Inspection on 29/11/05 for Oakwood Bungalows Nursing Home

This inspection was carried out on 29th November 2005.

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

The inspector found 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 4 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 26/05/05

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 Hollingwood Chesterfield Derbyshire S43 1DX Lead Inspector Susan Richards Unannounced Inspection 29th November 2005 10:00 Oakwood Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Oakwood Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Oakwood Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Oakwood Bungalows Nursing Home Address 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) Devon Court Devon Drive Hollingwood Chesterfield Derbyshire S43 1DX 01246 476222 Elmcare Limited Charlotte Janet Bowen Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Oakwood Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. LD Learning disability, not falling within any other category Date of last inspection 26th May 2005 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 in Hollingwood and 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 home’s philosophy of care is based on O’Brien’s Life Principles and Accomplishments, which aims to promote normalisation in terms of the daily lives of each service user in accordance with their individual risk assessed needs and care plans. The home provides each service user with single room accommodation, each having a wash hand basin. There are separate male and female bathing and toilet facilities, a choice of communal lounge and dining space and a small well kept garden area. There is a domestic size kitchen, which is suitably equipped and a dedicated laundry room, where service users who are able can prepare drinks and snacks or launder their own clothing with support from staff. The Manager is supported by a team of Registered Nurses, care and hotel services support staff and external management arrangements. Oakwood Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of this inspection was on case tracked for two newer service users, the arrangements for the staffing of the home, (recruitment, induction and training) and some of the management arrangements in the home, including that relating to complaints and adult protection. The care plans and associated records of the service users case tracked were also examined and their care discussed with the manager and staff. Due to the needs of those service users at that time, the Inspector was not able to discuss their care with them during the inspection. General discussions were held with a number of other service users who were in the home. What the service does well: What has improved since the last inspection? Open-ended information has been provided for service users to enable them to make an informed choice in respect as to whether or not to have a lock fitted to their bedroom doors, with the result that four service users have chosen to Oakwood Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 Page 6 do so. Suitable locks have been provided for those service users in accordance. All care plans are safely stored thereby promoting the confidentiality of service users. A renewal programme for corridor carpets and comfortable chairs has been established. 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 Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Oakwood Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 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 the following standard(s): 2, 3 & 4. There was a consistent approach to the formulation of individual person centred needs assessments and daily living plans, which were well documented and in accordance with evidence based practise. There was a clear and flexible approach to service user admissions in accordance with their individual needs and requirements. Service users needs were generally well met, although the policy guidance for staff in respect of dealing and responding to violence and aggression from service users did not underpin clear and consistent practise. EVIDENCE: There was individually recorded needs assessments in place for each of the service users whose care was examined. These included single assessment and care planning information as provided by care management arrangements and also individual comprehensive needs assessments as collated by the home. This was in accordance with a recognised nursing care model and provided an excellent holistic and person centred record of their individual needs, including identified strengths and needs within a framework of risk assessment. Individual daily living plans were formulated in accordance with the above and in conjunction with the service user and significant others where appropriate. Oakwood Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 Page 9 The Inspector discussed with the manager and staff, the arrangements for admissions, training (see also Concerns, Complaints and Protection and Staffing sections of this report) and the care delivery systems and arrangements as linked to aspects of individual service users care. These were generally satisfactory, although some inconsistencies were identified in relation to approaches to responding to and managing violence and aggression, including policy guidance for staff. The arrangements for the admission of two more recently admitted service users were examined and discussed. These were in accordance with the home’s admission policy and procedure, included trial visits and trial periods and compatibility with existing service users. Oakwood Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 Service users care plans clearly identified their goals and personal aspirations, and as to how those individual needs, goals and aspirations would be met. Policy guidance for dealing with violence and aggression from service users did not underpin or promote consistent practise whilst individual care approaches for service users were being determined. EVIDENCE: Service users case tracked had fairly comprehensive person centred care plans recorded, which were being actively and regularly reviewed. As relatively new admissions, some assessment information, which was not wholly available prior to their admission, was still being determined by staff in the home as part of their assessment process. For example, for one service user, this related to their communication needs and for the other to their challenging behaviours. Discussions were held with the manager and staff regarding methods for the determination of their individual needs and formulation of care planning approaches in respect of the above. Policy guidance was also examined in relation to these, including the management of violence and aggression. Oakwood Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 Page 11 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): The standards in this section were not assessed on this occasion. EVIDENCE: Oakwood Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 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): The standards in this section were not assessed on this occasion. EVIDENCE: Oakwood Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 There were satisfactory systems and arrangements in place to enable service users or their representatives to complain and/or raise concerns. The policy and procedural guidance for staff regarding dealing with violence and aggression from service users did not provide clear and consistent information. It did not promote best practise and was entirely specific to Oakwood as a care setting. EVIDENCE: There is a complaints procedure for the home, which is provided in suitable formats for service users, both within the service user guide and also displayed openly. The system for the reporting and recording of complaints was discussed and records examined. There had been no formal complaints since the previous inspection for this service. Individual issues or concerns raised by service users were recorded in their care records, including outcomes. The policy and procedural guidance provided for staff in respect of adult protection and prevention of and responding to any allegation or suspicion of abuse was examined and discussed, together with the arrangements for staff instruction and training. These were satisfactory. Discussions were held with the manager and staff regarding dealing with violence and aggression from service users. The Inspector looked at this in terms of individual approaches to the care of the service users case tracked and also the home’s policy and procedural guidance, which was also examined, along with the arrangements for associated staff training. Oakwood Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 Page 14 Policy and procedural guidance did not determine in any clear order of overall approach. Some of the procedural information was relevant to a local hospital setting having full time medical staff and was not relevant to practise at Oakwood as a care setting. The systems and arrangements for the management and handling service users monies were also examined. These were satisfactory. Oakwood Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 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 Service users were accommodated in a safe and well-maintained environment, which suited their needs and promoted their independence and privacy. EVIDENCE: A full inspection of the building was not undertaken on this occasion, although a number of communal areas were seen during the course of the inspection. Areas seen were clean and generally well maintained, furnished and decorated. As raised on previous inspection reports, corridor carpets, although clean were ready for a replacement programme. This had been included on the programme for the coming year (2006). Changes had been made (as raised at the previous inspection) to the methods of consultation used to ensure that service users were enabled to make an informed choice as to whether to have a lock to their own bedroom door. Four service users had since chosen to have these, which were provided and were suitable. Service users spoken with were satisfied with their environment. Oakwood Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 Page 16 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 The arrangements for the recruitment, induction, training and supervision of staff were generally satisfactory, although there were some deficits in terms of staff records kept and key induction policy guidance for staff. Overall the home was properly staffed in accordance with service users needs. However, a lack of clear policy guidance in relation to dealing with violence and aggression in the home compromised the delivery of consistent evidence based practise suitable for Oakwood care setting. EVIDENCE: The arrangements for the recruitment, induction, training (including NVQs) and supervision and support of staff were examined. This included the examination of relevant policy guidance and staff job descriptions, staff personal and induction and training records and discussions with the manager, staff and some service users. Details of staff employed were provided, together with staff duty rotas and details of staff turnover. The induction process for staff had been extensively reviewed and a revised format introduced. However, this did not include key policy and procedural guidance/information for dealing with violence and aggression from service Oakwood Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 Page 17 users, although there were service users accommodated who had challenging did express challenging behaviour. The personal files of three staff, all of who had commenced employment since the previous inspection, were examined. These did not contain copies of their references or birth certificates. The manager advised that staff were never employed without the provision of two written references and felt that these were possibly filed with central staff records held at a sister home for the organisation. Oakwood Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 Page 18 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): 40, 41 & 42. Whilst the majority of systems and arrangements in place promoted the rights, safety and welfare of service users, there were a number of significant deficits in relation to records and record keeping, policy and procedural guidance (including aspects of staff training and instruction in respect of these). These deficits potentially compromised the safety and welfare of service users and undermined the efficacy of staff in terms of their accountability and responsibilities to service users. EVIDENCE: A number of the home’s policies and procedures were examined in accordance with the case tracking of service users and also the staffing arrangements for the home. These were satisfactory, with the exception of the policy and procedural guidance for dealing with and responding to violence and aggression from service users (See Complaints and Protection section of this report) and also there was no policy guidance in respect of first aid (staff and service users). Oakwood Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 Page 19 A number of records, which are required to be kept in the home, were also examined during the inspection. These included: Assessment and care planning records (x2 service users case tracked). Staff records – deficits found – see the Staffing section of this report. Complaints records Staff duty rotas Records of service users belongings (x2 service users case tracked). Maintenance records – these were found to be satisfactory at the previous inspection for this service (May 2005), with the exception of the maintenance of gas appliances in the home, which was out of date. The manager advised that this had now been carried out, although there was no certificate provided. The arrangements for core health and safety training and policy guidance regarding safe working practises were examined and were generally satisfactory, although the status of all staff in terms of basic first aid instruction was not verified (with no policy guidance provided). Oakwood Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 2 3 X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X x LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 3 2 2 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oakwood Bungalows Nursing Home Score X X X X Standard No 37 38 39 40 41 42 43 Score X X X 2 2 2 x DS0000002068.V268500.R01.S.doc Version 5.0 Page 21 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 YA23 Regulation 13, 18 Requirement Timescale for action 28/02/06 2 YA34 17 3 YA42 13 4 YA42 13 The registered persons must ensure that there is clear and relevant policy and procedural guidance in place for staff in relation to dealing with and responding to violence and aggression from any service user and that staff receive proper instruction (and to be included in the induction process) as to be conversant with these and to ensure consistency in (recognised) practise. The registered person shall 31/01/06 maintain records in the home in accordance with Schedule 4 – copies of 2 references for staff and a copy of their birth certificate. The registered person must 31/03/06 ensure that there are suitable arrangements for the training of staff in first aid and that there is suitable policy guidance in place in respect of first aid in the home. The registered persons must 02/01/05 provide/forward a copy of the most recent certificate for the maintenance of gas appliances to DS0000002068.V268500.R01.S.doc Version 5.0 Oakwood Bungalows Nursing Home Page 22 the Commission. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Oakwood Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Derbyshire Area Office 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. Extracts may not be used or reproduced without the express permission of CSCI Oakwood Bungalows Nursing Home DS0000002068.V268500.R01.S.doc Version 5.0 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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