaken relevant training in Protection of Vulnerable Adults to help them further protect the residents. Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 Page 19 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, 25, 26, 27, 28, 29 & 28 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Oakmount provided a homely, safe environment for the residents and the service users’ bedrooms met their needs and promoted independence. However not all areas of the home were well maintained or decorated or of a satisfactory level of cleanliness. EVIDENCE: The home had completed an action plan for the premises and some improvements had been made. An en suite shower room had been repaired and was working again. The carpet in the adjoining bedroom had been replaced and some other bedrooms and a lounge had been painted. Also overall the general cleanliness of the home had improved, especially in residents’ bedrooms. One resident had some equipment to help with mobility problems. However there were still areas that needed urgent attention. In particular the kitchen needed some repair work and urgent cleaning in places. One lounge needed re decorating as the wallpaper was coming away from the walls. One bathroom was in urgent need of decorating and brightening. There Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 Page 20 was ceiling damage in the games room. Some other matters relating to furnishing and cleanliness were also discussed with the manager. It was agreed that the home should produce a new plan for premises improvement and which should include plans for the thorough cleaning of certain areas. Outside there was a patio area with a bench and seats as a facility for the residents and staff and residents smoked outside. The bedrooms were personalised, and regarded as the residents’ private space, though privacy was compromised in the two “shared” rooms. However the rooms appeared to meet the needs and tastes of individuals. The residents were encouraged to be responsible for cleaning their rooms and this was seen as a way of promoting independence. However this approach did not always ensure that all parts of the rooms were kept clean. There was sufficient communal space and residents made use of the different parts available including two lounges and a smoke/games room. The hot water that was tested indicated that it was too hot and could potentially put residents at risk. Risk assessments had been undertaken with individuals but these did not indicate the measures needed to ensure that people do not scald themselves. This is outstanding from the previous inspection. Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 Page 21 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): 31, 32, 33 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefited from a stable and experienced staff team who were undertaking appropriate qualifications and training. They worked as a team to meet the needs of the service users. EVIDENCE: There was an effective and stable staff team with a low turnover of staff, which benefited the residents who appeared to appreciate this stability. According to the information obtained and observation at the time of the site visit, the number of staff on duty was satisfactory. The staff in the home at the time of the site visit appeared motivated and supportive to the residents and those residents spoken with stated that staff supported them as necessary. There were no new members of staff since the previous inspection but a social work student on placement was about to start work in the home. Therefore staff recruitment procedures could not be properly assessed at this inspection. Support workers were developing the necessary skills and competences to support the residents. Records and discussion with the manager showed that Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 Page 22 all of the staff, apart from one, had completed NVQ courses to at least level 2 and that most had gained NVQ at level 3. There were regular staff meetings, which were often used for in house training. This helped communication between management and support staff and helped staff gain the necessary skills. Records and discussion with staff showed that the staff training programme was being developed according to the needs of the residents and staff. The manager and a senior carer had completed a mental health course and had begun to put some theories and techniques into practice to assist residents to identify and achieve goals. Support workers had completed training in managing aggression, intervention, “conflict resolution”, Protection of Vulnerable Adults and the Mental Capacity Act. The member of staff spoken with confirmed some of the training and felt that opportunities for training were good within the home. This was supported by the results of the staff survey questionnaires, where staff said that they felt well supported and that there were good training opportunities. Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff and residents benefited from open, accessible and supportive leadership, and the views of the residents were used to develop the service. The health and safety of the residentsand staff was in general promoted but the residents were at risk from water that was too hot. EVIDENCE: The registered manager, Mrs Burnett had completed the appropriate manager’s qualifications and had managed the home since 2002. She had attended other relevant training, for example a 6 week mental health course and an NVQ assessor course. The owner is a registered nurse, mental health, and has previous relevant management experience. He visited the home frequently and was supportive of the manager, staff and residents. All spoken Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 Page 24 with described him, and Mrs Burnett, as approachable and supportive. There were regular staff meetings to assist communication, support and training and a monthly management meeting was held between the owner and the manager. The home’s quality assurance system had been developed to ensure that residents’ views were formally included in the monthly management meetings and that action on any points raised was agreed. However there were no formal methods of finding out about the views of relatives and other stakeholders such as visiting professionals. The home had health and safety policies and procedures that helped to ensure a safe environment for residents and staff. Information supplie by the home prior to the inspection showed that the gas installations and boiler and electrical wiring had current certificates of testing. The homes portable electrical appliances had been tested within the last 12 months. However at the time of the site visit the hot water was too hot and could put residents at risk (see above). All support workers had updated training in first aid and food hygiene. The residents had also undertaken training in food hygiene which helped them understand and take responsibility for their own health. Staff had also completed infection control training which should enable them to better understand the importance of maintaining cleanliness in the home. Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 2 3 3 4 3 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 1 25 3 26 3 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 3 32 3 33 3 34 x 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 3 2 x x 2 x Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 Page 26 YES 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 YA2 Regulation 14 Requirement The in house assessment must include a comprehensive assessment of mental health matters and needs and must be regularly reviewed and updated The risk assessments should be completed properly with an assessment of risk and clear strategies for reducing or eliminating the risk, including the risk of falling and the risk associated with water that is too hot. Correct and up to date records must be kept of all medication received into the home so that medicines are properly checked and mistakes and damages are identified. The date of receipt of medication must also be recorded so that medicines can be properly traced. Damaged trays and loss of medication must be reported to the pharmacist immediately to ensure that the medication is replaced as quickly as possible. The practices for the administration of medicines to the person identified must be DS0000044999.V360175.R02.S.doc Timescale for action 13/06/08 2 YA9 13 (4)(a)(c) 13/06/08 3 YA20 13 (2) & 17 (1) (a) Sch 3, 3 (i) 31/05/08 4 YA20 13 (2) 31/05/08 5 YA20 13 (2) 31/05/08 Oakmount Version 5.2 Page 27 6 YA24 23 (2)(b)&(d) 7 8. YA30 YA42 23 (2)(d) 13 (4)(a) reviewed with the community pharmacist to make them safe and ensure that this person is given the correct medicines. All parts of the home must be well decorated and maintained and bright, including the areas identified at the inspection, and must inform the CSCI of the progress made All parts of the home must be kept clean. Residents must be protected from water that is too hot (Previous timescale of 10/08/07 not met) 30/11/08 31/05/08 31/05/08 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 YA6 Good Practice Recommendations The care plans should contain sufficient detail in all aspects of health, personal and social care that reflects the complexity of the support needed in all relevant matters, including mental health, specialist support and communication and including how decisions have been made regarding matters of choice and rights, e.g. the consumption of alcohol and smoking cigarettes. Regular internal audits of medication systems and procedures should be undertaken regularly to identify and rectify mistakes and also there should be a formal system of assessing staff competence in medication practices. The Medication Administration Records should always be signed at the time medication is given not in advance or in retrospect, to show that medication has been given correctly. The quality monitoring of services and facilities in the home should be extended to relatives and visiting professionals. 2 YA20 3 YA20 4 YA39 Oakmount DS0000044999.V360175.R02.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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