Inspection on 10/05/06 for Ocknell Park

This inspection was carried out on 10th May 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ocknell Park 17/07/07

Ocknell Park 07/02/06

Ocknell Park 24/05/05

Ocknell Park 21/02/05

Ocknell Park 18/10/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Ocknell Park Stoney Cross Lyndhurst Hampshire SO43 7GN Lead Inspector Laurie Stride Unannounced Inspection 10 & 12th May 2006 10:00 th Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 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 Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 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. Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ocknell Park Address Stoney Cross Lyndhurst Hampshire SO43 7GN 023 8081 1287 023 8081 4083 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) Truecare Group Limited Mr D Bennett Care Home 11 Category(ies) of Learning disability (11), Mental disorder, registration, with number excluding learning disability or dementia (11) of places Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th February 2006 Brief Description of the Service: Ocknell Park is a large detached house set in its own grounds in the heart of the New Forest. The home has one lounge and one lounge/dining area and a large conservatory that leads to a patio area with fishpond. The eleven residents each have their own bedrooms and these are located on both floors of the home. The home has large well-maintained gardens. Within the grounds there is also a day service that the residents can attend. The aim of the home is to provide accommodation and support for people with complex and challenging behaviour who have either a learning disability or a learning disability with associated mental health problems. The current range of fees charged by the home is £1,800 to £2,500 per week. Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and took place over two days, the 10th and 12th of May 2006. The inspector met and spoke with four of the residents, two members of the support staff, the registered manager and two assistant managers. A tour of the premises was undertaken and samples of the home’s records were read. Positive comments about the service were received from residents and staff and evidence of good practice was seen. Since the last inspection the majority of previous requirements had been met. What the service does well: What has improved since the last inspection? The home’s Statement of Purpose and Service User’s Guide has been amended to include details of supervision which may have an effect on resident’s privacy and independence. Care plans reflect the levels of staff supervision inside and outside the home and show how decisions regarding supervision are arrived at. Care plans also detail the signs and symptoms indicating that individual residents may need ‘as required’ medication. The home’s records show that referrals and contacts are made with relevant health and social services’ personnel regarding changes in resident’s mental health. There is a system for recording and responding to complaints made in confidence by residents. The home has a policy and procedure regarding residents who are arrested and held in custody, including staff acting at these times as appropriate adults. Arrangements have been made regarding the collapsed lintels in the cellar to establish the structural safety of the building and building work required, however this has still to be completed. A quality assurance system has been developed to seek the views of residents and other stakeholders. Incidents such as significant aggression are notified to the Commission and the home Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 6 has taken steps to ensure that the correct safety policies and procedures are followed. 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. Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 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 Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 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): 1,2 & 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and prospective residents benefit from clear information about the home’s policies and procedures. The home has a comprehensive system for assessing prospective residents’ needs and there was sufficient evidence from this inspection to indicate that the home is currently meeting the needs of the residents. EVIDENCE: The home’s Statement of Purpose and Service Users’ Guide are available in the home and give information about the service provided and the complaints procedure. Since the last inspection visit these documents have been amended to include reference to the fact that some residents may require oneto-one, or two-to-one, support and supervision around the home and/or community, which has a direct effect on the independence and privacy of the residents. The documents state that such support will be identified through the assessment process involving professional parties and recorded within care plans and risk assessments. Also that any identified restrictions, the reason why and the form these will take, will be explained in the preferred language to the resident. This meets a requirement made in the last inspection report. The home’s process for admission of residents involves the completion of its own assessment as well as representatives of the home attending multiOcknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 9 agency Care Programme Approach (CPA) planning meetings, led by social services and health trusts. Records of comprehensive pre-admission assessments are held in residents’ files. There had been no new admissions to the home since the last inspection. One resident had been discharged from the home following a decision by the management and external professionals that the home could no longer meet the individual’s needs. Previous reports have raised concerns that some residents are accommodated with needs beyond that which can be met by the home. The home records a relatively high level of incidents of aggression and violence from residents necessitating physical restraint, although this lessened significantly during April this year. Although there has been no overall review of its operational policy, as previously recommended, there are improvements, some still in the process of being made, in terms of the recording and analysis of incidents, the record of contacts with mental health specialists and additional safety measures, following reports and requirements by the Environmental Health Officer (EHO) and Commission for Social Care Inspection (CSCI). Care plan records have also improved and there are plans to provide more mental health related training to all staff. Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 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): 6,7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good care planning arrangements and staff respect residents right to make decisions where they are able. Documentation regarding one-toone support and supervision has improved. EVIDENCE: As at previous inspections, records of residents’ care plans were seen to be of a good standard with clear guidelines for staff where areas of risk were identified. Each plan seen focused on a specific need and detailed the objectives and method of support, describing any restrictions on choice and freedom that may be imposed by specialist program, for example through the Care Programme Approach (CPA). Objectives included minimising risks and methods included opportunities for residents to discuss their feelings. A previous requirement was for care plans to accurately reflect the level of staff supervision both inside and outside the home. Through the sample of four residents case-tracked, this requirement appeared to have been met. Of these residents, two required frequent one-to-one supervision and their care Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 11 plans gave detailed written guidance about when and why this is needed and how staff should carry it out with each resident. One example showed an additional care plan for when increased level of observation was needed, with guidance about how long such increased monitoring should last. Records of individual care reviews showed that decisions around residents’ supervision were agreed and monitored with the involvement of the relevant care manager/police liaison. One of the care plans seen referred to a type of physical intervention that is no longer used in the home and it was agreed that the plan would be updated. An assistant manager and a member of staff both demonstrated the new type of intervention as recommended by the British Institute of Learning Disabilities (BILD). Records of prone restraints were also discussed and the registered manager agreed to make clearer the duration of such interventions when used. (See also Standard 23: Protection). Through records of meetings and discussion with residents it was evident that they and their relatives/representatives had opportunities to take part in their care reviews. Residents confirmed they knew about their care plans and those seen had been signed by the resident and contained monthly evaluations recorded by key workers in the home. One of the assistant managers explained that the home contacts residents’ care managers once a year to arrange reviews. In some cases these are held on a six monthly basis as decided by the relevant care manager. In discussion with some residents it was apparent that they would like the opportunity to move on to alternative accommodation but felt frustrated that nothing appeared to be happening in this respect. The home’s record of joint review meetings showed that move-on for these residents was discussed. Residents knew who their care manager and key worker is and records showed visits by an external advocate. Through observation, discussion with residents and records of specialist referral, staff were seen to provide residents with information, assistance and communication support to make choices and decisions. Residents are supported to manage their finances and the reasons and level of support is documented. Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported in choosing activities, leisure and educational interests based on their individual needs. The daily routines of the home promote residents rights and responsibilities and residents enjoy their meals. EVIDENCE: Through conversation with residents and staff and written records, it was evident that a range of activities was provided with individual programmes developed to each person’s needs and preferences. Activities include golf, snooker, cookery, self-help and life skills, community access, personal shopping, art, crafts and pottery, visits to the cinema and car boot sales. One resident who chooses to attend a church on some evenings is supported to do so. Where activities include community access risk assessments are carried out to ensure that this is managed safely. The home is in a rural location and the staff have the use of two home owned vehicles for transporting residents. Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 13 Residents have opportunities to attend local colleges and some attend the day services on site if this is more suitable to their needs. Residents talked about their hobbies and interests and were observed making choices about their daily activities. Staff assist residents to make choices about where they would like to go on holiday and residents spoke about this. Discussion with residents and inspection of the home’s staff rota indicated that staffing levels are sufficient, including at weekends, to ensure leisure activities are available to all residents. The home’s Statement of Purpose states that residents are afforded the opportunity to have appropriate personal, family and sexual relationships, subject to restrictions agreed in their care plans and/or risk assessments. A notice in the home details visiting arrangements and residents confirmed they have visitors in the home and can visit people themselves. Residents’ families are able to be involved in the their support, where appropriate, by attending reviews and having open dialogue with staff in the home. Daily routines promote residents’ independence and choice, for example some residents spoke of helping in the kitchen and cleaning their rooms while others talked of discussing everyday matters at residents’ meetings. Residents’ responsibilities for housekeeping tasks are specified in their individual plans. There is a policy on residents’ privacy in their bedrooms and residents’ confirmed that they have their own keys and staff knock on doors. In one instance where this was reported not to have happened, a clear explanation of the event had been documented. Residents were seen to have access to the home and grounds and any specific restrictions placed on residents’ freedom of movement are referred to in the Statement of Purpose and Service Users’ Guide and detailed in individual care plans. Staff were observed talking with residents and using residents’ preferred forms of address which were recorded in their care plans. Planned seasonal menus are provided and a record is kept of the food provided to each resident. Residents and staff eat together at mealtimes and residents can also choose to eat alone or in a different location in the home. A food satisfaction survey records residents’ comments on each meal and those who spoke with the inspector said the food was good. Residents confirmed they are also involved in the planning and preparation of meals and this was recorded in their care plans. At lunchtime residents were able to choose from a range of sandwich fillings and these were presented attractively. Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ personal support and health needs are being met and the home is now liaising more effectively with psychiatric professionals regarding resident’s mental health. Procedures for the administration of medication are satisfactory with improved staff guidance as to when ‘as required’ medication is needed. EVIDENCE: Each of the four care plans seen gave details of residents’ personal support and healthcare needs, including help with personal hygiene where necessary. The home operates a designated key-worker system with a backup co-worker, ensuring continuity of personal support for each resident. Any restriction on residents’ choice of support staff, such as male one-to-one support, is as a result of assessed need and is documented. Continuity is also promoted through a partnership approach with residents’ families, where appropriate. For example, a residents’ family had attended with staff training given by a speech therapist in order to improve communication with the resident. Specialist support is also available from the community learning disability and mental health teams. The home has developed a contemporaneous recording system showing all contacts with health professionals. Recent records showed Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 15 that the home was liaising effectively with external mental health practitioners when a residents’ behaviour became cause for concern. This meets a previous requirement. The home has a written policy and procedure for residents’ medication and uses a monitored dosage system to hold and administer medication. A sample of two residents’ medication records were seen and checked against the cassettes of medication and this showed the system to be working. Residents may have ‘medication as required.’ This is only dispensed after support staff have confirmed that it should be administered by consultation with the home’s manager or clinical supervisor. Since the last inspection residents’ care plans have been further developed to include details of the symptoms that indicate when this medication needs to be dispensed. Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has improved its complaints handling procedures so that residents know their views are listened to and acted on. Residents are better protected through improvements to the home’s health and safety procedures. EVIDENCE: The home’s complaints procedure is contained in the Statement of Purpose and the Service Users’ Guide. Residents who spoke with the inspector confirmed they knew who to speak to if they had complaints or concerns. Since the previous inspection identified a requirement the home has put in place a confidential system of recording complaints and a quality assurance questionnaire has been issued to residents and staff. There have been no reported complaints in the time since the last inspection. The home has a copy of the relevant local authority adult protection procedures and each resident’s care records contain a section detailing individual needs and the risk of abuse. The previous inspection report highlighted a concern that the frequent use of restraint indicates that the home accommodates residents with needs that it cannot always meet; and both the Commission for Social Care Inspection (CSCI) report and the Environmental Health Office (EHO) report raised concerns about the need to improve health and safety procedures in this respect. The Commission had received senior management reports for March and April indicating that the home is taking action to meet the requirements of CSCI and EHO. (See also Standard 42: Safe Working Practices). The home’s Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 17 records for April showed there had been a reduction in the number of incidents resulting in physical intervention. There is a policy on the use of physical restraint and the registered manager is accredited with the British Institute of Learning Disability to train staff working in the home in the correct use of physical intervention. Where appropriate, the home carries out an assessment of the resident’s needs regarding aggression and how this should be dealt with. Restraint is used as a last resort with procedures clearly setting out methods to de-escalate and defuse situations where there is a risk of aggression. Physical intervention may also be used to escort a resident back to the home when there is a risk of that person harming himself. Two residents who spoke with the inspector confirmed they felt safe in the home, except when other residents exhibited aggression. One said that the staff dealt with this well. Through discussion with two members of the support staff it was evident that staff had received relevant training and knew and understood the procedures. There were individual files kept of all notifications made to the Commission for Social Care Inspection, including recording sheets for incidents of physical aggression, with the purpose of assisting the evaluation and review of residents changing needs. A computer system is also being implemented that can assist the home to analyse incidents involving physical intervention, identify triggers, possible causes and strategies for earlier intervention and prevention. The assistant manager responsible for creating the system demonstrated how it worked and said this was in use for 2006 although there were no results yet at this early stage. At the previous inspection a requirement was made relating to the fact that staff act in the role of appropriate adult under the Police and Criminal Evidence Act 1984 when a resident is arrested. The home has a copy of the relevant local authority guidance relating to the provision of appropriate adults. The home has now included this in their Statement of Purpose stating that within Ocknell Park senior management are the only people who can act as an appropriate adult for any of the residents, providing they have not been involved in the incident. This includes the manager, deputy manager, assistant manager and team leaders. This requirement has also been met. Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 18 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 & 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents benefit through living in a clean, spacious and attractive home, however further improvements are needed to ensure that it is a safe and comfortable environment as it is not structurally sound and not all furnishings are appropriate. EVIDENCE: The home is situated in the New Forest, is set within spacious and attractive grounds and blends in with the local area housing. Residents who talked with the inspector confirmed they liked the accommodation, particularly their bedrooms which were individually personalised. Some of the staff team had enhanced the premises with plants and flowers. A tour of the premises was undertaken and showed where improvements had been, or were being, made and where these were needed. As mentioned in the previous report, a significant portion of the home’s cellar has collapsed including a concrete supporting lintel. The area has been cordoned to prevent any staff from entering. The previous requirement for arrangements to be made to establish the structural safety of the building and Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 19 any building works required appeared to have been partially met. The registered manager confirmed that a surveyor had been to inspect the area and the subsequent report was now with the organisation’s financial director. The requirement will therefore remain in place until there is further available evidence of it being fully met. The worn furniture in the conservatory had not been replaced, despite requirements by CSCI on three previous occasions. The registered manager said that an order had been placed with the organisation’s financial department but no timescale had been given. Due to changes in the way CSCI inspects and reports on the quality in homes this requirement will not be repeated in this report, as there is not sufficient evidence of detriment to residents at this time. An area on the upper floor landing was being converted to a linen cupboard. The registered manager was seeking to replace a television in the residents’ lounge with one more suitable for a resident with impaired vision. The home is separated from the day service buildings by an uneven road or track and it is recommended that a risk assessment is undertaken and action taken if the need is identified, with regard to the level and condition of the road. The home has a small but suitable laundry area that is situated away from areas where food is stored, prepared and eaten. A new washing machine with a sluice facility had been installed. A good level of cleanliness was observed in all areas seen during the inspection. Staff have training in infection control and relevant guidance and safety measures are in place. Cleaning materials are kept in locked cupboards, hand-washing facilities are available and gloves and aprons are provided for staff. The Environmental Health Officer (EHO) had conducted a food hygiene inspection on 09/05/06. The assistant manager confirmed that action was being taken with regard to the subsequent requirements in relation to fridge temperatures, cleaning the extractor grill, waste food being stored in a container with a lid and removing rust from a sink. The report also stated that a food hazard analysis was in place with records kept, the kitchen was generally clean and there was evidence of good practice. The organisation conducts regular checks of the cleanliness/maintenance of the home and health and safety issues and these are recorded. Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 20 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): 32, 34 & 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is further developing a comprehensive staff training programme to better meet the complex needs of residents. Improvements need to be made to the home’s system of recording all recruitment checks carried out on new staff in order to ensure residents are protected. EVIDENCE: An outstanding requirement from two previous inspections relates to the home reviewing the levels of qualified staff. The service provider’s report for March 2006 indicated that an advertisement was placed for trained nurses. The following report for April stated that no progress has been made in recruiting an additional qualified senior member of staff. In light of the ongoing attempt to recruit additional qualified staff and no evidence at this inspection to indicate that residents’ needs were currently not being met, this requirement will not be repeated. The registered manager said that, while he felt residents’ needs were being met, additional qualified staff would enable the home to meet residents needs better. The home maintains clear records of staff training and qualifications. Out of a total of twenty-four care staff, excluding the registered manager, it was confirmed that thirteen held NVQ level 2 or 3 qualifications, with another five Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 21 currently working towards NVQ level 2 awards. Both assistant managers were currently working towards NVQ level 4 qualifications. This demonstrates that the home is meeting the staff qualification targets outlined in the National Minimum Standards (NMS). Members of the support staff who spoke with the inspector demonstrated their knowledge and understanding of resident’s rights and needs and of team approaches to meeting needs and dealing with challenging situations. Four residents who spoke with the inspector had positive views about the staff, for example saying that staff are good, patient and talk to residents. Staff recruitment records were being held at a central office and relevant staff information had been transferred onto CSCI published pro-formas held on computer. This will be addressed separately to this report on this occasion to ensure all required agreements with CSCI are in place. A sample of four of the pro-formas were inspected and some but not all the required information had been entered, indicating that either the form had not been completed or the information was not available. There is a staff training and development plan and designated person with responsibility for the training programme. The office contained a clear record of training attended by each member of staff and when updates were due. New staff receive a structured induction and evidence was seen that the home uses Learning Disability Award Framework (LDAF) accredited training to provide underpinning knowledge for progress towards achieving NVQs. The training programme is clearly linked to residents’ needs and the aims of the home. All staff undertake statutory health and safety training, breakaway techniques and management of violence. The programme also includes other training relevant to mental health issues and the assistant manager responsible for the programme talked about plans for more staff to undertake such training in 2006. Two members of staff said the training was good and one commented that further mental health training would be beneficial. There are established arrangements for staff supervision, however a record of when formal supervision had occurred was not available on the day of the inspection. Staff comments indicated that the home’s managers were accessible and supportive. This standard will be assessed at the next key inspection. Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has made good progress generally in meeting previous requirements and demonstrating that the home is being run in the best interests of residents, however more evidence is needed to show that safety procedures are being followed. EVIDENCE: Mr David Bennett is the current registered manager and is a Registered Mental Nurse (RMN) who also holds a Registered Managers Award (RMA) management qualification. Mr Bennett currently holds an additional post as operations manager and said that a qualified person had recently been offered the post of manager for Ocknell Park, who will then apply to be registered with CSCI. A quality assurance system surveying residents’ views about the home is being implemented as required in the previous inspection report. The results of this survey were being collated at the time of the inspection. A resident confirmed Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 23 knowledge of the survey and talked also about residents’ meetings held in the home. Records of residents and staff meetings were seen, showing that these were now being held again. The home has a file of written policies and procedures and some of these were seen in relation to relevant standards. The registered manager said that all policies and procedures were reviewed. Since the previous inspection, the home has taken action and met the majority of the requirements within timescales. A report made by the Environmental Health Officer (EHO) in January had pointed out failures in safety procedures. Meetings between the EHO and the organisation’s health and safety consultant were reported to be ongoing and the EHO was due to re-visit the home on 01/06/06. A written communication to the home’s staff from the health and safety consultant was seen. The assistant manager demonstrated how improvements had been made to safety procedures such as staff call alarms when in the grounds of the home. The area had been tested and re-mapped to show any exclusion zones where call alarms may not function effectively. Staff carry both a call alarm and a two-way radio when escorting residents in the grounds and must periodically inform the shift leader of their location. There is a written procedure that staff are responsible for ensuring that their call alarms and two-way radios are charged and working at the start of each shift. This procedure was seen in operation during the inspection. The assistant manager said that these improvements were to be discussed with the EHO. A requirement made at the last inspection was for the home to ensure that the correct safety policies and procedures in the home are followed. This was made with particular reference to the home’s policy for the safety of cutlery. A written procedure was seen to be in place in the kitchen, reminding staff that the knife drawer and cutlery inventory must be locked/checked and signed by the allocated person on the day. The inventory was not in place or available at the time of the inspection and the assistant manager said that he would look into this. The requirement will remain in place and the standard will be reassessed at the next key inspection. Records showed that all staff members receive health and safety training including moving and handling, fire safety, first aid, food hygiene and infection control. The home’s records of equipment and appliance checks and services were seen to be up-to date and complete. The organisation also undertakes regular monitoring of the home, including checks of the routine testing and maintenance of equipment. Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 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 1 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 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 2 X Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 25 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 23(2)(b) Requirement Arrangements must be made regarding the collapsed lintels in the cellar to establish the structural safety of the building and undertake any building works required. This is outstanding from the previous inspection report: 07/02/06. Staff recruitment records or proforma as agreed with CSCI must be held in the home with all required information. The home must ensure that the correct safety policies and procedures in the home are followed. This is outstanding from the previous inspection report: 07/02/06. Timescale for action 31/08/06 2. YA34 19(1)(b) Schedule 2 13(4) 30/06/06 3. YA42 30/06/06 Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 26 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 YA24 Good Practice Recommendations A risk assessment should be undertaken and action taken if the need is identified, with regard to the level and condition of the road or track between the home and the day service buildings. Ocknell Park DS0000055846.V287928.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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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