Inspection on 08/01/07 for Oakwood

This inspection was carried out on 8th January 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Oakwood 03/01/06

Oakwood 01/08/05

Oakwood 03/11/04

Oakwood 12/05/04

Oakwood 08/01/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Oakwood 16 The Wiend Bebington Wirral CH42 6RZ Lead Inspector Les Smith Key Unannounced Inspection 8th January 2007 09:30 Oakwood DS0000018922.V308464.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 Oakwood DS0000018922.V308464.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. Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakwood Address 16 The Wiend Bebington Wirral CH42 6RZ 0151 643 9421 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) www.macintyrecharity.org MacIntyre Care Mrs Joan Arnold Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd January 2006 Brief Description of the Service: Oakwood is registered to accommodate 5 adults with a learning disability. Oakwood is a two-storey property located in a residential area. On the ground floor there is a lounge, dining room, kitchen, laundry, shower room, toilet and a single bedroom with en-suite. On the first floor there are 4 single bedrooms, a bathroom, toilet and an office. Bathing aids are provided. The home has a large garden, which has a seating area. There is wheelchair access via a ramp from the lounge. Parking is available on the main road. Oakwood is located in a central position close to Birkenhead and Prenton. There are local shops within walking distance and the bus stops nearby. Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place over one day for a total of 7 hours. During the visit time was spent examining care records and associated documents, staff files, management records and discussions were held with the manager and staff members on duty. Observation of care and activities during the day showed that staff had a good rapport with residents. Residents were clearly encouraged and supported to make choices according to their own preferences. The home is clean and presents a homely environment for the residents. Meals were seen to be varied and nutritious whilst meeting residents personal likes and dislikes. Maintenance of privacy and dignity was observed at all times. Resident’s health needs are well met. What the service does well: 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. Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 6 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 Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 7 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): 1,2,3,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their representatives have access to the information required and can be confident that their needs will be fully assessed thereby promoting confidence in the homes ability to meet their needs. EVIDENCE: There have been no admissions to Oakwood since the previous visit. Documents seen demonstrated that there is a comprehensive initial assessment process in place that includes gathering information from family or representatives and other health care professionals. The information covers all that recommended in the National Care Standards for Younger Adults and is sufficiently detailed to provide a good basis for the care planning process. Evidence was also seen that introductory visits to the home are made to enable prospective residents to meet the current residents and staff. Files examined showed that all residents had a service user agreement in place. The document in one file had not been signed appropriately due to difficulties experienced in procuring the services of an advocate for the resident. The manager gave assurances that every effort is being made to address this situation. Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 8 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): 6,7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents at Oakwood benefit from a comprehensive and consistent care planning process that supports and promotes independence and wellbeing for individual residents. EVIDENCE: Records examined showed that each resident has a person centred essential lifestyle plan in place. The information in the plans is comprehensive and gives clear guidelines for staff in relation to all aspects of care required. Reviews of care requirements are carried out regularly and evaluations of care effectiveness are carried out monthly. A substantial amount of effort and work has been carried out in providing the personal lifestyle plans in a pictorial format to provide increased accessibility and input from the individual residents. Risk assessments seen demonstrate that independence is balanced with identifiable risks to residents wellbeing. Appropriate and relevant professionals are consulted and involved in establishing how residents’ needs are to be met most effectively and any identified risks minimised. Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 9 Observations during the course of this visit and examination of records showed that residents are encouraged and supported to make decisions about their lives in accordance with their individual abilities and preferences. Likes and dislikes and personal preferences in relation to daily living such as times to get up and go to bed and activities and interests that they enjoy are clearly documented and promote respect of personal choice. Residents’ records are held securely and staff members spoken to demonstrated awareness of confidentiality requirements. Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 10 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): 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. Flexible routines and personal activity programmes promote personal development and provide the opportunity to develop and maintain relationships allowing for emotional and social needs to be met. EVIDENCE: A wide range of activities is provided for the residents at Oakwood. The encouragement of independent living skills, use of community facilities and leisure facilities are included in the activities provided. Each resident has an individual programme of activities that allows for their personal preferences and participation is documented. Activities are supported by clear support guidelines and risk assessments if required. Should a resident indicate a wish to undertake a new activity the staff at the home undertake relevant enquiries and undertake risk assessments before any resident involvement occurs. Therapeutic services are facilitated by referrals to appropriate organisations. The staff promotes ongoing contact with friends and family and the opportunity to develop friendships is promoted. Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 11 Observation during the visit showed that routines are as flexible as possible. Guidelines indicating the level of support needed by individual residents to make their own choices and be as independent as possible are clearly documented and staff members demonstrated a good knowledge of the individual requirements. Menu records were reviewed and showed that residents’ benefit from varied and balanced meals. Dietary requirements are clearly recorded within the care plans together with details of any assistance that a resident may need with eating. Residents have a good choice of meals and staff members encourage a balanced diet. Weight and appetite are monitored and the services of a dietician are obtained if any concerns are identified. Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 12 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): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ personal support and health needs are well supported, however, medication management could be strengthened to meet best practice guidelines. EVIDENCE: The personal preferences in relation to personal care routines are clearly documented. Observations demonstrated that staff members promote respect for the residents and maintain and maintain individual dignity at all times. Residents see visiting GPs’ or other health care professional in private. Evidence was seen that access to health care services is facilitated as required and residents’ are assisted to attend health care appointments. There is a clear policy for the receipt, storage, administration and disposal of medications in place. MAR (Medication Administration Record) sheets and relevant medications were reviewed and found to be in satisfactory. It is recommended that two members of staff should sign any handwritten entries on the MAR sheets. The administration of ‘as and when required’ medications should be supported by clear guidelines as to when the medication should be given. The guidelines should include e.g. how a resident indicates that they Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 13 have a pain and need a painkiller or the circumstances when a sedative type medication should be given. Evidence was seen that only staff who have received appropriate training are responsible for medication administration. The policies in place, records and practices seen during this visit indicate that any serious illness would be managed with respect and in accordance with the personal wishes of the individual or their appointed representative. Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their representatives may be confident that their views are taken seriously and will be acted upon in a timely and effective manner and those residents are protected from any form of abuse. EVIDENCE: There have been no complaints received at the home or directly to the CSCI since the previous visit. The complaint procedure is available in pictorial format that allows for the residents to understand and make a complaint if they wish. The procedure is detailed and the stages of the complaint management and that a response will be made within twenty-one days. Staff members spoken to had an understanding of how to respond to complaints. The home has a copy of Wirral borough Council’s adult protection procedure and staff members have received appropriate training in the recognition of abuse and the procedures to follow if abuse is suspected or alleged. The home manages the personal allowances and the director of MacIntyre Care is the appointee for all of the residents living at the home. A random selection of residents’ monies and associated records were checked and found to be correct. The homes polices and procedures for the management of residents monies and financial affairs safeguard residents but it continues to be recommended that advocates be used to oversee the affairs for residents who have limited or no family contact. Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 15 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): 24,25,26,27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of décor and furnishings within this home is good and provides residents with a homely, comfortable and safe environment to live EVIDENCE: A tour of the home was made accompanied by the manager. The home is well maintained as evidenced by the minimal number of outstanding minor repairs. The shower room has been refurbished although the extractor fan was not working at the time of this visit. The dining room has been redecorated and refurbished to provide a much brighter environment. The downstairs toilet that has a step down is the most used facility due to the better access. The use and suitability of this toilet is kept under review with specific regard to residents changing needs and abilities. Individual bedrooms are well decorated and furnished and showed a high level of personalisation. One room was decorated in plain white and waiting further decoration when the resident had chosen the colour he wished it to be. There are sufficient communal areas available for residents and visitors are welcome to see residents in their own rooms or the dining area. The home has Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 16 a large rear garden, which has a seating area and access via a ramp from the lounge. The garden area whilst tidy has the potential for significant improvement, which would enhance the outdoor facilities for residents. All areas of the home were clean, fresh and hygienic at the time of this visit and it is clear that all staff members work hard at maintained a high standard of cleanliness throughout the home. Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 17 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): 31,32,33,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sufficient competent and trained staff employed to meet the assessed needs of residents who are supported and protected by a robust recruitment policy EVIDENCE: Examination of the staffing roster showed that a minimum of two staff members are on duty during the day and evening with one team member on a waking duty overnight. All staff members spoken to viewed the current staffing levels as appropriate for the needs of the residents and enable full participation in group and individual activities. A third member of staff is available during the day if required. Any shortfall in staffing for any reason is met from a relief staff that knows the residents and how the home works thereby ensuring continuity of care. Records were examined for staff members recruited since the previous visit. Original documents are held at the organisations’ head office as agreed with the CSCI but documents are held at the home that provide the evidence that all required information and documents have been obtained. A review of these records shows that the home has a robust recruitment process. Examination of records and discussions with staff members showed that training is provided ensure that residents assessed needs are met by the Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 18 provision of a high standard of care in accordance with good practice guidelines. The home has in excess of 50 of the workforce qualified to a minimum of NVQ level two and seven staff members have the level three qualifications. All new staff members undertake a structured induction programme within the first six weeks followed by a foundation training which last 6 months. All members of staff have a personal development portfolio, which record training in areas such as MacIntyre Cares’ Base values, care planning, health and safety and administration of medications. Should a new member of staff be recruited who has no previous experience of working with people with learning disabilities, the organisation provides a package for the Learning Disability Award Framework, which is completed alongside the personal development portfolio. All staff are expected to progress to the NVQ level 2 qualification after six months employment. Staff supervision is in place and takes place approximately every six weeks with an annual staff appraisal system also in place. Staff members spoken to stated that they felt well supported and that everyone worked as team. Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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): 37,38,39,40,41,42,43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management at Oakwood provides good leadership and guidance promoting and protecting the health, safety and welfare of residents and manages the home in their best interests. EVIDENCE: Oakwood benefits from an experienced and appropriately qualified manager who is able to demonstrate that she undertakes regular training to keep her knowledge base and skills up to date. The management style is open and transparent with a focus on managing the home in the best interests of residents. The home holds the Investors in People Award, which is subject to regular review. The organisation conducts an annual audit of how the home supports and meets residents assessed needs, which includes consultation with relatives and residents representatives. An annual development plan is also produced for the home. The designated key workers elicit as far as possible the views of Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 20 residents in line with the residents’ individual ability. Regulation 26 visits are carried out and copies forwarded to the CSCI. Policies and Procedures are regularly reviewed and maintained up to date by the organisation and all documents are readily available to all staff. Both home and individual records are securely stored and in good order, stored securely and used in accordance with the Data Protection Act 1998 thereby promoting and protecting the health, safety and welfare of both residents and staff. Fire alarm and emergency lighting checks are appropriately done and recorded. COSHH assessments had been undertaken and cleaning materials were stored in an appropriate place. On the day of this inspection the home was displaying a valid public liability certificate in a prominent place. All relevant safety certificates for Gas, Electricity, portable appliance tests and hoists were seen and were found to be valid. Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 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 3 3 3 3 3 3 3 3 3 Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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 Refer to Standard YA20 YA20 YA23 Good Practice Recommendations It is recommended that guidelines for the administration of ‘as and when required’ medications are put in place It is recommended that hand written two people sign scripts on the MAR sheets. It is recommended that advocates be used to oversee the management of service users monies for service users who have limited or no family contact. Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Oakwood DS0000018922.V308464.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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