Inspection on 17/07/07 for Ocknell Park

This inspection was carried out on 17th July 2007.

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 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

Ocknell Park 10/05/06

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 Craig Willis Key Unannounced Inspection 17th July 2007 10:00 Ocknell Park DS0000055846.V341161.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 Ocknell Park DS0000055846.V341161.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. Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ocknell Park Address Stoney Cross Lyndhurst Hampshire SO43 7GN 023 8081 1287 023 8081 4083 ocknellpark@truecare.co.uk 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.V341161.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th November 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 two lounge/dining areas 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 £1932.42 to £2767.45 per week. Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The evidence used to write this report was gained from a review of the information the provider sent to the Commission for Social Care Inspection (CSCI) since the last visit. This information included incident reports sent to CSCI, an annual quality assurance assessment and comment cards from eleven people who live in the home, seven relatives and one care manager. A site visit to the home was made on 17 July 2007. During the site visit the inspector spoke with four of the residents and observed the interactions between residents and staff. The inspector also spoke with the manager and three members of staff on duty. A tour of the building was made and documents relating to the running of the home were inspected during the visit. What the service does well: There are good systems to assess people’s needs before they move into the home. This helps to assure people their needs can be met. People’s needs are set out in clear care plans and risk assessments, which are reviewed with them each month. People living in the home take part in a wide range of activities they enjoy. People are supported to keep in contact with their family and friends. People are supported to attend the health services they need and feel that staff treat them well. People are supported to safely take medication they have been prescribed. People are confident any complaints they make will be taken seriously and responded to. Action is taken to keep people safe from abuse. The home is well maintained and provides a comfortable, clean and safe environment for people. Staff receive good training, which helps them to meet people’s needs. The views of people living in the home are regularly gathered. This information is used to plan improvements to the service. Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 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.V341161.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems to assess the needs of people before they move into the home, which helps to assure people their needs can be met. EVIDENCE: The records of six residents were inspected during the visit, including one person who has recently moved into the home. For each person an assessment of their needs had been completed prior to them moving into the home. Copies of the care management assessments were also available on file. Once an assessment has been completed and a person identified as suitable for the home a transitional plan is developed and the person is invited to visit the home several times, including an overnight stay. The potential resident is consulted throughout the process and the assessment is updated following the visits. All eleven residents completed a CSCI survey and all said they were asked if they wanted to move into the home. Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care planning and risk assessment systems are good and provide clear information to enable staff to meet people’s needs. EVIDENCE: The personal files of six residents were inspected during the visit. All of these files contained a set of care plans and risk assessments that had been developed from the person’s needs assessment. These plans are reviewed monthly with the resident and their keyworker. The plans contain a functional analysis and risk assessments for people in respect of challenging behaviour and physical interventions. These documents clearly set out how staff should support the person to manage their behaviour, including at what stage and how staff should physically intervene. All six plans seen promoted the use of distraction and re-direction in managing challenging behaviour and physical interventions are used as a last resort. The plans have been changed to reflect Truecare’s change of policy on the types of restraint that are used. All staff spoken with were clear on the changes introduced by the company and the Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 Page 10 type of restraint they must no longer use. All incidents resulting in staff physically intervening to restrain people are recorded and reported. There is a system in place for reviewing incidents to assess whether the planned interventions are working. People spoken with said they took part in regular reviews of their plans and were supported to develop their independent living skills. Evidence was seen that people had signed their care plans and other documents to indicate their agreement with the contents. Staff spoken with demonstrated a good understanding of people’s needs and how they should meet them. One person has been supported to start work to develop a person centred plan. The manager said he plans to develop the use of person centred planning models and extend the support to all people living in the home. Eleven people completed a CSCI service user’s survey, eight said they always make decisions about what they do each day and three said they sometimes make decisions. Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 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. The home provides good support for people to take part in activities they enjoy and meet their lifestyle choices. EVIDENCE: People spoken with said they enjoy the activities they take part in. 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. People also attended courses at local colleges. There is a day service room in the home, where people can take part in arts, cooking and pottery sessions. The home has two vehicles that are used for community access. The home has a very large garden, some of which has been used to grow vegetables. People are supported to take part in deciding what to grow and to cultivate the plants. Eleven people completed a CSCI service user’s survey. All said they had enough to do during the day and at weekends and ten said they had enough to do in the evenings. One relative said they did not feel their son Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 Page 12 was supported to take part in enough activities. The manager said he would look into this to find if there was anything else the person wanted to do. Residents spoken with said they were supported to maintain regular contact with their family and friends. One the day of the visit one person went out to the gym with a family member. The care planning system has identified specific needs in relation to spirituality and sexuality and support is provided to meet these needs. People living in the home are supported to plan the menus, which provide a varied and balanced diet. Each person living in the home has completed a likes and dislikes record in relation to food. People spoken with confirmed alternatives were available if they wanted and their likes and dislikes were respected. Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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. The home has good systems to meet people’s health, emotional and personal care needs and people are supported to take their medication safely. EVIDENCE: Details of people’s health, emotional and personal care needs are set out in the care plans and people spoken with said staff know what their needs are and treat them well. Records are maintained of appointments with a range of health professionals, including GP, dentist, optician and community psychiatric services. Records include any advice given by the practitioner. People spoken with said they were able to see their doctor when they needed to. Eleven people completed a CSCI service users’ survey, six said staff always treat them well, four said they sometimes do and one person did not answer the question. Eight said staff always listen to them and act on what they say, one said staff sometimes do, one said staff never do and one did not answer the question. None of the people living at Ocknell Park currently administer their own medication. Medication is stored in a locked cabinet in the office and most tablets are received in a monitored dosage system. A record of medication Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 Page 14 administered to people is kept and had been fully completed. A separate cabinet is used for the storage of controlled drugs and two members of staff sign when controlled drugs are administered. The balance of one of the controlled drugs was checked and found to match the records. There are clear procedures in place for the administration of medication that is prescribed to be taken “as required”. Authorisation must be obtained from a senior manager before these medicines are administered and records showed that this procedure was being followed. All staff administering medication have completed training in safe administration of medication. People spoken with said they were supported to take their medication when they needed it. One care manager completed a CSCI survey and stated care staff always support people to administer medication correctly. Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems to keep people safe from abuse and people are confident that any complaints will be listened to and acted upon. EVIDENCE: The home has a complaints procedure, which is supplied to people in the Service Users’ Guide. Eleven people completed a CSCI service user’ survey and they all said they know who to speak to if they are not happy, ten people said they know how to make a complaint and one did not answer the question. There is a complaints record and residents have made three complaints since the last inspection. The record indicated that all three complaints had been addressed and the complainants were happy with the way the home responded and the action taken. People spoken with said they know how to complain and were confident any complaint would be taken seriously and investigated. One care manager completed a CSCI survey and said the home always responds appropriately when concerns are raised. Since the last inspection three allegations have been reported to adults social services and have been investigated under the safeguarding adults procedures. Two of the incidents are concerned with the way people are restrained and one was about they actions of a member of agency staff. All three investigations have been concluded by adult social services following strategy meetings during which the home demonstrated that the concerns had been addressed. As result of the investigations, Truecare have changed their policy on restraint and some methods of restraint are no longer used. The incident concerning a Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 Page 16 member of agency staff has been resolved, with action taken by the agency to address the problem. Staff members spoken with demonstrated a good understanding of abuse and action to take if abuse is witnessed, reported or suspected. Staff members were also aware of changes made in the restraint policy and confirmed that they had received training. The manager reported he 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. Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and provides a comfortable, clean and safe environment for people. EVIDENCE: A random inspection was carried out on 10 November 2006 to follow up on a requirement made at the previous inspection that collapsed lintels in the cellar must be repaired. It was found that this requirement had been complied with. A tour of all the communal areas of the home and gardens was made during this visit. The manager reported that following a recommendation in the last key inspection report, it was planned to tarmac the track in the grounds, so that it was safer for staff to access the car park. The manager was not sure when this work would take place. All areas of the home were clean and well maintained. Eleven people completed a CSCI service users’ survey; six said that the home was always clean and fresh, four said it usually was and one did not answer the question. People spoken with said they liked the home and felt Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 Page 18 it met their needs. People also said they had what they need in their bedrooms. The home has a suitable laundry area that is situated away from areas where food is stored, prepared and eaten. The washing machine has a sluice facility. All areas seen during the inspection were clean. 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. Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 Page 19 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): Standards 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The systems for staff recruitment and training are good and help to ensure people are protected and their needs are met. The recruitment of additional staff will help to ensure people’s needs continue to be met. EVIDENCE: The manager reported that nine of the twenty staff have achieved the National Vocational Qualification (NVQ) in care at level 2 or above and nine staff are working towards the award. The manager reported that there are currently a number of staff vacancies that he is recruiting to, with adverts in the local press. Staff spoken with said there have been some difficulties with the number of agency staff used, although there is now a more regular group of agency staff that covers shifts, which makes a big difference. A random inspection was carried out on 10 November 2006 to follow up on a requirement a the previous inspection that a record must be keep in the home of the checks carried out on staff before they start work. At the random Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 Page 20 inspection it was found that this requirement had not been complied with and it was re-stated. The manager reported in the annual quality assurance assessment for CSCI that they obtain Criminal Records Bureau (CRB) checks and references for all staff before they start working in the home. During this visit the files of four members of staff were sampled and found to contain all the required information. The home has a training programme and staff spoken with said they felt the training provided was good and helped them to meet people’s needs. Courses staff have completed include fire safety, management of violence and aggression, moving and handling, risk assessment, safeguarding adults, first aid, breakaway techniques, epilepsy, schizophrenia and autism. The manager has a training matrix that shows when staff are due to attend refresher courses and helps plan training throughout the year. Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 Page 21 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): Standards 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 home is well managed, which helps to ensure people are kept safe and the views of residents are used to plan improvements. EVIDENCE: The manager is a Registered Mental Nurse (RMN) and has also completed the registered manager’s award. The manager takes part in regular training to keep him up to date with current developments and good practice. An operations manager visits the home each month to assess the quality of the service provided. Reports are made of these visits and include any actions that are required. The manager reported that a survey of residents and other stakeholders, for example relatives and care managers, is conducted each year. The results of these surveys are incorporated into the annual Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 Page 22 development plan to ensure that the service continues to improve. The manager also conducts an audit of the home against national minimum standards throughout the year. A random inspection was carried out on 10 November 2006 to follow up on requirements made at the previous inspection that the home’s policy and procedures regarding safety must be followed. It was found that this requirement had not been complied with and it was re-stated. The concern that led to this requirement was that staff were not always following the correct procedures regarding the use of emergency alarms and two-way radios. During this visit all staff were following the home’s procedures and those spoken with said this always happened now. Records demonstrated that equipment was regularly charged, to ensure it was available for use and a recording log for the charging and signing out of alarms and radios was fully completed. The manager reported in the annual quality assurance assessment for CSCI that equipment in the home, such as fire detection and fighting equipment and the heating system were regularly serviced and maintained to ensure they were safe. A sample of these records was checked during the visit and confirmed that maintenance was up to date. Assessments are completed for chemicals used in the home and hazardous substances are securely stored when not in use. Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 Page 23 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 X 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 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 3 X Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 Page 24 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 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. Extracts may not be used or reproduced without the express permission of CSCI Ocknell Park DS0000055846.V341161.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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