Inspection on 01/08/05 for Oakwood Home - Leonard Cheshire Disability

This inspection was carried out on 1st August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oakwood Home - Leonard Cheshire... 27/08/08

Oakwood Home - Leonard Cheshire... 20/09/06

Oakwood Home - Leonard Cheshire... 19/01/05

Oakwood Home - Leonard Cheshire... 16/08/04

Oakwood Home - Leonard Cheshire... 15/03/04

Oakwood Home - Leonard Cheshire... 22/01/04

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 (Cheshire) Home Radford Close Offerton Stockport SK2 5DL Lead Inspector Sylvia Brown Announced 1 August 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 (Cheshire) Home F54 F04 oakwood (cheshire) A s8604 v233663 010805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Oakwood (Cheshire) Home Address Radford Close, Offerton, Stockport, SK2 5DL 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) 0161-419-9139 0161-419-9312 oakwood@nw.leonard-cheshire.org.uk Leonard Cheshire Mrs S Jehu (Locum Manager) CRH - Care Home 16 Category(ies) of LD - Learning Disability (16) registration, with number LD(E) - Learning Disability over 65 (16) of places PD - Physical Disability (16) PD(E) - Physical Disability over 65 (16) Oakwood (Cheshire) Home F54 F04 oakwood (cheshire) A s8604 v233663 010805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Service users to include up to 16 PD, up to 16 PD(E), up to 16 LD and up to 16 LD(E). Service users to include up to 16 with an acquired brain injury for rehabilitation. Date of last inspection 19 January 2005 Brief Description of the Service: Oakwood is part of the Leonard Cheshire group of homes. The Leonard Cheshire Foundation is a registered charity. Oakwood is a specialised facility which caters for the rehabilitation needs of up to 15 adults, aged between 18 and 65, all of who have an acquired brain injury. The home is registered to provide care and accommodation for one person over the age of 65. Oakwood is one of a small number of specialist homes in Britain which offers the kind of structured environment to enable people, after acquiring a brain injury, to return home and live as full a life as possible. As a consequence of these limited resources, the service users at Oakwood are from all parts of the United Kingdom. The objectives of Oakwood are to sufficently rehabilitate service users to enable their return back into the community. Complex packages of care which are individually developed to enable each service user to regain skills and confidence through re-learning self caring routines, socialisation and education. Oakwood (Cheshire) Home F54 F04 oakwood (cheshire) A s8604 v233663 010805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Oakwood was announced and completed in one day, commencing at 8:00am. Time was spent speaking to service users, staff and relatives. Questionnaires were sent to service users, relatives and professional visitors to the home. Of these, two relatives, two professional visitors and two general practitioner questionnaires were returned, comments received are included within the report. At the time of the inspection the home was without its own registered manager and was being managed by a locum manager who has extensive experience in managing change and developing services and homes to meet their aims and objectives. Prior to the inspection the home completed a pre-inspection questionnaire. Time was spent sitting and talking to residents, staff and visitors. On the day of the inspection three residents who have lived at the home for some considerable time were in the process of moving on to new placements. In addition, one service user was being escorted to the dentist for treatment. What the service does well: Each service user has an individual care plan (ISP) and work programme which are devised by numerous professionals who specialise in supporting people with a brain injury and the individual resident. Feedback from visiting medical professionals identified that the home communicates well and works in partnership with them. Oakwood (Cheshire) Home F54 F04 oakwood (cheshire) A s8604 v233663 010805 stage 4.doc Version 1.40 Page 6 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 (Cheshire) Home F54 F04 oakwood (cheshire) A s8604 v233663 010805 stage 4.doc Version 1.40 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 (Cheshire) Home F54 F04 oakwood (cheshire) A s8604 v233663 010805 stage 4.doc Version 1.40 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) 2 & 3 Service users are assessed prior to and during their stay. EVIDENCE: Examination of residents’ files identified that assessments were completed prior to admission and throughout their stay. It was recognised by the locum manager that the process used for the most recently admitted resident could be improved, including how information was obtained and recorded. The registered manager was able to provide evidence that training was being undertaken to improve practice. Previously, although admitted to the home for rehabilitation, most residents were not enabled to return home in a timely manner, culminating in some languishing at Oakwood unnecessarily. However, new systems mean that information provided to prospective service users which details the aims and objectives of the home and the support provided to promote rehabilitation will be carried through. Oakwood (Cheshire) Home F54 F04 oakwood (cheshire) A s8604 v233663 010805 stage 4.doc Version 1.40 Page 9 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 Service users know their personal needs are recorded. sufficiently consulted or kept informed of changes. Relatives were not EVIDENCE: The home holds multi-disciplinary meetings to ensure that changing needs are recognised and recorded, however families spoken to stated that, in the main, they felt excluded from the consultation process and that information was not readily proved to them in a timely way. At the time of the inspection the home was re-establishing routines to promote rehabilitation. The locum manager was clear that service users will not be included in the day-to-day running of the home, as the emphasis of each placement will be to achieve set goals and return to the community. Notwithstanding the previous comments, the views of service users should be formally sought regarding service provision within the home. Oakwood (Cheshire) Home F54 F04 oakwood (cheshire) A s8604 v233663 010805 stage 4.doc Version 1.40 Page 10 Some residents take some risks. The locum manager stated she was aware that staff need confidence in enabling residents to take risks, as it forms part of the residents’ assessment, progress and abilities, enabling them as far as possible to gain and maintain independence and choice. Where risks are recognised, ISP’s detail risk areas and the support required to promote safety. Oakwood (Cheshire) Home F54 F04 oakwood (cheshire) A s8604 v233663 010805 stage 4.doc Version 1.40 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 standard(s) 12, 13, 15 & 17 Service users have the opportunity to meet with people their own age, however the cultural and sexual needs of service users are not met. The home provides service users with a varied and healthy menu . EVIDENCE: Some service users are able, with support, to go out into the community and meet with people their own age. Nevertheless, the inspector could not ascertain what opportunities they have to meet and make friendships outside of the home and have sexual relationships. The locum manager explained that the home was not as culturally aware as it should be and that areas of the service need developing to ensure the holistic needs of residents from an ethnic background and who have cultural differences have their needs met. Oakwood (Cheshire) Home F54 F04 oakwood (cheshire) A s8604 v233663 010805 stage 4.doc Version 1.40 Page 12 Since the last inspection in-house and external social activities have decreased. It is imperative that the younger adults have the opportunity to enjoy social activities outside of their rehabilitation programme. The home offers an extensive menu with a variety of meals served at each meal time. Observations were that all meals were automatically served to the residents, even though some residents had the ability to serve themselves. It was also noted that though many food options were served, there was no inclusion of food from ethnic communities, although the home was providing care to one person from such a community. Oakwood (Cheshire) Home F54 F04 oakwood (cheshire) A s8604 v233663 010805 stage 4.doc Version 1.40 Page 13 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 & 20 Residents receive personal care support and have their health care needs met, but not always in their preferred way. Medication administration procedures were not maintained to the required standard. EVIDENCE: Residents’ ISP’s detailed their care support needs and how they should be met. Preferences were noted regarding how personal care support should be provided and by whom. Although recorded, residents and their families could not confirm that support was always provided in the preferred manner. It became apparent that rigid routines were in place, however it was difficult to ascertain if the staff were always working in the best interests of residents or to ensure tasks were completed. When speaking with a resident and his family, the inspector was interrupted on three occasions by staff who wanted to complete routines. Residents’ health care is monitored and reviews and support provided to ensure, as far as possible, good health is maintained. Oakwood (Cheshire) Home F54 F04 oakwood (cheshire) A s8604 v233663 010805 stage 4.doc Version 1.40 Page 14 Medication records failed to record administered medication appropriately and according to the required standard. Signature omissions were evident, prescribed shampoo and cream were not recorded as administered and handwritten medication unclear as to dosage and when administered dosage was not identified. Oakwood (Cheshire) Home F54 F04 oakwood (cheshire) A s8604 v233663 010805 stage 4.doc Version 1.40 Page 15 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) 22 The home’s complaint procedure is not effective. EVIDENCE: The home has a written complaints procedure in place. The pre-inspection questionnaire stated that there had been no complaints made since the last inspection. When spoken to, service users stated they knew how to make a complaint. Relatives made comment that they were aware of the complaints procedure, however past experience has led them to believe that their complaints are not recognised. Oakwood (Cheshire) Home F54 F04 oakwood (cheshire) A s8604 v233663 010805 stage 4.doc Version 1.40 Page 16 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 & 30 The environment requires significant upgrading to meet required standards. It was clean and free from odours. EVIDENCE: The previous inspection highlighted many areas within the home which required upgrading. Prior to the inspection the home submitted a comprehensive work programme which identified timescales and action to be taken to ensure the home’s environment and facilities are improved. Two service users invited the inspector into their rooms. The rooms were appropriately furnished and personalised according to the service users’ own wishes. Again, the inspector observed electrical equipment in close proximity to sink basins and running water; such placement of equipment places service users at an increased risk of accident and/or injury. Oakwood (Cheshire) Home F54 F04 oakwood (cheshire) A s8604 v233663 010805 stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 & 35 Service users’ needs are met by trained staff. EVIDENCE: The pre-inspection questionnaires indicates that of the 47 staff employed, 11 have completed NVQ training at level 2 or above. The home has not managed to meet the training target recommended of 50 of staff trained to NVQ level 2 or above by 2005. Staff complete induction training at the commencement of their employment and training schedules produced indicated training is ongoing for all staff. Supervision is provided on a one to one and group basis. Oakwood (Cheshire) Home F54 F04 oakwood (cheshire) A s8604 v233663 010805 stage 4.doc Version 1.40 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 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 & 42 Service users’ health and well being is protected, though the lack of consistent leadership has affected the running of the home. EVIDENCE: The home has been without a registered manager and/or strong leadership for some considerable time. Temporary managers have been seconded to run the home whilst management issues have been resolved. Currently, the home is being managed by a locum manager who has been specifically brought in to not only manage the home but to re-establish is rehabilitation status and develop the service to meet its stated aims and objectives. The manager has a wealth of experience and is competent to make the significant changes required. Oakwood (Cheshire) Home F54 F04 oakwood (cheshire) A s8604 v233663 010805 stage 4.doc Version 1.40 Page 19 On the day of the inspection three service users were being discharged back into their own community. One person being discharged indicated his pleasure at going ‘home’ and that he had been waiting a long time. The home has not completed a quality assurance review which seeks the views of service users, families, staff and visiting professionals and stakeholders, as stated within the Regulations. Policies and procedures are in place, with health and safety personnel visiting the home regularly to complete safety checks. Servicing records were up-todate and correct. Fire safety officers inspected the home in July 2005, at which time a number of non compliance areas were identified and remedial action required, some of which remained outstanding at the time of the inspection. Oakwood (Cheshire) Home F54 F04 oakwood (cheshire) A s8604 v233663 010805 stage 4.doc Version 1.40 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 3 x x Standard No 22 23 ENVIRONMENT Score 1 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 2 2 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x x x x x x Standard No 11 12 13 14 15 16 17 x 2 2 x x 2 3 Standard No 31 32 33 34 35 36 Score x 2 x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oakwood (Cheshire) Home Score 2 3 1 x Standard No 37 38 39 40 41 42 43 Score 3 3 1 3 x x x F54 F04 oakwood (cheshire) A s8604 v233663 010805 stage 4.doc Version 1.40 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 YA20 Regulation 13(2) Requirement The registered person must ensure that medication administration records are maintained appropriately and conform to required standards and the Royal Pharmaceutical Societys guidance. The registered person must ensure that all staff are aware of their responsibilities to report and record all complaints. The registered person must ensure that the complaints procedure is provided to all residents and visitors, and that it is acted upon when a complaint is received. The registered person must ensure compliance with the fire officers report issued in July 2005. The registered person must ensure that the refurbishment programme is completed within the agreed timescales. The registered person must ensure drink making facilities and lamps are not placed near sinks/running water in residents rooms. The registered person must Timescale for action 31/08/05 2. YA22 22 31/08/05 3. YA22 22 31/08/05 4. YA22 13(4) 23(4) 23 30/09/05 5. YA24 15/12/05 6. YA24 13(4)(a) 31/08/05 7. YA39 24 31/01/06 Page 22 Oakwood (Cheshire) Home F54 F04 oakwood (cheshire) A s8604 v233663 010805 stage 4.doc Version 1.40 complete a quality assurance audit, as required by Regulation 24 of the Care Homes Regulations, 2001. 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 YA8 Good Practice Recommendations The registered person should ensure that systems are introduced and implemented to consult with residents and their families regarding care planning and ensure information is passed on in a timely manner. The registered person should consult with residents regarding their satisfactionwith service delivery and enable them to affect changes, where appropriate, within the home. The registered person should increase opportunities for residents to meet with peers and form friendships and relationships outside of the home. The registered person should implement a culturally aware service which can meet the holistic needs of residents from an ethnic minority background. The registered person should ensure that sex and sexuality issues are discussed with residents and that their right to personal, private and sexual relationships is recognised and, as far as possible, met. The registered person should, where appropriate, enable residents to serve themselves at meal-times. The registered person should ensure that residents are supported in the way they prefer. The registered person should ensure that 50 of staff complete NVQ training by March 2006. 2. YA8 3. 4. 5. YA12 YA12 YA15 6. 7. 8. YA16 YA18 YA32 Oakwood (Cheshire) Home F54 F04 oakwood (cheshire) A s8604 v233663 010805 stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 2nd Floor Heritage Wharf Portland Place Ashton under Lyne, OL7 0QD 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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