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Inspection on 23/02/06 for Oxclose Lane Care Home

Also see our care home review for Oxclose Lane Care Home for more information

This inspection was carried out on 23rd February 2006.

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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The current service users have shared this home for several years and have established good relationships and their own routines. Support is given to enable them to continue to maintain their lifestyles. Each service user is encouraged and supported to be as independent as possible and make their own decisions. Sufficient staff are provided to provide the appropriate support.

What has improved since the last inspection?

Medication storage has been improved so that each person`s tablets are kept separately in the cupboard. The shower room door has been replaced and a lounge carpet was thoroughly cleaned. All electrical appliances have been appropriately tested.

What the care home could do better:

The written support plans were in the process of being revised and this is long overdue. The manager should ensure they are kept up to date and formally review each one at least every six months to make sure all needs are met. There were some missing signatures of staff to show that tablets were taken by service users and the manager must make sure all staff follow correct procedures when administering and recording medication. There are a few things that still need attention inside the home, such as the sofa that needs to be replaced and a bath that has a hole in the enamel. Three service users have been waiting since September 2005 for new mattresses and bathrooms generally need to be redecorated.

CARE HOME ADULTS 18-65 Oxclose Lane Care Home 154-156 Oxclose Lane Arnold Nottingham NG5 6FF Lead Inspector Meryl Bailey Unannounced Inspection 23rd February 2006 02:00 Oxclose Lane Care Home DS0000008731.V271707.R01.S.doc Version 5.0 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 Oxclose Lane Care Home DS0000008731.V271707.R01.S.doc Version 5.0 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. Oxclose Lane Care Home DS0000008731.V271707.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Oxclose Lane Care Home Address 154-156 Oxclose Lane Arnold Nottingham NG5 6FF 0115 967 0657 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) H2057@MENCAP.ORG.UK www.mencap.org.uk Royal Mencap Society Ms Catherine Kimbley Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Oxclose Lane Care Home DS0000008731.V271707.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd August 2005 Brief Description of the Service: Oxclose Lane Care Home provides support including personal care and accommodation for seven people. It is located within close proximity to all community amenities. There are two lounge areas and a large kitchen/diner. All service users are accommodated in single bedrooms. The ground floor bathroom offers assisted bathing facilities. The ground floor is accessible to wheelchair users and three of the bedrooms are on this floor. There is no lift to the other four bedrooms. The care provider is Mencap Homes Foundation, but the premises are owned by Metropolitan Housing Association. Oxclose Lane Care Home DS0000008731.V271707.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and conducted by one inspector during one afternoon and early evening. Six service users were seen and some contributed their views. One was in hospital. Five staff were seen, as the inspection spanned two shifts. Comments and views of staff have been incorporated into this report. Information has also been taken from records. The communal areas of the home were inspected and the bathrooms and one of the bedrooms were viewed. The manager was not available on the day of the inspection, but discussion was held with her on the following day in order to gain sufficient information to complete the inspection. What the service does well: 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. Oxclose Lane Care Home DS0000008731.V271707.R01.S.doc Version 5.0 Page 6 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 Oxclose Lane Care Home DS0000008731.V271707.R01.S.doc Version 5.0 Page 7 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): These standards were not assessed at this inspection. EVIDENCE: Oxclose Lane Care Home DS0000008731.V271707.R01.S.doc Version 5.0 Page 8 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 and 7 Current individual support plans are inconsistent. Some hold clear information, but others are not up to date and this could lead to needs not being met by staff. Support is given to enable service users to make their own decisions. EVIDENCE: The individual plans for three of the service users were inspected. One of these had recently been fully revised. It contained clear information to enable staff to meet identified needs and provide appropriate support. There was a great deal of cross-referencing to ensure people would understand how actions were linked to risk assessments and specific health needs. The other two plans were not up to date. It was not clear when they had last been fully updated. Some parts were dated 2003/04. In one case, there was some indication from daily notes that mental health needs had changed and some letters supported a change, but the plan had not been appropriately updated. The manager stated that she was in the process of updating all plans and was doing this in consultation with service users. From plans and daily notes and also from discussion with service users there was evidence of their involvement in planning meals and activities. They were encouraged to make their own decisions within limitations of resources available. Oxclose Lane Care Home DS0000008731.V271707.R01.S.doc Version 5.0 Page 9 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): 13 and 15 Service users are established in the local community and maintain relationships with family and friends. EVIDENCE: Service users spoke about the contact they maintain with family members, with regular visiting patterns. A Golden Wedding celebration was planned in one family and other service users were invited to attend. A link was established with another home in the local community and some joint activities were planned. Use was also made of the local leisure centre and one service user went out to play badminton there with a support worker during this inspection. There was a notice board in the dining room displaying forthcoming events. A calendar had been made by one service user with photographs of service users and staff to indicate their birthdays. Most service users accessed the shops in Arnold town centre and also shopped in Nottingham city centre with support where needed. Oxclose Lane Care Home DS0000008731.V271707.R01.S.doc Version 5.0 Page 10 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): 20 Arrangements can be made for service users to administer their own medication, but it is generally the responsibility of staff. Correct procedures were not always carried out and this could put service users at risk. EVIDENCE: There was reference on one service user’s file about self-medication, but all others had their medication looked after. Medication storage had improved since the last inspection in that each service users medicines were kept separately. One staff member was observed giving medication to one service user and then signing the Medicine Administration Record sheet. The correct procedure was followed, but on examining the Medicine Administration Record sheets it was found that there were gaps in respect of one service user’s morning tablets. Staff stated that these were given at a different time to other service users’ medication. However staff must always initial the sheet to give evidence that the tablets have been taken. The manager confirmed that three of the seven staff had completed the “Care of Medicines” training course. Oxclose Lane Care Home DS0000008731.V271707.R01.S.doc Version 5.0 Page 11 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 and 23 Service users have access to a complaints procedure, but staff are not fully aware of the procedures relating to protecting adults. EVIDENCE: No complaints had been recorded since 2004. The Mencap complaints procedure was available and service users said they would speak to the manager if they were unhappy about anything. In the manager’s absence, staff were not clear about the Nottinghamshire Committee for the Protection of Vulnerable Adults policy and procedure. It was found on a shelf and the amendments were found in a separate file. Any staff left in charge needs to know what procedure to follow in the event of any alleged abuse. Staff had some training regarding awareness of abuse as part of their induction with Mencap. Oxclose Lane Care Home DS0000008731.V271707.R01.S.doc Version 5.0 Page 12 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, 27 and 30 The premises generally meet the needs of the service users, but some maintenance and replacement is required to maintain a comfortable home. EVIDENCE: The premises comprised of two adapted houses. There were two lounge areas and a large kitchen/diner. All service users were accommodated in single bedrooms. It was noted at the last inspection that one sofa was worn and needed replacing. Staff said a new one had been ordered. One service user was choosing a new bed during the previous inspection. Since then it had been agreed that the bed was not needed, but she and two others were to have new mattresses. They were ordered in September 2005, but had not been provided, as there was a delay in agreeing the expenditure by Mencap. The manager said that she was only able to agree up to £75, with the exception of food. This restriction had a serious effect on providing items to meet needs. Bathrooms also need attention and one bath needs replacing. The skirting board in both bathrooms was damage and unclean. The communal areas of the premises were otherwise found clean. Oxclose Lane Care Home DS0000008731.V271707.R01.S.doc Version 5.0 Page 13 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, 33, 34 and 35. Staff are available in sufficient numbers to meet the needs of the current six service users. Staff training is provided. Mencap’s recruitment policy is in operation to protect service users. EVIDENCE: Five staff were seen during the inspection. The staffing rota showed that there were always two staff on the premises during the day when any service users were at home. During the inspection three were on duty at any one time and some 1:1 support was given. At night, between 9pm and 7.30am, staffing was reduced to one person sleeping in. Just one of the support staff had achieved Level 2 of he National Vocational Qualification, but others had some equivalent qualifications. Mencap provided foundation training and the manager confirmed that each member of staff had 5 full days training per year. Staffing records were not available on the day of the inspection visit, but the manager provided evidence on the following day to confirm that the most recently appointed staff member had been checked through the Criminal Records Bureau prior to commencing employment. Oxclose Lane Care Home DS0000008731.V271707.R01.S.doc Version 5.0 Page 14 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 and 42 The home is run by an experienced manager. Health and safety are promoted in the environment. EVIDENCE: The manager had 16 years experience at the home and was well known by all service users. She is registered with the Commission and staff reported that she provided positive leadership. There were risk assessments with respect to risks within the environment with appropriate action taken to protect service users and staff. One of the staff had specific responsibility for carrying out weekly checks and all fire extinguishes were checked on 20th February 2006. Portable electrical appliances were tested on 16th January 2006. Oxclose Lane Care Home DS0000008731.V271707.R01.S.doc Version 5.0 Page 15 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X 2 X X 2 LIFESTYLES Standard No Score 11 X 12 X 13 4 14 X 15 4 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Oxclose Lane Care Home Score X X 2 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 3 X DS0000008731.V271707.R01.S.doc Version 5.0 Page 16 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. 4. Standard YA6 YA20 YA24 YA24 Regulation 15(2) 13(2) 16(2)(c) 16(2)(c) Requirement Ensure individual support plans are kept under review and revised as needs change. Ensure all staff follow correct procedures when administering and recording medication. Recover or replace the sofa. This is outstanding from the last inspection. Ensure the three mattresses already ordered are delivered and put in place for service users. Replace the damaged bath. Ensure bathrooms are thoroughly cleaned and redecorated. Timescale for action 31/03/06 24/02/06 31/03/06 31/03/06 5. 6. YA27 YA30 23(2)(j) 23(2)(d) 30/04/06 31/03/06 Oxclose Lane Care Home DS0000008731.V271707.R01.S.doc Version 5.0 Page 17 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2, 3. Refer to Standard YA6 YA23 YA24 Good Practice Recommendations Review all individual support plans every six months and ensure revisions are dated and signed. Insert amendments into the Nottinghamshire Committee for the Protection of Vulnerable Adults policy and procedures and remove any pages no longer relevant. Review systems for approving expenditure so that required items are provided in a timely fashion. Oxclose Lane Care Home DS0000008731.V271707.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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. Extracts may not be used or reproduced without the express permission of CSCI Oxclose Lane Care Home DS0000008731.V271707.R01.S.doc Version 5.0 Page 19 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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