Inspection on 20/06/07 for Oxbridge House

This inspection was carried out on 20th June 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oxbridge House 17/06/08

Oxbridge House 17/11/06

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Oxbridge House Oxbridge Lane Stockton-on-Tees TS18 4JB Lead Inspector Val Daly Key Unannounced Inspection 20th June 2007 09:30 Oxbridge House DS0000066802.V343677.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 Oxbridge House DS0000066802.V343677.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. Oxbridge House DS0000066802.V343677.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oxbridge House Address Oxbridge Lane Stockton-on-Tees TS18 4JB 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) 01642 633552 01642 633551 Milewood Healthcare Limited Ms Ada Mary Ali Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Oxbridge House DS0000066802.V343677.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th November 2006 Brief Description of the Service: Oxbridge House is a large detached property in a quiet residential area of Stockton. The property was previously a privately owned hotel. Accommodation for nine service users is provided on three floors. Milewood Healthcare Limited has carried out extensive re-furbishment including the provision of en suite facilities to each bedroom all of which meet the spatial requirements of the National Minimum Standards. In line with Milewoods policy to encourage service users to exercise choice and to make decisions about issues affecting their lives bedrooms have been left undecorated so that each prospective service user can choose the décor and furnishings for their own room. Communal facilities comprise a dining room and sitting room. Externally there is a large garden to the front of the property and a small yard to the rear. The weekly fees are £1389.81. One to one support is charged at £13.13 per hour. Oxbridge House DS0000066802.V343677.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was a key inspection and was completed by a regulation manager and an inspector over one day. As a key inspection, all of the key standards were examined. A tour of the home took place, resident’s records were examined, records including accidents, complaints and menus were looked at and a resident, two members of staff and the manager were engaged in discussion about life at Oxbridge. A pre inspection questionnaire was provided, which had been completed by the manager. What the service does well: What has improved since the last inspection? Since the previous inspection the Statement of Purpose has been updated and is clearer as to the category of resident the home can accommodate. Two sets of resident’s documentation were examined and they both contained full assessments of needs and strengths. There was also information to show that prospective residents are introduced to the home, have visits, then overnight stays over a period of time. A resident interviewed confirmed that he had visited the home many times prior to him moving in. Since the previous inspection 75 of the staff have achieved NVQ level 2 or above. Oxbridge House DS0000066802.V343677.R01.S.doc Version 5.2 Page 6 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. Oxbridge House DS0000066802.V343677.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 Oxbridge House DS0000066802.V343677.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective people to use a service have the information needed to choose a home and they have their needs assessed. EVIDENCE: Since the previous inspection the Statement of Purpose has been updated and is clearer as to the category of resident the home can accommodate. Two sets of resident’s documentation were examined and they both contained full assessments of needs and strengths. There was also information to show that prospective residents are introduced to the home, have visits, then overnight stays over a period of time. A resident interviewed confirmed that he had visited the home many times prior to him moving in. Oxbridge House DS0000066802.V343677.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): 6, 7 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Individuals are involved in decisions about their lives however they each are required to have a plan of care. EVIDENCE: Two sets of resident’s documentation were examined. Only one contained a care plan, which included the resident’s needs and action to be taken. However the plans were not dated or evaluated. There was a lot of repetition in the information and the plans were not user friendly. Within the documentation there was guidelines on how to meet the residents needs, which had been provided by a health professional from outside the home that was involved in the residents care. There were risk assessments in place and a risk management plan. The risk assessments were in areas such as road safety, visits to relatives, use of gardening equipment, aggression and absconding. They had not been reviewed and there were no dates for evaluation. The daily records were comprehensive, stating how the resident spent their days. Oxbridge House DS0000066802.V343677.R01.S.doc Version 5.2 Page 10 From reading documentation and talking to staff it seemed that one resident left the home every morning, climbing over a fence after taking morning medication. This resident returned to the home late at night, often after drinking alcohol. The manager said that a strategy meeting had been arranged where the residents placement would be discussed. Oxbridge House DS0000066802.V343677.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): 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. People who use the service are able to make choices about their lifestyle. EVIDENCE: The assessment documentation included the activities the resident enjoyed or would like to do. The activities the resident enjoyed were listening to music, shopping, walking, gardening and going out with staff. The activities the resident would like to do were swimming, cookery classes and country and western dance classes. It was stated in the documentation that the resident would need support from staff to enable him to try the activities. There was no evidence to show that the resident had been able to try new activities and the resident confirmed this during interview. The manager said that the residents choose their own activities every week, a plan was examined and showed on resident visited a relative twice weekly, went to the town market twice weekly and helped staff carry out cleaning tasks Oxbridge House DS0000066802.V343677.R01.S.doc Version 5.2 Page 12 in the home. Discussion took place with the manager regarding the need to have more structured activities, for the residents to be out and about more in the community. The manager said she had been talking to the residents about a holiday and a suggestion had been to go camping. A resident interviewed had a good friendship with another resident in the home. The menus showed a variety of food being offered to the residents, the main meal being at teatime apart from Sunday when a roast dinner was served at lunchtime. The home does not have any catering support and staff and residents said that staff cooks the meals with residents often helping with the preparation. Oxbridge House DS0000066802.V343677.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): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: The care plans examined detailed the personal support given. All residents in the home have their own General Practitioner, and residents attend appointments with either a member of staff. A health action plan is completed. Each resident receives support from staff on a daily basis to the level that they choose and require. Policies and procedures are in place for the ordering, receipt, storage, disposal and administration of medication. However the manager said that they are in the process of being reviewed. Oxbridge House DS0000066802.V343677.R01.S.doc Version 5.2 Page 14 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 & 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns. However the complaints procedure and the adult protection procedure are required to be more robust. EVIDENCE: A resident interviewed said he would talk to a member of staff or the manager if he had a complaint. The home has a complaints policy and procedure in place which refers to equal opportunities, however this needs to be reviewed and up dated to include the Contracts and Commissioning Department of the Local Authority. This was highlighted in the previous inspection. The home has an adult protection policy but local information needs to be included. This was highlighted in the previous inspection. Oxbridge House DS0000066802.V343677.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe and comfortable environment. EVIDENCE: A tour of the home was carried out. Resident’s bedrooms contained personal possessions and were comfortable and homely. They were individually decorated with the resident choosing the colour scheme and soft furnishings. Since the previous inspection the downstairs room at the front of the house had been converted into a games room for the residents and there was also a computer. The home was clean and odour free. The home does not have any domestic support, therefore all cleaning tasks are carried out by staff, with residents assisting with their own bedrooms. The home is a large building and there are a lot of communal areas to keep clean. Staff interviewed described the many cleaning duties they have in the home. It was recommended to the manager that some specific domestic hours be put in place to ensure the home is kept clean and staff are not detracted from their care role. Oxbridge House DS0000066802.V343677.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. 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. Staff in the home must receive a robust induction programme and further training specific to people with a learning disability and complex needs. EVIDENCE: The home has recruitment policies and procedures in place. Two staff files examined showed that the home’s policies are being followed and all the required documentation was in place. Induction training was recorded as having being carried out, however both the basic induction and Skills for Care induction had been signed off by the Deputy manager as having been completed in one day. Training files were examined which showed training had been carried out since the previous inspection in; Moving and Handling, Protection of Vulnerable Adults, Emergency Aid, Equal Opportunities and Confidentiality and Non violent Crisis Intervention. Their needs to be more training undertaken specific to people with learning disabilities and complex needs. Within the information in the home it stated that staff received training in areas such as; Social Role Valorisation, Medical and Social Model of Disability, Autism and De- escalation and LDAFF, Induction and Foundation. However Oxbridge House DS0000066802.V343677.R01.S.doc Version 5.2 Page 17 staff interviewed said they had not received training and the manager confirmed this. The manager said that prior to a new resident moving in to the home a health professional involved in the care of the resident talks to the staff team about how to manage the resident’s needs. However there was no documentary evidence of this in the training files. Since the previous inspection 75 of the staff have achieved NVQ level 2 or above. Oxbridge House DS0000066802.V343677.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. 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 quality assurance system needs to be developed further to enable staff, relatives and other health professionals to give their views on the service. EVIDENCE: The home has an annual business plan and the manager shared the action points that she is working through. Residents complete questionnaires, which are sent to head office and an action plan is formed from the responses. The quality assurance needs to be developed further, to enable staff, relatives and other health professionals to give their views on the service. This was discussed and highlighted in the previous inspection. The operations manager visits regularly and carries out audits of various aspects of the home. There are regular meetings for residents and staff and minutes are kept. The home has health and safety policies and procedures in place. Training files Oxbridge House DS0000066802.V343677.R01.S.doc Version 5.2 Page 19 showed that some staff had received training in health and safety, all staff require this training. From the previous inspection the fire escape still required re painting, the manager said that this had been organised. Oxbridge House DS0000066802.V343677.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME 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 S2core 22 2 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 2 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 3 X 2 X X 2 X Oxbridge House DS0000066802.V343677.R01.S.doc Version 5.2 Page 21 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 16 Requirement The manager must develop agree with each resident a plan of care which details how their health and welfare needs are going to be met. This is required to safeguard the people who use the service. Timescale for action 31/07/07 2. YA7 13 (4) b 3. YA22 22 Risk assessments must be 31/07/07 reviewed and evaluated regularly to safeguard the people who use the service. The manager must ensure the 31/07/07 complaints procedure is reviewed and updated to include • Local information • Residents can make a complaint to the commissioning authority. This is required to safeguard the people who use the service. The manager must ensure the protection of vulnerable adults procedure is reviewed and updated to contain the local contact details. This is required to safeguard the people who use the service. 31/07/07 4. YA23 13 Oxbridge House DS0000066802.V343677.R01.S.doc Version 5.2 Page 22 5. YA24 14 (4)(a) 23 The registered person to ensure 31/07/07 the fire escape, which has flaking paint and is rusting in places, is painted. This is required to safeguard the people who use the service. The registered person must ensure that all staff receives induction training. The staff training and development training should meet the Sector Skills Council workforce training targets. This is required to safeguard the people who use the service. The manager must ensure that all staff must receive training in Health and Safety. This is required to safeguard the people who use the service. 31/07/07 6. YA35 18 (1) (a) 7. YA42 18 (1) (a) 31/07/07 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 YA37 Good Practice Recommendations The quality assurance system needs to be developed further to enable staff, relatives and other health professionals to give views on all aspects of the service. This will safeguard the people who use the service Oxbridge House DS0000066802.V343677.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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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