Inspection on 27/04/06 for Oxford House

This inspection was carried out on 27th April 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 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

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

CARE HOME ADULTS 18-65 Oxford House 7 Oxford Road Worthing West Sussex BN11 1XG Lead Inspector Mrs L O’Donnell Unannounced Inspection 27th April 2006 02:00 Oxford House DS0000065480.V292124.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 Oxford House DS0000065480.V292124.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. Oxford House DS0000065480.V292124.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Oxford House Address 7 Oxford Road Worthing West Sussex BN11 1XG 01903 201201 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) Arundel Care Services Limited Miss Kay Marie Hollywood Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Oxford House DS0000065480.V292124.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to 5 male and/or female service users aged between 18-64 years in the category of learning disability can be admitted. N/A as new registration Date of last inspection Brief Description of the Service: Oxford House is a care home registered to provide personal care for up to five Service Users in the category Learning Disability. It is a detached property located within Worthing. It is within walking distance of the town centre, other local amenities and public transport. The property has been adapted for its current use. The accommodation is provided in five individual bedrooms which are located on the ground and first floors. Four of the bedrooms have full ensuite facilities, with the fifth having sole use of an adjacent wet room. The lounge and dining room are located on the ground floor. All rooms are decorated and furnished to a high standard. The home has its own private garden which is well maintained. The service is owned by Arundel Care Services. Oxford House DS0000065480.V292124.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an Unannounced Inspection which took place over two visits to the home. The first lasting 4 hours, the second 1 hour. The Inspection was undertaken by one inspector. This was the first inspection of the home following their registration with the Commission on 4th November 2005. Prior to the visits the inspector reviewed registration documentation and any communication received. During the visits the inspector spoke with residents and staff, including the Registered Manager, undertook a tour of the home and reviewed a variety of records. In between the two visits contact was made with relatives by telephone. The home has a friendly and welcoming atmosphere and is clearly run in the best interests of the residents, who play a full and active role in this. The Registered Manager, management and staff team are to be commended for the work undertaken to achieve this in the short time since registration. Overall it is the judgement that Oxford House provides a good quality service. What the service does well: The pre admission assessment process fully involves the prospective resident and their representatives, and detailed records of this are kept. The care planning process is thorough and focuses on residents reaching their full potential. Residents are fully involved in all aspects of life at the home. Residents are able to pursue their own interests, with staff support as necessary. A variety of balanced and nutritious meals are provided, which residents are supported to choose, prepare and cook. Health care needs of residents are well managed, with guidance in place to meet specific individual needs. Relationships between staff and residents are relaxed and supportive. Oxford House DS0000065480.V292124.R01.S.doc Version 5.1 Page 6 Residents are supported by a competent and effective staff team. Residents’ benefit from a well-run home, with an open and positive atmosphere. The home provides a homely comfortable and safe environment, which is decorated and furnished to a high standard. Resident’s comments included, ‘I like living here’, ‘it is good’. 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. Oxford House DS0000065480.V292124.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 Oxford House DS0000065480.V292124.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): 2 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The needs of prospective residents are fully assessed prior to moving into the home. EVIDENCE: The records for two residents were reviewed during the visit. For both residents there was a detailed assessment undertaken by Social and Caring Services outlining identified needs and how these should be met. In addition the home had undertaken their own assessment (by the Responsible Individual or Registered Manager or both) with involvement from both the prospective resident and their relatives. Relatives spoken with confirmed that both they and the prospective residents had been involved in this process. Both assessments were seen to provide information on all aspects of health, personal and social care needs. Oxford House DS0000065480.V292124.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents assessed needs are reflected in their individual care plans which are reviewed and updated as necessary. Residents are able to make decisions about their lives. Residents are consulted on and are able to participate in all aspects of life within the home. Residents are supported to take responsible risks within the context of their care plan and the homes risk management strategies. EVIDENCE: The care plans for two residents were reviewed. These were lengthy documents but were well ordered and detailed and provided information as to the indivdual personal, health and social care needs of the residents. Oxford House DS0000065480.V292124.R01.S.doc Version 5.1 Page 10 In discussion with staff, now that the care plans were set up, they found them easy to access and use. There is a keyworker system in place, with two care workers acting in this role for one resident. The keyworkers take responsbility for ensuring that the care plans are up to date and reviewed and amended as necessary. Behaviour support guidelines are in place as necessary with identified behaviours, triggers and management guidelines. Staff record any incidents on observed behaviour charts. It was evident through discussions with residents and staff that the residents are able to make decisions about their day to day lives, with daytime activities determined by residents needs and wishes. Risk assessments are in place covering all identified risks, along with action needed to minimise and manage these. Oxford House DS0000065480.V292124.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents are supported to maintain and develop independent living skills. Residents are able to take part in appropriate educational and fulfilling activities. residents enjoy a range of leisure activities. residents are supported to maintain links with family and friends. the rights of residents are respected and their independence and freedom of choice promoted. Residents enjoy a healthy and balanced diet. Oxford House DS0000065480.V292124.R01.S.doc Version 5.1 Page 12 EVIDENCE: It was clear through discussions with residents, staff and through records seen that residents are supported to maintain and develop social, communication and independent living skills both through activities within and outside of the home. As the home opened following registration late last year, residents have not yet been able to enrol on college courses. However information regarding college courses has been obtained and staff aim to support residents to chose and enrol on preferred courses for September. Relatives spoken with confirmed that it was hoped that residents would start college in September. In speaking with residents it was clear that they have a wide range of interests and hobbies and are able to pursue those, with staff support as necessary. Whilst waiting for college enrolment, residents choose how they wish to spend their days, with input from staff to ensure a balanced variety of day trips, both educational and recreational. Activity plan guidelines were seen within care plans, these recorded that residents have enjoyed activities such as, shopping, attending auctions, going to gym, walking, cooking, money management. One resident spoke about the day service that he attends at which he works within a blacksmiths which he enjoys a lot. During the second visit to the home staff spoke of the holiday that two residents have planned and booked, with staff support. The residents chose where they wanted to go and were fully involved in process of planning and booking. Relatives confirmed that they were always made to feel welcome in the home and that communication from staff was very good. Residents were observed to have unrestricted access to all parts of the home and garden and chose where they wanted to be during the day. They have been able to personalise their own rooms, both in décor and in being able to furnish as they wish and were able to bring any personal possessions with them when they moved into the home. Menus were seen for the week. Residents chose what meals they would like on a weekly basis, with one resident choosing the main meal for the day. Cook books are available to help the residents with this. Menus showed that residents could chose to have a take away during the week if they liked. The Oxford House DS0000065480.V292124.R01.S.doc Version 5.1 Page 13 menus showed that a good variety of meals were served, providng a balanced and nutiritous diet. Residents assist in the preparation and cooking of meals. During the first afternoon a member of staff was observed to make biscuits and cookies with a resident. Oxford House DS0000065480.V292124.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 from evidence gathered both during and before the visit to this service. Personal support is provided as residents prefer and require. The health care needs of residents are monitored and met. Residents are protected by the homes policies and procedures for dealing with medicines. EVIDENCE: The two care plans seen during the visit both gave detailed and clear information as to the health and personal care needs and how these are to be met. It was noted that where there are specific health care needs, there are care plans in place i.e. behaviour management, epilepsy. In addition detailed records are kept to monitor these health care needs. Access to health professionals is obtained as necessary. All residents are registered with a local doctors surgery. One resident has seen an occupational therapist and their report was included within the care plan. Relatives Oxford House DS0000065480.V292124.R01.S.doc Version 5.1 Page 15 confirmed that access to health professionals was arranged as required with residents registered with local doctors, dentists and opticians. Staff have developed and use behaviour support guidelines, which include, identified behaviours, triggers and management guidelines. Records show that these guidelines have been successful with far fewer incidents of challenging behaviour noted. One relative confirmed that she had seen a very positive change in behaviour, with the resident being more relaxed and very settled. Policies and procedures in place for administration of medication. Staff use the Boots Monitored Dosage System for the administration of medication. It was noted that all medications are checked into the home by the manager and only senior shift leaders administer the medication. Information about prescribed medications is kept. Medication was seen to be stored securely and all administration records in respect of medication were up to date. Oxford House DS0000065480.V292124.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 from evidence gathered both during and before the visit to this service. There is a clear and accessible complaints procedure within the home. Residents are protected from abuse. EVIDENCE: There is a policy and procedure in place for complaints. A book for recording any complaints received was seen, no complaints were recorded. Relatives spoken with very satisfied with the services and care provided so far. They were also aware of who they would speak with, if they had any issues or concerns and were confident that appropriate action would be taken. The west sussex guidance is in place in repsect of adult protection. Staff have received training in the protection of vulnerable adults. In addition adult protection forms part of the induction training programme for all new staff. Oxford House DS0000065480.V292124.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28 & 30 Quality in this outcome area is excellent. This judgement has been made from evidence gathered both during and before the visit to this service. Residents live in a safe and homely environment. Residents bedrooms suit their needs and lifestyles. Resident bedrooms promote their independence. Toilets and bathrooms provide privacy and meet individual needs. A range of comfortable and accessible shared rooms and spaces are provided. The home is clean, tidy and hygienic. Oxford House DS0000065480.V292124.R01.S.doc Version 5.1 Page 18 EVIDENCE: During the visit a full tour of the home was undertaken. The home provides a safe, comfortable, bright and welcoming environment for residents and visitors. It is decorated to a high standard with high quality furnishings and fittings. All residents have large bedrooms. They were able to choose their own colour scheme and have furnished them as they wished. Four of the bedrooms have ensuite facilities, with the fifth having a wet room adjacent to it, with sole use for the resident. All residents have personalised their rooms and have been able to bring their own possessions with them. Residents advised that they were able to choose wchih room they wanted and were very happy with them. There is a well furnished lounge and a large through dining/ kitchen room, which is again well furnished. Beyond the kitchen there is a sunroom/ conservatory area which houses the washing machine/ dryer. The home was clean and tidy throughout. There are policies and procedures in place regarding the control of infection and staff confirmed that they ahd all of the necessary equipment and protective clothing to use as required. Relatives confirmed that the home was always clean and tidy when they visited. Residents confirmed that they liked the home and enjoyed living there. Oxford House DS0000065480.V292124.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Staff have the competencies and skills to meet the needs of the residents. Residents are supported by an effective staff team. Residents are protected by the homes recruitment procedures. Staff receive training to enable them to fulfil the aims of the home and meet the needs of residents. Staff receive supervision. EVIDENCE: It was clear through discussions with staff, residents and through records seen that the staff team are competent and able to meet the needs of the residents. Staff were observed to be approachable and relaxed with residents who were keen to talk and chat with them about a variety of different issues and topics during the day. Oxford House DS0000065480.V292124.R01.S.doc Version 5.1 Page 20 Staff demonstrated a good understanding and awareness of the needs of residents and how these are to be met. Of the 12 staff within the team, four have a National vocational Qualification at level 2; five are enrolled to start (three at level 3 and two at level2). The rotas seen showed that there are generally three staff on duty during the day, with two during the night (one waking and one sleeping) Staffing at weekends is generally 2 as some of the residents visit families. However the staffing is flexible to ensure that the staff team can meet the needs of residents on a daily basis and allow them to enjoy activities as identified. Staffing levels are high resulting in all individual needs of residents being met and a relaxed atmosphere within the home. The recruitment records for four staff were seen, all had an application form, references, CRB/POVA first, induction records and supervision records in place (with the exception of one who only had one reference however this had been addressed by the time of the second visit.) Staff confirmed that they had regular supervision. Training records showed that a range of training was available for staff. Staff confirmed that they had taken a number of different training courses both in general areas such as food hygiene, moving and handling, and health and safety, as well as specific training identified through the needs of individual residents. Relatives confirmed that they had confidence in the staff team with comments including, ‘staff are supportive’ ‘all seem very good – nothing is to much trouble’. Oxford House DS0000065480.V292124.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 & 42 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents benefit from a well run home. The management approach of the home creates an open, positive and inclusive atmosphere. Residents’ views are considered in all aspects of the home. The health and safety of residents and staff is promoted and protected as far as is reasonably practicable. EVIDENCE: The registered manager had already demonstrated her fitness to manage the home during the registration process. During the visit the manager was Oxford House DS0000065480.V292124.R01.S.doc Version 5.1 Page 22 observed to have a good working relationship with both residents and staff. All records were up to date, in good order and easily accessible. Residents were observed to be very involved in the day-to-day running of the home. Staff also confirmed that they were very involved in all aspects of the running of the home and had opportunities and were able to influence and affect the way in which the service is delivered. The atmosphere within the home was relaxed and welcoming. A quality assurance tool is currently being developed. However it was evident throughout the visit that residents provide feedback to staff on an ongoing basis and staff were observed to encourage feedback from residents. Relatives were also confident that their views were taken into consideration. All records seen in relation to health and safety were up to date and risk assessments are in place for any identified environmental or general issues. Oxford House DS0000065480.V292124.R01.S.doc Version 5.1 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 4 25 4 26 4 27 4 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 2 X X 3 X Oxford House DS0000065480.V292124.R01.S.doc Version 5.1 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 Oxford House DS0000065480.V292124.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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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