Inspection on 27/08/08 for Oakwood Home - Leonard Cheshire Disability

This inspection was carried out on 27th August 2008.

CSCI found this care home to be providing an Good service.

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

Oakwood Home - Leonard Cheshire... 01/08/05

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 08/11/2008.

CARE HOME ADULTS 18-65 Oakwood (Cheshire) Home Radford Close Offerton Stockport Cheshire SK2 5DL Lead Inspector Mrs Fiona Bryan Unannounced Inspection 27th August 2008 10:00 Oakwood (Cheshire) Home DS0000008604.V370098.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 (Cheshire) Home DS0000008604.V370098.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 (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakwood (Cheshire) Home Address Radford Close Offerton Stockport Cheshire SK2 5DL 0161-419 9139 0161 419 9312 corinne.waters@lcdisability.org www.LCDisability.org Leonard Cheshire Disability 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) Manager post vacant Care Home 13 Category(ies) of Learning disability (13), Learning disability over registration, with number 65 years of age (13), Physical disability (13), of places Physical disability over 65 years of age (13) Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered persons may provide the following categories of service only: PC, to service users of the following gender: Either; whose primary needs on admission to the home are an Acquired Brain Injury and who require rehabilitation. The maximum number of service users who can be accommodated is: 13. 20th September 2006 2. Date of last inspection Brief Description of the Service: Oakwood is part of the Leonard Cheshire group. Leonard Cheshire is a registered charity. Oakwood is a specialised facility, which caters for the rehabilitation needs of up to 13 adults, all of who have an acquired brain injury. Oakwood is one of a small number of specialist services in Britain, which offer 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 sufficiently 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. The cost of the service is individual to the needs of the service user and the amount of support they require. The current fees range from £1669 - £3383 per week. Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key unannounced inspection, which included a site visit, took place on Wednesday, 27th August 2008. The staff at the home did not know that this visit was going to take place. All the key inspection standards were assessed at the site visit and information was taken from various sources, which included observing care practices and talking with people who live at the home, the person in charge and other members of the staff team. Two people were looked at in detail, looking at their experience of the home from their admission to the present day. A selection of staff and care records was examined, including medication records, training records and staff duty rotas. Before the inspection, we asked for surveys to be sent out to residents and staff, asking what they thought about the care at the home. Four residents and five staff returned their surveys. Many of the residents found it difficult to communicate and staff had helped them to answer the questions. Feedback from these questionnaires is included in the report. We also asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helps us to determine if the management of the home see the service they provide the same way that we see the service. We feel she completed this well and we agree with what she wrote. She was able to tell us what plans she has in place to continue developing the service. The manager had been appointed since the last key inspection. What the service does well: Detailed assessments are undertaken with each resident before they are admitted to the home to ensure they meet the criteria for admission and so the resident can be assured that their needs can be met. Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 6 A detailed individual support plan is developed in consultation with each resident, which clearly records the goals for that person and how they are to be achieved. A range of health care professionals works together, and with each resident to maximise their progress and independence. Staff felt that the manager was supportive and appeared to enjoy their work. One member of staff commented “Good team working. Manager is very knowledgeable and approachable”. Staff were observed to be patient and competent when dealing with residents. People with communication difficulties were given time to express their wishes. Since her appointment, the manager has undertaken a satisfaction survey with the residents and was able to show how she had taken their views into account and what she had done to address any issues they raised. Staff received training in a variety of topics. However, the target for staff achieving NVQ qualifications was not met and more staff should be encouraged to pursue this training. What has improved since the last inspection? What they could do better: Each resident’s progress is discussed once a fortnight at a multi-disciplinary meeting (MDT). Detailed records are kept of the discussions and decisions made. Although it was reported that residents were made aware of these meetings and were asked their views or could attend, the records did not show this. Residents are well supported by staff in respect of their physical rehabilitation and life skills, but further consideration should be given to the provision of IT, further education, jobs and holidays to expand residents’ opportunities for development and independence. Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 7 Some improvements are needed in respect of the recording and stock control of medicines. Procedures for recording the withdrawal of residents’ money should be stronger. The manager should keep staffing levels under review, especially at weekends, to ensure that there are sufficient staff to meet residents’ needs. Leonard Cheshire conducted a health and safety inspection of the home in August 2008, which identified several areas for action. The manager was able to update us on progress to date and gave us a commitment that all the shortfalls identified will be addressed within the timescales they have set. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People are only admitted to the home after a full assessment has been undertaken, thereby ensuring that people are only admitted if the manager is confident the staff have the skills and knowledge to meet those needs. EVIDENCE: Whilst we were at the home we asked to see the service user guide. This contained information about the home and the services offered. The team leader said that a copy was provided to each resident when they were admitted and that prior to admission the manager always visited each new resident and gave them information about the home. Two residents who returned surveys wrote that they did not receive enough information about the home before they moved in to help them decide if it was the right place for them. The team leader acknowledged that further consideration could be made as to how information could be made more accessible for new and prospective residents. Two residents were case tracked. Detailed assessments had been carried out with both of them prior to their admission. Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 10 Staff who returned surveys said that all relevant information was supplied in each resident’s Individual Service Plan (ISP) folder, which was put in place before the resident arrived, to ensure staff were aware and informed. Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents were generally involved in planning and agreeing their care needs which provides them with some control over how they want the care to be delivered. EVIDENCE: Two residents were case tracked. Each had a detailed Individual Support Plan (ISP) in place that was person centred and provided specific information about their preferences and routines. All residents were reviewed once a fortnight by the multi-disciplinary team (MDT) and accurate records were kept of these discussions and any decisions taken. Further in-depth reviews were held for each resident every 12 weeks. Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 12 Each resident was assigned two key workers and one of them would attend the MDT meeting. It was reported that residents were given the opportunity to attend, however there should be more evidence on the MDT record that residents’ views have been sought or they have been asked and encouraged to attend the meetings. ISP’s contained detailed information about the best communication methods for each resident and staff were observed following the actions stated. For example, one resident used an alphabet chart to communicate and staff were seen to allow plenty of time for the resident to answer their questions. Each resident had a risk matrix covering all aspects of potential risks to them, such as nutrition, swallowing, skin condition, mobility, mental health, abuse (including their risk to others and the risk from other residents currently on unit to them). A very detailed action plan had been written in each case to minimise identified risks. Staff were observed offering residents options and choices, for example, with where they wanted to sit, what they wanted to drink and so on. Staff confirmed that a key worker system was in knowledgeable about individuals’ needs and preferences. place, and were Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents were encouraged to make daily choices and follow their preferred daily routines, as far as their rehabilitation programmes would allow. EVIDENCE: Two therapy co-ordinators work at the home and they are responsible for organising individual daily programmes for each resident. There are five “supported living flats” that are designed to accommodate people who are improving living skills in preparation for leaving Oakwood and either going home or moving to other semi-supported accommodation. There were two people currently in residence in the flats and staff supported them to do their own shopping, cooking, laundry and cleaning, etc. Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 14 The other five residents currently living at the home still required more support from staff and, as the emphasis was focussed on rehabilitating residents, they were encouraged to follow goal orientated programmes, for example, improving trunk stability, by spending time in the gym using equipment such as the parallel bars and standing frames. These residents were not at the stage of considering employment or further education opportunities but one of the residents in the supported living flats was. The home does not have proper IT access for residents and this should be considered to broaden residents’ opportunities and enable them to access other resources, look for employment or research educational interests. The manager did say in the information returned to us that staff had tried to encourage educational and employment opportunities but found it difficult to get the majority of residents to engage in these. It was reported that none of the residents had been on holiday away from the home. It would be considered good practice to arrange a holiday for each resident within the contract price, which each resident helps to choose and plan. In surveys returned by residents, one person said they could always make decisions about what they did each day, two said they sometimes could and one person said they never could. Staff said that meals were discussed with the five residents who did not do their own shopping and a weekly menu was devised that all residents were happy with. The weekly menu was displayed in the kitchen and was adapted to suit the needs of each resident. For example, some residents preferred Ryvitas and cottage cheese to sandwiches as they were trying to lose weight. A light meal was served at lunchtime and a larger meal was prepared at teatime. Each resident’s keyworker made their lunch, with help from the resident if they wished. One of the staff was designated during the afternoon to make the evening meal, which consisted of dishes such as pasta carbonara, chicken in red wine, prawn curry and fish and chips. The service user guide advises people to visit in the evenings and at weekends so that residents’ rehabilitation programmes are not interrupted. Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents’ health and personal care was being met by staff who were aware of their individual needs. EVIDENCE: Two residents were case tracked. Their ISP’s detailed their personal care needs and their preferred method of support. Residents said staff were kind and treated them well. Intervention programmes had been developed for more complex health care issues as well as personal care needs. For example, one resident exhibited challenging behaviour at times and a plan was in place to help staff manage this consistently. Records showed that residents received input from a range of healthcare professionals, including physiotherapists, occupational therapists, district nurses, dieticians, Speech and Language Therapist (SALT) and a neuropsychologist. Records demonstrated consultation processes, reviewing and monitoring of all aspects of health for the resident. Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 16 Residents looked well cared for; clean, dressed appropriately and using equipment specifically made or adapted for them, where necessary. 75 of the residents who returned surveys said that staff always or usually treated them well and listened and acted on what they said. No further comments were made by the residents that said staff only sometimes treated them well or acted on what they said. We looked at the medicine records for the residents we case tracked. Medicines coming into the home had been recorded. Where instructions for the administration of medicines are handwritten by a member of staff, a second member of staff should sign that they have checked it. Records were not always fully completed for the administration of PEG feeds. An accurate record should be maintained so the resident’s dietary intake can be monitored. One of the medicines for one resident had not been given to them for a week. Staff had recorded that the medicine was out of stock. Prompter action should be taken to ensure that when medicine stocks run low they are replaced so the residents do not miss doses. Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Staff had received training in protection issues, so they would know what to do if they suspected residents were not being properly treated. EVIDENCE: Extensive adult protection procedures were in place and staff training was ongoing. Staff were aware of the procedures to follow if they suspected abuse or had concerns. Written complaints procedures were in place and residents were provided with a copy of the procedures at the point of admission. One resident spoken to said he knew how to make a complaint and “would have no hesitation in complaining if necessary”. The manager said that following a residents’ survey she carried out, further work had taken place to ensure residents knew how to raise concerns, as from the feedback, one resident had said they did not know. The complaints procedure has recently been posted out to family members. The home keeps a record of complaints made and this showed that they had been investigated and dealt with properly. Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 18 Since the last inspection one complaint has been referred by the manager to the safeguarding adults team and an investigation into this matter is ongoing. The manager took appropriate action and has worked with the safeguarding team to investigate the complaint. The team leader felt that staff and management at the home had built good relationships with residents’ families and was sure they would raise concerns if they found it necessary. Procedures were in place to help residents manage their money. We were unable to look at these in detail as the manager was not available but when we looked at the records we noticed that two signatures were not always obtained when transactions were carried out. Two members of staff or the resident and a member of staff should sign when cash is withdrawn from a resident’s account. Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Lack of proper maintenance in some areas means that the environment is not always user friendly for the residents living at the home. EVIDENCE: A partial tour of the home was undertaken. The home was clean and tidy and 75 of residents who returned surveys said the home was always or usually clean and fresh. It was reported that one cleaner worked four hours per day from Monday to Friday. Part of the daily programme for each resident was to keep their bedroom tidy and the night staff cleaned the communal areas at night, when residents were not using them. Since the last key inspection, Oakwood Cheshire has converted eight bedrooms into five self-contained flats. The flats are more suitable for enabling residents to regain their independence. The reduction in rooms means that there is now only accommodation for 13 residents instead of the previous 16. Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 20 The five self-contained flats each provided a kitchen and living area and separate wet room. They had been designed to maximise independence for the residents living in them. In the AQAA the manager reported that there are now plans to modernise the remaining eight bedrooms and quotes are being obtained to commence and complete the work by the end of the year. These rooms do need upgrading and the communal areas would also benefit from some redecoration and refurbishment. Some additional facilities were provided in line with the home’s remit for rehabilitation, such as a physiotherapy room and a gym. However, one relative who returned a survey earlier this year felt equipment was becoming dated and prone to breaking down and suggested more investment in exercise and physiotherapy equipment was needed. A senior manager from Leonard Cheshire carried out a Health and Safety inspection at the beginning of August 2008 and the report from this recognises some areas of the home need attention, for example, general maintenance tasks and upkeep of the garden and external pathways. Upkeep of the building is discussed further in the management section of this report. Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Staff are generally provided in sufficient numbers to meet residents’ needs. EVIDENCE: Opinions were varied from residents and staff regarding staffing levels at the home. Five staff returned surveys and all of these said there were usually enough staff to meet residents’ needs, but several made comments such as “Technically there are enough staff for service users; however, rehabilitation is a complex programme and is time consuming and considering the service users have appointments, go shopping, cooking whilst staff have to help do programmes, there isn’t enough, so something will always not get done”, and “Sometimes there are not enough staff to fulfil specific tasks like going on outings”. Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 22 Staff spoken to on the day of the site visit said that agency staff were used regularly and that due to staff “shortages” residents’ rehabilitation programmes were sometimes not carried out as they should be but personal care needs were always met. Two residents said they sometimes had to wait for help. The staff duty rotas for the weeks commencing 18th and 25th August 2008 were seen. During the week, in the mornings, there were generally five support workers plus one or two therapy co-ordinators and the team leader and the manager. In the afternoons and evenings the numbers of support workers often dropped to four with one of the therapy workers working until 6pm and the team leader and the manager working until 5pm. At weekends one therapy co-ordinator worked on Saturdays but neither did on Sundays and numbers of support workers were sometimes reduced. The cleaner does not work regularly at the weekends and support workers have to make the meals or assist residents to make their own meals, so staffing, particularly at weekends, may be only borderline sufficient. Rotas also did not demonstrate if there was flexibility in staff working patterns and shifts, to take into account the needs of the residents, for example, in supporting them outside the home at weekends and during the evenings. The AQAA said that only five out of the 24 support workers employed at the home had achieved NVQ level 2 or above. This constitutes 20 of staff. Another three staff were undertaking the training but more staff need to be encouraged to gain this qualification to meet the National Minimum Standard for NVQ training. Training records showed that staff had undertaken a range of training, such as medicine management, disability and the law, safeguarding adults, individual support planning, key working, First Aid, moving and handling, food hygiene, infection control and fire awareness. The manager reported that additional training had been provided to staff when new residents were admitted who needed feeding pumps. Training updates are delivered by specific practitioners on a weekly basis to staff following the MDT meetings, to ensure staff understand any changes in interventions or goals for the residents. Discussions about the best ways to communicate with residents are provided by the Speech and Language Therapist (SALT), although this type of training and input is not certificated. Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 23 Leonard Cheshire have a training and development office based in Warrington and it was reported that all new staff receive induction training there once a week for six weeks. The team leader said that once induction was completed it was intended that each staff member had a personal development plan put in place and she was starting to do this for each person. Although it was highlighted at the last key inspection, it was acknowledged that formal staff supervision sessions were still not done regularly. The reason for this was cited as lack of time. Staff personnel files could not be viewed at this inspection as the manager was not available and these records were locked away to comply with Data Protection. No issues were identified concerning the recruitment procedures for new employees at the last inspection and the manager confirmed in the AQAA that a robust recruitment procedure was maintained. Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The manager has a good understanding of the areas in which the home needs to improve and indicated how this improvement was going to be managed which will result in better outcomes for people living at the home. EVIDENCE: Since the last inspection a new manager has been recruited who has nearly completed the process to register with the CSCI. Since her appointment the manager has conducted a residents survey to gain their feedback about how the service was meeting their needs. The manager was able to show that issues raised from the survey had been noted and work undertaken to address them. Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 25 Group residents’ meetings are not held but all residents have the opportunity to make comments and suggestions about the service during their regular reviews. Staff said the manager was supportive and approachable. Comments included “My manager supports me throughout everything and is a great help” and “The service manager is involved with all day to day tasks. She is always willing to assist and give support”. At this site visit a number of health and safety issues were identified. For example, regular checks of the building and equipment had not been carried out. The team leader said that this was because a maintenance person was no longer employed and although staff had been allocated to undertake certain tasks, they did not always have time to do them. Although there were issues, it was apparent that they were already known to the manager and senior management of Leonard Cheshire. The company had conducted an internal health and safety inspection on 1st August 2008 and the team leader had produced an action plan to address the outstanding work. Timescales of between one and three months had been agreed for the completion of the work and since the site visit the manager has confirmed that a number of the items have been dealt with and arrangements made for the imminent resolution of the rest. Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 26 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 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 2 29 2 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 27 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 Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 28 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 Refer to Standard YA7 YA14 Good Practice Recommendations The records of MDT reviews should show that the resident has been asked to give their view and/or asked to attend the meeting. Further work should be carried out to consider areas such as IT, further education, jobs and holidays to expand residents’ opportunities for development and independence. Where staff hand write instructions for the administration of medicines, this should be verified and countersigned by a second member of staff. Staff should ensure that an accurate record is maintained when residents are receiving enteral feeds. The arrangements for ordering medicines should be reviewed to ensure that residents do not run out of medicines. When money is withdrawn from a residents account there should be two signatures to verify this. Consideration should be given to replacing or adding to the gym equipment provided. The manager should continue to support and encourage staff to undertake NVQ training so that the target of 50 of support workers holding this qualification can be met. Staffing levels should be kept under review and the rota should provide evidence that flexibility in staff cover enables residents’ needs to be met. The registered person should ensure that all staff receive increased formal supervision during the transition stages and development of the home. The manager should make sure that that the matters arising from the Health and Safety audit undertaken on 1/8/08 have been addressed. 3 4 5 6 7 8 9 10 11 YA20 YA20 YA20 YA23 YA29 YA32 YA33 YA36 YA42 Oakwood (Cheshire) Home DS0000008604.V370098.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Manchester Area Office Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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