Inspection on 08/01/07 for Oxford Respite Service

This inspection was carried out on 8th January 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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oxford Respite Service 18/10/05

Oxford Respite Service 14/06/05

Oxford Respite Service 11/03/05

Oxford Respite Service 22/02/05

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 Oxford Respite Service 43 Saxon Way Northway Oxford OX3 9DD Lead Inspector Catherine Kane Unannounced Inspection 8th and 12th January 2007 3:350 Oxford Respite Service DS0000061775.V326525.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 Oxford Respite Service DS0000061775.V326525.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. Oxford Respite Service DS0000061775.V326525.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oxford Respite Service Address 43 Saxon Way Northway Oxford OX3 9DD 01865 751115 01865 308142 lynne.dickie@oldt.nhs.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) Oxfordshire Learning Disability NHS Trust Lynda Christine Dickie Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6), Physical disability (5) of places Oxford Respite Service DS0000061775.V326525.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Use of the flat at 43 Saxon Way to support an individual for three months from 13 October 2006. During this time the registered numbers will increase from 5 to 6. 18th October 2005 Date of last inspection Brief Description of the Service: Oxford Respite Service, 43 Saxon Way, provides a short term breaks respite service for up to five people with learning and physical disabilities who live in and around the Oxford City area. The home has ground floor accommodation for five people where there is full access for people who use a wheelchair. A variation to the registration to include the use of the self contained first floor flat attached to the home has been approved for a period of three months from 13 October 2006 to provide accommodation for one additional person. The service is run and managed by Oxfordshire Learning Disabilities NHS Trust (OLDT) and is accessed only through referrals from local authority care management. The guest contributes from £49.65 to £90.65 per week. Oxford Respite Service DS0000061775.V326525.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 3.35pm on Monday, 8 January 2007. She returned on Friday, 12 January 2007. The inspector was in the service for a total of five and a half hours. The inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that the CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the service and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has, in this report, made judgements about the standard of the service. She spoke with three members of staff who were on duty on the first day of the inspection. She met with the registered manager later that week. The inpsector saw some guests preparing to have their evening meal and saw how staff help residents look after and take their medicines. She also looked at residents’ care plans and other records kept in the home and made a tour of the part of premises. The inspector would like to thank the manager and her staff team for their assistance with the inspection. She also thanks residents and all others who shared their experience of this home. What the service does well: Guests say they “have fun” when they visit the home and that staff look after them well. The home continues to have a friendly, relaxed atmosphere with positive relationships between guests and staff. Staff had a good understanding of residents’ support needs. The home would be able to meet the needs of individuals of various religious, racial or cultural backgrounds. Meals provided are good. Personal care and healthcare support provided in this home is good. Staff say morale is good. Oxford Respite Service DS0000061775.V326525.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. Oxford Respite Service DS0000061775.V326525.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 Oxford Respite Service DS0000061775.V326525.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): 1 and 2 Quality in this outcome area is good. The admission procedure is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager provided details of changes to the home’s bedroom accommodation and relocation of the office/sleep in room since the refurbishment. The manager stated that the statement of purpose document is to be republished shortly to include these amendments. There have been eight new guests who have started using the home since the last inspection. The pre-admission assessment records were seen; all but one included a full care needs assessment. The manager assured the inspector that a full pre-admission assessment had been completed prior to the admission of this person and a copy of the assessment would be obtained. Generally, admissions are not made to the home until a full needs assessment has been undertaken. The home is then able to confirm that it can meet the needs of the individual through the service it delivers, as detailed in the statement of purpose. Oxford Respite Service DS0000061775.V326525.R01.S.doc Version 5.2 Page 9 Evidence confirms that the assessment is conducted professionally and sensitively and has involved the family or representative of the person who uses the service. Prospective new guests are given the opportunity to spend time in the home. Oxford Respite Service DS0000061775.V326525.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is adequate. The care planning system in place to provide staff with the information they need could be improved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection the inspector viewed six person-centred care plans. These were generally easy to understand, written in plain language and considered all areas of the individual’s life including health, personal and social care needs. The plan is regularly reviewed and includes comprehensive risk assessments. Five of the six plans viewed did not include a photograph of the service user. There is a considerable number of people accessing this service at different times and a number of new staff working in the home. Photographs would provide essential information to staff to enable them to correctly identify individuals in order to provide them with the care they need and minimise risk of error, for example with medication. Oxford Respite Service DS0000061775.V326525.R01.S.doc Version 5.2 Page 11 The inspector observed in the care plan of one guest that a form of restraint should be used if the individual becomes distressed to protect them from harm. It was not clear from the care plan who had made the decision to use this technique which could compromise the person’s dignity and restrict their freedom. Whilst the inspector understands that the decision put limitations in place may have been done with the best interests of the person in mind, this must be done only through a full care planning process if the person is not able to give their full consent. This would involve those individuals who would be able to act on the resident’s behalf, for example their relatives or advocate and other social care or healthcare professionals. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural backgrounds. Oxford Respite Service DS0000061775.V326525.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. Opportunities for people who use this service to take part in a variety of interesting activities is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the first day of the inspection the inspector was in the home during the early evening. Six people were accessing the service at that time - four people for overnight stays and two people for teatime visits. She spent this time with all six guests and the three staff on duty. Three guests had very good communication skills, were confident and able to tell the inspector about their experiences of the home. The other three guests also had good understanding and even though they had some difficulty communicating with the inspector they were all able to let her know about Oxford Respite Service DS0000061775.V326525.R01.S.doc Version 5.2 Page 13 some things that are important for them. One guest told the inspector, “It’s a very nice place. The staff talk to people nicely and they help people.” Many activities provided in-house were based on what guests prefer to do in their leisure time; these included listening to music, watching TV, videos, DVDs, computer games, puzzles and games, garden, art and crafts and cooking. Activities outside the home include going to the sports centre and other leisure activities in the Oxford area. Guests are supported to attend any day service, college, groups or clubs that they would usually go to whilst at home with their families. One relative of a guest returned a questionnaire to the inspector. They indicated that they are very satisfied with the care provided in the home. One relative commented, “My son loves ‘his weekends off’!! We all need a break and he has the chance to ‘chill out’. He packs his own case ready to go and that says it all!!” The inspector was in the home when the evening meal was being prepared. The meal was freshly cooked spaghetti Bolognese followed by dessert. One guest said, “The meals the staff cook are very nice”. Regular drinks and snacks are available. A varied menu is provided and residents’ special dietary needs are catered for. Oxford Respite Service DS0000061775.V326525.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. The personal and healthcare needs of guests are well met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Essential information needed by staff to be able to provide personal and health care support was included in care plans. Staff help guests to look after their own medication. Guests healthcare needs are generally undertaken by their families and arrangements in the case of an emergency can be made. The home will liaise with GPs, district nurses and other healthcare professionals when necessary. From information viewed in care notes the inspector is aware that the home has been able to support one guest with some complex healthcare needs with good support from the local GP practice and the community learning disability nurse. Oxford Respite Service DS0000061775.V326525.R01.S.doc Version 5.2 Page 15 Since the last inspection new medicine cabinets have been securely fitted into each bedroom. The home uses a standard medication administration record (MAR), which is handwritten. Records were kept of staff assessed as competent to administer medicines and these were seen during the visit. During the inspection two staff members confidently demonstrated how residents’ medicines are looked after and how residents are helped to take their medicines. Oxford Respite Service DS0000061775.V326525.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. The home has a protection from abuse policy and the complaints procedure is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager declared that the home has received one verbal complaint in the last year. From information discussed with the manager during the inspection this issue was dealt with in line with the OLDT complaints policy. The Commission has received no information relating to complaints in the last year. Guests who spoke with the inspector had a good understanding of their right to make a complaint and to whom they need to speak to if they have any concerns. Staff have attended specific training on protecting vulnerable people from abuse and about local adult protection procedures in line with the Oxfordshire Multi-Agency Codes of Practice. The Commission has received no information relating to adult protection issues in the last year. Oxford Respite Service DS0000061775.V326525.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): 24 and 30 Quality in this outcome area is good. The home was tidy and clean at the time of the inspection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has undergone a major refurbishment of the bedroom accommodation since the last inspection. The sensory room has been converted to an office/staff sleep in room. The furniture and fittings are modern and domestic in style providing a home-like environment. The large lounge/dining room leads to the garden and patio area. The plasterwork in the office/staff sleep-in room was damaged around the window frame and needs to be repaired without delay. Oxford Respite Service DS0000061775.V326525.R01.S.doc Version 5.2 Page 18 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 and 35 Quality in this outcome area is good. At the time of inspection staffing levels appeared to be appropriate for the needs of the current resident group to be met. The systems in place for recruitment of new staff demonstrate a systematic and thorough screening and interview process. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Over the two days of the inspection visit the inspector spoke with four members of staff. The home has a core of well-established staff who understand guests needs and who they relate well to. From information provided by the manager there has been a high use of agency staff in this home during June 2006 and August 2006 but this has improved with the recruitment of new staff. Two staff have left and six new staff have been recruited or transferred from other services since the last inspection. Staff commented that morale is good. Oxford Respite Service DS0000061775.V326525.R01.S.doc Version 5.2 Page 19 A guest in the home at the time of the inspector’s visit said, “The staff talk to people nicely. They help them to take their tablets and they keep the place nice and hygienic. It’s a very nice place.” A relative of a person who regularly uses this service commented, “The staff on duty are always welcoming and friendly.” The inspector visited the HR department at the head office on Thurday, 22 June 2006 as part of the inpection of another service run and managed by this organisation. Files seen were well maintained. However, information relating to staff that must be kept in the home for new staff was not available at the time of the inspector’s visit. The recruitment process is thorough. The home keeps a record of training completed by staff; staff spoken with confirmed details of the training they have undertaken. However, only one staff member has completed a relevant National Vocational Qualification (NVQ). The home has not met national targets to have 50 of staff qualified. One member of staff is qualified to assess NVQs in the workplace and the manager is optimistic that this will assist the home towards meeting the 50 target. Oxford Respite Service DS0000061775.V326525.R01.S.doc Version 5.2 Page 20 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 and 42 Quality in this outcome area is good. The registered manager has a good understanding of management areas in which the home needs to improve and has plans in place to address this. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It is expected that the registered manager shall undertake further training qualifications at Level 4 NVQ in both Management and Care. Therefore, this standard is rated as ‘standard almost met’, scored 2. The registered manager is competent to run the home and meet its stated aims and objectives. Oxford Respite Service DS0000061775.V326525.R01.S.doc Version 5.2 Page 21 The manager has sound knowledge and experience in care of people with a learning disability, quality assurance systems, equal opportunity issues, development and implementation of the service’s policies and procedures, good people skills, strong leadership of staff which leads to confident workers, responds to need and provides an excellent role model and manages the service efficiently. She has a strong ethos of being open and transparent in all areas of running of the home and is aware of current developments, both nationally and by the CSCI and plans the service accordingly. One relative of a person who regularly uses this service said, “The management I feel is excellent, they have always attempted to accommodate my needs as a parent.” A monitoring audit of the services provided in this home completed by the local authority has taken place but this was not available at the time of the inspection. The manager completes a monthly quality monitoring checklist. However, whilst there is evidence that senior managers do visit the home, there have been no proprietor’s representative’s monthly visit reports issued since the last inspection. Whilst the Commission no longer requires that a copy of this report be sent to the CSCI, a copy must be kept in the home and made available for inspection. The home has sound policies and procedures in line with current thinking and practice. Efficient systems are in place to monitor staff adherence to policies and procedures during their practice. The home works to a clear health and safety policy and checks take place to ensure that the home meets relevant health and safety requirements and legislation. Records kept were generally adequate and are routinely completed. Where issues have been identified these have been acted upon successfully to ensure that residents’ care is not compromised. Oxfordshire Learning Disability NHS Trust, operating as the Ridgeway Partnership, who runs this service, has financial and accounting systems subject to internal and external audits. The organisation was rated as a high level performer in the Healthcare Commission 2006 report. Oxford Respite Service DS0000061775.V326525.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 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 2 X 2 X X 3 X Oxford Respite Service DS0000061775.V326525.R01.S.doc Version 5.2 Page 23 No 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 17(2) Requirement The registered person must provide the CSCI with details of how they plan to ensure that information relating to all people who use this service includes a recent photograph. The registered person must ensure that a record is kept of decisions that have been made for residents and the reasons why these decisions have been made. The registered person must provide the CSCI with details of the repair and maintenance programme for the home to include the badly damaged plasterwork in the office/staff sleep-in room that needs to be repaired without delay. The registered person must ensure that information required relating to staff must be kept in the home and made available for inspection. Timescale for action 15/03/07 2. YA7 Schedule 3 15/03/07 3. YA24 23(2)(b) 15/03/07 4. YA34 19 Schedule 2 15/03/07 Oxford Respite Service DS0000061775.V326525.R01.S.doc Version 5.2 Page 24 5. YA39 26 The responsible person must ensure that they, or their representative, completes a monthly unannounced visit to the home and a copy of the report is kept in the home and is made available for inspection. 15/03/07 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 YA35 Good Practice Recommendations The inspector strongly recommends that increased efforts should be made to support staff to achieve an NVQ qualification. Oxford Respite Service DS0000061775.V326525.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Oxford Respite Service DS0000061775.V326525.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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!