Inspection on 11/07/07 for Oakmount

This inspection was carried out on 11th July 2007.

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 no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oakmount 29/04/09

Oakmount 01/05/08

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 09/07/2008.

CARE HOME ADULTS 18-65 Oakmount 68 -70 Westgate Burnley Lancashire BB11 1RY Lead Inspector Mrs Pat White Key Unannounced Inspection 11th July 2007 09:30 Oakmount DS0000044999.V340065.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Oakmount DS0000044999.V340065.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Oakmount DS0000044999.V340065.R01.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) 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.V340065.R01.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 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, which also served as a staff sleep - in 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 hairdressing, transport, some leisure activities and magazines and papers. 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 service users can expect if they choose to live at the home. Oakmount DS0000044999.V340065.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit, carried out on the 11th July 2007, was part of an 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 service users, 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. In addition an Annual Quality Assurance Assessment (AQAA) was completed for the Commission and information from this is included in the report. Survey questionnaires from the Commission were sent to the home for service users to complete. In addition questionnaires were also sent to relatives and professionals who visited the home. At the time of writing the report one relative and one social worker had returned a completed questionnaire but none of the service users had. Three service users were spoken with in some detail, and there views are included in the report. Others were spoken to but did not specifically give their views about the home. What the service does well: The support workers worked hard to meet the needs of the service users. Relationships between staff and service users always seem positive, and supportive towards service users. The relative stated in the questionnaire that the resident concerned was “looked after with great care” and that the staff “do a super job”. The support workers assisted and encouraged service users to be as independent as possible and to make choices about their routines and lives. The service users were encouraged and assisted to take part in activities. These included going to “Greenspace”, day centres and doing leisure activities. The service users go on holiday together each year and choose where they want to go. At the time of the site visit service users were looking forward to a caravan holiday which they said they had chosen. The food was varied, nutritious and tasty and most service users said they enjoyed the food. The service users were well looked after and they had all the necessary medical attention and treatment they needed. One service user said she had Oakmount DS0000044999.V340065.R01.S.doc Version 5.2 Page 6 contact with the Social Services and the psychiatrist again after a number of years so that treatment could be reviewed. One service user was regularly supported to attend the diabetes clinic. The social worker felt that the staff were good at making sure that service users attended all their medical appointments. Service users’ medication was safely managed and administered and service users received the correct medication. The manager had been in post for a number of years and there was a relatively low turn over of staff. This benefited service users as they had continuity of care, and were looked after and supported by people who knew them. The home provided a safe place for people to live. All the necessary safety checks were carried out and the home had a health and safety advisor. What has improved since the last inspection? What they could do better: Oakmount DS0000044999.V340065.R01.S.doc Version 5.2 Page 7 The way service users were admitted to the home must be improved to make sure that the staff are clear about what people’s needs are and whether or not the home can meet these needs. The written information about service users’ needs and how they should and would like to be supported could be further improved to reflect the varied and complex needs of each service user. For example there could be more information about people’s mental health needs and preferences for their daily routines. The ability of service users to administer their own medication should be assessed, written down and reviewed to assist service users to be independent in this matter if they wished and to ensure they administered medication safely. Some other parts of the home’s medication system could be further improved, such as writing clear instructions for the administration of medication so that staff knew exactly what to do. Unused medication should be frequently returned to the pharmacist so that a large supply of unused medication does not build up. Some parts of the home still needed redecorating and repairs, and the plan made for these jobs must be followed. Also the residents must be protected the risk of scalding from water that is too hot. The home’s procedures for appointing new support workers could be improved in order to protect service users from unsuitable staff. 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.V340065.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Oakmount DS0000044999.V340065.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 & 4 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Recent admission procedures would not assist prospective users to make a real choice about whether or not Oakmount could meet their needs and aspirations. The assessment of need was not sufficiently comprehensive to determine whether or not the home could meet people’s needs. EVIDENCE: Since the previous inspection a service user had been admitted as an “emergency”. The manager did not have sufficient time to undertake a comprehensive assessment of needs, and the service user did not visit the home prior to admission. A social work assessment had been received by the home the day before admission, but some important aspects of this assessment had not been sufficiently explored. As a result it was not clear whether or not the home could meet the needs of this person or if the home was a suitable place for him. There were no records of the manager and the owner meeting this service user prior to his admission to the home. Care plans and discussion with manager showed that some service users who had lived in the home for some time did not have an up to date written assessment of their needs, which addressed all the relevant issues, including those relating to mental health matters. This has been outstanding over a Oakmount DS0000044999.V340065.R01.S.doc Version 5.2 Page 10 number of inspections. However discussion with the manager and service users and looking at other records, indicated that some service users’ needs were being met and that some had maintained improvement in terms of behaviour, motivation and level of activity since the last inspection. Three service users spoke positively about life in the home. They stated there was more going on, and they had things to do that they were looking forward to. The relative who completed the questionnaire stated that the needs of her relative were always met. Also the social worker who completed the questionnaire stated that the home’s assessment procedures were “usually” carried out satisfactorily so that the right service was planned and that the home “usually” responded to the diverse needs of the service users including gender and age. Two senior members of staff had completed a mental health course that had enabled them to better understand the service users and to put their knowledge into practice. Oakmount DS0000044999.V340065.R01.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 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. In spite of some of the service users care plans having useful information, the complexity of some of the service users’ needs was still not fully reflected in the care plans and some care plans had not been reviewed and updated. Service users were supported in making decisions about their lives and have choices in their everyday lives but the supporting risk assessments could be improved. EVIDENCE: All service users had care plans that contained some details of what staff needed to do to support people. There was evidence that these were reviewed and updated in accordance with a previous requirement, and they showed some improvement in terms of including more current information and how risks were assessed and managed. The key worker system was in operation to assist the process of reviewing and writing care plans. Oakmount DS0000044999.V340065.R01.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 service users whose records were viewed had needs associated with learning disability. However there was no reference to such needs on the care plans or of mental health needs. The care plan of the most recently admitted service user did not address “specialist needs” referred to in the social work assessment. Service users were assisted to make choices regarding their routines, and activities throughout the week. Staff could demonstrate why any restrictions on choice had been enforced and some of these were written on the care plan. When restrictions were made these were negotiated with the service users and some were determined by the multi - disciplinary team. There were frequent service users meetings, and one to one meetings with key workers. These were opportunities for service users to discuss choices and preferences. The recent smoking restrictions had been discussed frequently and meals served in the home and trips out. All service users 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 of the home. Some service users assisted in cooking, and making meals for the others. The risk associated with some service users was assessed prior to admission, and risk assessments had been developed in the in house care plans. Since the previous inspection this aspect of the care plans had improved and had been extended to include more areas, including self – medication and management of service users’ finances. However some of the risk assessments viewed had not been completed properly and had no indication of the level of risk. Oakmount DS0000044999.V340065.R01.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): 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. Service users 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: Service users were encouraged to take part in fulfilling activities, both educational and leisure. Some service users attended a therapeutic work centre. Another service user attended a drop in centre and had a weekly plan of activities. Another service user attended a day centre. One service user had completed a cookery course. Service users 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. Oakmount DS0000044999.V340065.R01.S.doc Version 5.2 Page 14 The frequency and type of leisure activities, including trips out, had recently increased according to service users requests. It was clear that staff were trying to find different things to interest and motivate people. One service user had been supported in going swimming and other forms of exercise in order to become healthier. A five - day holiday is included in the fees paid and service users were looking forward to another caravan holiday. This was not however stated in the contract Service users were supported in forming and maintaining relationships. They were encouraged to have contact with relatives, and several service users had regular meetings with members of their families. The relative who completed the questionnaire stated that the home always helps them to keep in touch with the resident concerned and informs them of all important matters or changes. Service users rights to choice and independence were respected. Restrictions were agreed with individuals and the multi disciplinary team. There were appropriate locks on the bedroom doors. Service users could stay out late if this was safe and appropriate, and could have a front door key on these occasions. Rules on alcohol and smoking were stated in the terms and conditions. Service users were strongly encouraged to join in the activities but can choose not to, so that their right to choose their own lifestyle was maintained. The social worker and the relative who completed the questionnaires both said that the home “usually” respected individuals’ privacy and dignity and “usually” supported them to live their chosen life. The food served was healthy and suited the service users’ preferences. Service users help to plan the menus. Service users spoke positively about the food served, and the meals observed and those on the menus showed the main meals were nutritious and appetising. The food suited different tastes ranging from curries to traditional Sunday lunch. According to service users wishes more choice had been introduced for the main meal each day. Breakfast and lunch - time meals were flexible around the service users routines and they were responsible for their own meals at these times. Service users ate the main meal together in the evening and sometimes helped staff to prepare and cook it. Oakmount DS0000044999.V340065.R01.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 good. This judgement has been made using available evidence including a visit to this service. Appropriate personal support was provided to service users, and in such a way as to promote independence. In general staff administered and managed medication safely and service users were supported to administer their own medication. However this was not always monitored sufficiently. EVIDENCE: Service users were provided with the varying level of personal support and prompting with personal hygiene matters that they needed. Service users were expected to take some responsibility for keeping their rooms clean and doing their washing in order to promote independence and maintain life skills. Service users were encouraged to choose their own clothes and styles etc. Continuity of support was facilitated by the key worker system. The relative who completed the questionnaire thought that the home always gave the right support to the resident concerned. The service users physical and mental health care needs were promoted, and there were many examples of service users having the health care that they Oakmount DS0000044999.V340065.R01.S.doc Version 5.2 Page 16 needed. The records kept in the home confirmed this and also showed that appropriate referrals were being made. Some of the service users had ongoing contact with the mental health services and one service user had recently recommenced contact in order to have a review of medication and treatment. Service users’ had appropriate contact with their GP’s, district nurses and specialist services for any physical health problems, such as diabetes. The social worker who completed the questionnaire stated that Individual’s health care needs were “usually” monitored and attended to. Medication procedures and practices in the home were safe and staff had undertaken appropriate training. Policies and procedures were previously checked and found to be satisfactory and there were many areas of good practice. Some service users were supported to manage all or part of their medication and the social worker who completed the questionnaire said that the home always supported individuals to manage their own medication. There was a supporting risk assessment for one service user who had recently been given back this responsibility, but none for the others who were applying their own creams. The Medication Administration Record Sheets (MARs) were generally up to date and signed appropriately which showed that medication was being administered according to the prescriber’s instructions. However the following matters should be addressed. There was an excess of medication that should be returned to the pharmacist. Several service users were applying their own creams but there were no clear directions on the MARs about when some of these should be applied. Staff were unclear about this so were not sure if these creams were being applied correctly. The management of medication classed as “When Required” (PRN) could be improved. Some medications listed on the MARs were being administered as PRN but there were no clear directions on the MARs as to whether or not they were to be given as PRN, and no instructions as to when they should be given. For other medication that was stated to be PRN on the MARs, e. g. Paracetamol, there were no clear directions or indicators as to when these should be given. This was particularly pertinent for one service user with verbal communication problems. Oakmount DS0000044999.V340065.R01.S.doc Version 5.2 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. 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 home had a complaints procedure of which the service users had a copy in their service user guides. The AQAA stated that one complaint had been recorded since the previous inspection. This had been satisfactorily resolved. No complaints had been made to the CSCI. Service users expressed grumbles and concerns directly as they occurred, in the one to one meetings with staff, and at service users’ meetings. One service user spoke to the inspector on the site visit about a matter of ongoing concern. This was discussed with the manager and steps were started to look into the matter again. Other routine matters were brought to staff’s attention throughout the day and these were dealt with appropriately. The relative stated in the questionnaire that she knew how to make a complaint, and she and the social worker said the home “usually” responded appropriately to concerns raised. Service users’ were protected from abuse by the home’s “protection from abuse” policies and procedures. These included a “whistle blowing” policy and step-by-step procedures to follow in the event of suspicions or allegations of abuse and according to the Government guidance. There had been no allegations of abuse reported in recent years. Training in adult abuse was included in the NVQ courses and staff had undertaken intervention training , including how to deal with aggressive behaviour. Oakmount DS0000044999.V340065.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 28 & 30 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 service users and the service users’ bedrooms met their needs and promoted independence. There was a satisfactory level of cleanliness throughout the home but the décor and maintenance in some parts of the home should be improved. EVIDENCE: An up dated action plan with time scales had been received for the improvement of the environment, and a tour of the premises showed that this was being implemented and that there had been some further improvements since the previous inspection, particularly in the communal areas. Some windows had been repaired and others had been replaced, and the kitchen and one of the bathrooms had been painted again. A bedroom carpet had been replaced. However there was a major job outstanding on an en suite bathroom and this should be completed without delay. Outside there was a patio area with a bench and seats as a facility for the service users. However the social worker stated in the questionnaire that the décor and furnishings Oakmount DS0000044999.V340065.R01.S.doc Version 5.2 Page 19 and fittings were of an unsatisfactory standard and that the home needs major renovations. The bedrooms were personalised, and regarded as the service users’ private space, though privacy was compromised in the two “shared” rooms. However the rooms appeared to meet the needs and tastes of individuals. The service users were encouraged to be responsible for cleaning their rooms and this was seen as a way of promoting independence. Some bedrooms were in urgent need of decorating to improve the private space of the service users concerned. The communal areas had recently been improved and modernised, and service users made use of the different parts of communal space available including two lounges and a smoke/games room. The home provided a safe place for the service users. A fire safety inspection was undertaken in 2006 and ensured that the fire precautions had been updated and were satisfactory. The level of cleanliness in the home had improved and there were no unpleasant odours. Since the previous inspection a cleaning regime and new procedures had been introduced, and on this site visit some areas of previous concern, including the bathrooms and some bedrooms, were found to be improved. Staff had also completed infection control training which enabled them to better understand the importance of maintaining cleanliness in the home. Oakmount DS0000044999.V340065.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users benefited from a stable and experienced staff team who were undertaking some appropriate qualifications and training. However the home’s recruitment practices would not protect service users from unsuitable staff. EVIDENCE: Support workers were developing the necessary skills and competences to support the service users. Records and discussion with the manager showed that most of the staff had completed NVQ courses to at least level 2. The manager stated that all the permanent staff had gained NVQ at level 3. Both the social worker and the relative who completed the questionnaires thought that the staff “usually” had the right skills and experience to look after people properly. There was an effective and stable staff team with a low turnover of staff, which benefited the service users who appeared to. According to the rotas and observation at the time of the site visit, the number of staff on duty was satisfactory. Staff on duty at the time of the site visit appeared motivated and supportive to the service users and staff and those service users spoken with stated that staff supported them as necessary. Oakmount DS0000044999.V340065.R01.S.doc Version 5.2 Page 21 There were regular staff meetings, which were often used for in house training. Since the last inspection one person had been recruited as bank staff. This person had previously been on a student placement and the college had undertaken it’s own recruitment checks. However when this person became a paid member of the staff the registered person did not undertake the correct recruitment procedures according to the Care Homes Regulations, and as a consequence there were no up to date Criminal Records Bureau or Protection of Vulnerable Adults checks or written references for this person. This was poor practice was outstanding from a previous inspection and must be rectified. Records and discussion with staff showed that the staff training programme was being developed according to the needs of the service users 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 service users to identify and achieve goals. Support workers had completed training in managing aggression, intervention and conflict resolution. At the time of the site visit the manager had almost completed an accredited course to become an In house trainer. This will enable her to pass on knowledge and skills from courses attended to other members of staff Oakmount DS0000044999.V340065.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff and service users benefited from open, accessible and supportive leadership, and the views of the service users were used to develop the service. The health and safety of the service users and staff was in general promoted but the service users 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. She was also an NVQ assessor and had almost completed an accredited “in house trainers” course (see “Staffing”). The owner Mr Dangare 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 Oakmount DS0000044999.V340065.R01.S.doc Version 5.2 Page 23 service users. All spoken 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. Since the previous inspection the home’s quality assurance system had been developed to ensure that service user views were formally included in the monthly management meetings and that action on any points raised was agreed. The manager was advised to include professionals in the quality monitoring excercises. The home had health and safety policies and procedures that helped to ensure a safe environment for service users and staff and some of these were under review at the time of the site visit. The home’s fire precautions had been checked during a fire safety inspection in 2006 and improvements required had been completed. All staff had undertaken external fire training and the testing of fire equipment was satisfactory. However the manager stated that not all the fire drills were being recorded. The gas installations and boiler and an 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 service users at risk. All support workers had training in first aid and food hygiene but refresher courses in food hygiene were through in house videos. The service users had also undertaken training in food hygiene. The support workers had undertaken infection control training since the previous inspection. Oakmount DS0000044999.V340065.R01.S.doc Version 5.2 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 Standard No Score 1 x 2 1 3 2 4 2 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 2 25 3 26 2 27 x 28 3 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 2 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 3 x x 2 x Oakmount DS0000044999.V340065.R01.S.doc Version 5.2 Page 25 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 admission procedures, including a comprehensive written assessment, must determine whether or not the home can meet people’s needs so that people are not wrongly placed. The placement of the person identified must be reviewed with the placing authority and the CSCI notified of the outcome of this by the date agreed. All excess surplus medication must be timely returned to the pharmacist so that there is not an accumulation of unused medication in the home Risk assessments for those service users capable of administering their own prescription creams must be completed and regularly reviewed so that staff can monitor whether or not service users are administering medication safely and appropriately Timescale for action 10/08/07 2. YA20 13(2) 10/08/07 3. YA20 13 (2) 10/08/07 4. YA20 13(2) There must be clear instructions 10/08/07 from the prescriber regarding DS0000044999.V340065.R01.S.doc Version 5.2 Page 26 Oakmount 5. YA24 6. YA34 PRN medication, including creams, and when this should be given so that service users receive medication at the right time. 23 The registered person must (2)(b)&(d) ensure that all parts of the home are well decorated and maintained, including the areas identified at the inspection, and must inform the CSCI of the progress made. 19 (1), The registered person must schedule 2 ensure that persons do not amendment commence work in the home until all procedures have been followed according to the Regulations, including CRB/POVA checks, two written references from employers if possible. (Previous timescale of 07/07/06 not met) 13 (4)(a) The registered person must ensure that the service users are not at risk from water that is too hot. 30/11/07 10/08/07 7. YA42 10/08/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA2 Good Practice Recommendations It is strongly recommended that service users’ assessments are reviewed and updated and include sufficient written information on all relevant matters listed in standard 2 including mental health matters. Emergency unplanned admissions must be avoided if at all possible and the registered person should ensure that there is an introductory period that enables all parties involved to make a real choice about whether or not the home is a suitable place for people to live. The care plans should contain sufficient detail in all aspects DS0000044999.V340065.R01.S.doc Version 5.2 Page 27 2. YA4 3. YA6 Oakmount 4. 5. 6. 7. YA9 YA14 YA20 YA34 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. The risk assessments should be completed properly with an assessment of risk and clear strategies for reducing or eliminating the risk. The inclusion of a five day holiday in the fees should be stated in the contract given ton service users. The criteria and indicators for the administration of “when required” should be written down on or near the MARs so that staff know exactly when these should be given. It is strongly recommended that a tracking form, to record the dates of CRB/POVA and reference applications and returns and follow up contacts, be developed. The registered person should extend the quality monitoring exercises to visiting professionals. The details of all the fire drills held should be recorded so that the frequency of fire drills and the date of the last fire drill can be determined. 8. 9. YA39 YA42 Oakmount DS0000044999.V340065.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Oakmount DS0000044999.V340065.R01.S.doc Version 5.2 Page 29 - 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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