Inspection on 26/05/05 for Oakwood Bungalows Nursing Home

This inspection was carried out on 26th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oakwood Bungalows Nursing Home 14/12/06

Oakwood Bungalows Nursing Home 29/11/05

Oakwood Bungalows Nursing Home 22/11/04

Oakwood Bungalows Nursing Home 21/07/04

Similar services:

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

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

CARE HOME ADULTS 18-65 Oakwood Bungalows Nursing Home Devon Court Devon Drive Chesterfield S43 1DX Lead Inspector Susan Richards Unannounced 26 May 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Oakwood Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Oakwood Bungalow Nursing Address DEVON Court, Devon Drive, Hollingwood, Chesterfield, Derbyshire, S43 1DX Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01246 476222 01246 476111 Elmcare Limited Charlotte Janet Bowen Care Home with Nursing 10 Category(ies) of Learning disability (10) registration, with number of places Oakwood Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: LD Learning disability, not falling within any other category Date of last inspection 22 November 2004 Brief Description of the Service: Oakwood Bungalow provides nursing and personal care and support for up to 10 younger adults with learning disabilities. It is situated on a main bus route, to the north east of Chesterfield within a residential area, close to local amenities. The home aims to provide a stable and consistent lifestyle for service users, which enables them to develop within an environment, which is supportive to their individually assessed needs. The homes philosophy of care is based on O/Briens Life Principles and Accomplishments, including the promotion of normalistation in terms of the daily life of each service user. Care delivery is planned, based on a recognised assessment model and within a framework of risk management. Service users bedrooms are all single occupancy, each having a wash hand basin. There are separte male and female toilets and bathing/shower facilities. There is a choice of lounge space and access to a small well kept garden area. A dedicated laundry facility is provided, although those service users who are able can undertaken their own laundry with assistance from staff. The Manager is supported by a team of Registered Nurses and care and hotel services support staff. Oakwood Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. What the service does well: What has improved since the last inspection? What they could do better: The registered person should seek to further promote and increase autonomy and choice for service users and ensure that any information provided to them in respect of this is always provided in an open-ended manner, which enables them to make informed choices. The registered manager has identified the need to review and develop the arrangements for care staff training in respect of the specific conditions of service users – the Inspector is wholly supportive of this. Oakwood Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 6 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 Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Oakwood Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 & 5 Service users were provided with key information about the home and its services. There was a recognised approach to the planned admission of new service users, which accounted for their individual needs and choices, together with those of existing service users. EVIDENCE: Service users are provided with clear information about the home – both written and verbally. The Statement of Purpose for the home was in the process of being reviewed and updated by the Manager due to key changes in the arrangements for activities as requested by the service users. Key information was also provided for each service user in suitable formats. One of the more recently admitted service users said that she had settled in well and liked living in the home. She said that she had visited the home before being admitted and other service users felt that she fitted in well. Two service users were case tracked and had comprehensive needs assessments in place in their own files, which were documented in accordance with a recognised assessment model. Service users spoken with had been involved in these and families and carers interests were also accounted for. Oakwood Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 9 Staff spoken with provided details of their induction and training, including one new staff starter. These were satisfactory. There was clear policy guidance in place for new admissions to the home, which included compatibility, trial visits and the offer of a temporary period of residence before the decision was made to offer a permanent placement. Service users had been provided with individual terms and conditions in a simple format as well as standardised format, which provided all information. Oakwood Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9 & 10 The Manager and staff are working hard to develop methods for consulting with and empowering service users, with positive achievements identified by both service users and staff in respect of these. However, open-ended information was not always provided to enable service users to make informed choices and service user confidentiality was not always promoted. EVIDENCE: The service users case tracked had comprehensive care plans recorded, which were in accordance with their assessed needs and formulated within a framework of risk management. Service users knew about their care plans, which were signed by them and regularly reviewed with them. However, a number of behavioural care plans for individual service users were displayed on the office wall. The office was an open door to all service users and visitors. This was discussed with the manager in terms of confidentiality and it was agreed that these should be kept in the service users file with a copy to the service user as appropriate. There were arrangements in place to enable service users to access advocacy services, which some did on a regular basis by way of independent meetings. Oakwood Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 11 The Manager regularly held meetings with service users and there were regular one to one meetings between service users and their key workers/named nurses. The Manager had recently prepared a questionnaire for service users, which was due to be undertaken. However, the method for supporting service users to complete these was not clear. Service users spoke of recent changes to the arrangements for activities, which they had instigated. Two service users spoke enthusiastically about their plans to move to more independent accommodation, which was imminent and said that staff were very supportive of this move. Two newer service users had signed a written declaration, which stated that they had ‘declined to have a lock fitted to their bedroom doors.’ The wording of this was discussed with the manager in terms of it appearing as a ‘fait accompli and the need to provide more open-ended information to enable service users to make an independent informed choice. Oakwood Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 & 17 The Manager had been proactive since the previous inspection in facilitating a review of the arrangements for activities for each service user, promoting increased consultation in accordance with individual’s risk assessed needs, choices and lifestyle preferences. EVIDENCE: Since the previous inspection, service users had requested that the arrangements for their individual activities be reviewed. This had been undertaken via the named nurse system and each service user had been supported to make changes in accordance with their choices. Service users spoken with felt that this was going well. Records of activities, which service users regularly engaged in were kept within individual care files and included social, educational and recreational activities, both in and around the home and within the local community. Written information regarding individual activities had been provided for each service user in suitable formats. Oakwood Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 13 Annual holidays had been booked, again in consultation with service users, who said they were looking forward to their holiday. Service users had daily living plans, which included key responsibilities for housekeeping tasks and personal routines. Comments have been made in the section above in this report in relation to the promotion of service users choice as to whether to have a lock fitted to their own bedroom doors. Service users made positive comments to the Inspector about the food provided in the home and said that they were asked about their choices. Menus seen detailed a variety of foods and were indicative of a balanced diet. Service users care records detailed their individual dietary likes and dislikes. Oakwood Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 21. There were suitable systems and arrangements in place to ensure that service users were well supported in terms of their personal and healthcare needs. EVIDENCE: The personal support needs of each service user case tracked were documented by way of their individual assessments and care plans including their preferences. The home operates on the basis of the philosophy of normalisation and individual’s care plans were reflective of this. Individual records were kept of service users access to outside healthcare professionals for the purposes of regular routine healthcare screening and specialist healthcare interventions. All service users were registered with a named GP. The arrangements for then management and administration of medicines were not fully inspected on this occasion. However, the Inspector monitored compliance with a previous requirement made in respect of the use of and care planning for ‘as required medication.’ This had been complied with. Oakwood Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 15 There had been no deaths in the home since the previous inspection. There was relevant policy and procedural guidance in place for staff in relation to death and dying and some staff had attended bereavement courses. One service user was attending bereavement counselling on a regular basis following the death of a relative. Oakwood Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The standards in this section were not inspected on this occasion. EVIDENCE: Oakwood Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29 & 30. Overall the home provides for a clean, safe, comfortable and homely environment, although attention is required to the replacement of corridor carpets and some comfortable seating in lounge areas. EVIDENCE: All areas of the home were inspected. The home was observed to be clean, well ventilated and well lit. There is a programme in place for the routine upgrading and renewal of the fabric of the building and overall the home was fairly well maintained. However, corridor carpets require renewal. The Manager advised that this was planned in the near future. Comfortable chairs in communal areas were in need of review and replacement, with some having torn upholstery and worn seat cushions. Service users rooms were personalised and were well decorated and furnished and equipped, as were bathroom and toilets, with separate male and female facilities. The kitchen and laundry areas were clean and suitably equipped and there is access to a small outdoor garden area with seating. Oakwood Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 25 & 36 Service users are well supported by a dedicated staff team and the Manager constantly seeks to facilitate staff development in accordance with the needs of the service user group accommodated. Proper recruitment checks had not been fully completed before one identified staff member had commenced their employment. EVIDENCE: Staff spoken with was conversant with their roles and responsibilities and those of others. They had been provided with copies of their job descriptions, which were in accordance with services provided by the home. Discussions with a fairly new staff starter indicated that she had undertaken appropriate induction training since commencing her employment in the home. Each staff member is provided with a staff file. These were sampled and contained all key information relevant to their employment in the home and individual staff training and development records (including supervision and appraisals). Oakwood Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 19 All staff had attended updated induction training since the previous inspection in accordance with requirements. The Manager had recently undertaken a full audit of the home in accordance with its quality assurance policy. A copy of this document was seen, which included details of staff training undertaken, including NVQs for care staff, over the past year. Additional specialist training objectives were identified in the home’s development plan for the coming year (2005-06). Staff spoken with felt that the arrangements for training were good and agreed with the plan to further develop training in relation to service users specialist needs and conditions. Detailed information was provided for staff regarding each service user’s specialist medical condition(s) and recognised care and management practises in relation to these. Staff duty rotas were examined and were properly kept. A review of staffing and skill mix provided had been undertaken by the manager since the previous inspection and the provision of Registered Nurses had been increased in order to meet the needs of service users accommodated. The staff files of two more recent staff starters were examined. The most recent staff starter had commenced their employment in the home without the confirmation of satisfactory POVA and criminal records checks, although this had been requested. Satisfactory confirmation had been received since the commencement of their employment in the home. Oakwood Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 40, 41, 42 & 43. The home is well managed and run and service users rights and interests are promoted within a framework of effective communication and management systems. EVIDENCE: The Registered Manager is a Registered Nurse Learning Disabilities. She demonstrated commitment to her role and to the ongoing development of the home and its service provision. She provided satisfactory details of training and development undertaken by her since the previous inspection, including NVQ level 4 in management, which had recently commenced. She had a relevant job description. There is a regular cycle for auditing/quality monitoring of all aspects of services provided by the home. Reports of the most recent audits undertaken in the home by the Manager were inspected. The service user questionnaire had been updated with a view to undertaking this. Reports of regular visits to Oakwood Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 21 the home by the Registered Provider were seen, which were satisfactory and included details of consultation with service users and staff. A number of policies and procedures were sampled during the inspection process and were satisfactory. They were reviewed in accordance with changing practise or at least annually. A number of records, which are required by legislation to be kept in the home, were examined. These were satisfactory. Details of the arrangements for core health and safety training for staff were provided and were satisfactory. There was comprehensive policy and procedural guidance in place in relation to health and safety in the home and there were satisfactory arrangements for the annual maintenance of equipment in the home, with the exception of gas appliances, which had been serviced more than 12 months ago. There were suitable systems in place for the reporting and recording of accidents and untoward occurrences. Oakwood Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 2 3 3 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oakwood Bungalows Nursing Home Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 23 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 YA24 Regulation 23(2)(b) Requirement Corridor carpets must be replaced. Original timescale given in report 27.07.04 for 28.02.05. Open ended information must be provided for service users to enable them to make informed choices (in this instance in relation to locks on bedroom doors - records of consultation). Personal care plans must not be openly displayed. They must be properly stored with a copy provided for the service user in accordance with their choice. Comfortable chairs in communal areas must be replaced as necessary. New staff must only be confirmed in post following completion of a satisfactory police check and POVA check. An up to date certificate must be provided for the annual servicing of gas appliances in the home. Timescale for action 31.08.05 2. YA7 12(2) 31.07.05 3. YA10 12(4)(a) 31.07.05 4. 5. YA24 YA34 23(2)(c 19(1) & 19(4)(b) 13(4)(c 31.08.05 31.07.05 6. YA43 31.07.05 Oakwood Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 24 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 Good Practice Recommendations Oakwood Bungalows Nursing Home C52 C02 S2068 Oakwood Bungalows V230204 260505 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection South Point Cardinal Square Nottingham Road Derby, DE1 3QT 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. 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