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Inspection on 15/02/06 for Paks Trust 66 Oaston Road

Also see our care home review for Paks Trust 66 Oaston Road for more information

This inspection was carried out on 15th 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 home continues to run in a relaxed and homely manner, with residents and staff all working together in a friendly and easy-going atmosphere. Residents` comments about living at Beaman House, as 66 Oaston Road is also known, were all positive, and the atmosphere throughout was lively and cooperative, with much laughter and joking.

What has improved since the last inspection?

The recording of residents` finances has greatly improved. Work is on-going on updating and reviewing individual care plans and contracts.

What the care home could do better:

Work to improve individual care plans needs to be completed. It is understood from staff comments that this is well underway and being done by the manager. This work could usefully involve keyworkers, and the service user concerned, under the guidance of the manager. Some outstanding decoration work needs to be done. The issue of the staff sleeping-in room needs to be satisfactorily resolved.

CARE HOME ADULTS 18-65 Paks Trust - Oaston Road, 66 66 Oaston Road Nuneaton Warwickshire CV11 6JZ Lead Inspector Martin Brown Unannounced Inspection 15th February 2006 03:30 Paks Trust - Oaston Road, 66 DS0000004457.V283490.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 Paks Trust - Oaston Road, 66 DS0000004457.V283490.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. Paks Trust - Oaston Road, 66 DS0000004457.V283490.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Paks Trust - Oaston Road, 66 Address 66 Oaston Road Nuneaton Warwickshire CV11 6JZ 02476 742201 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) PAKS Trust Alan John Sheppard Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Paks Trust - Oaston Road, 66 DS0000004457.V283490.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th November 2005 Brief Description of the Service: The property is a 5 bed roomed narrow and tall Victorian end of terrace house on the edge of Nuneaton in a semi industrialised zone. It has a lounge, kitchen diner and lean to/conservatory room. Off the kitchen there is a shower room and separate toilet. There is a small back garden. Every one has a single bedroom. The staircase in the house is narrow. The ground floor has one bedroom. On the first floor there are two residents’ bedrooms and a bathroom. The other two bedrooms and a separate toilet are on the top floor. Staff use one of the communal rooms to ‘sleep in’ overnight. Paks Trust - Oaston Road, 66 DS0000004457.V283490.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is of the second unannounced inspection of the inspection year at this home, and should be read alongside the previous inspection report, from November 2005, for a fuller picture. Where key standards have been assessed on the previous inspection and have been met, these have not necessarily been inspected on this occasion. The returned pre-inspection questionnaire, in addition to ‘Comment’ cards received from relatives, visitors and from people living in the home, have helped to inform this inspection. Comment cards were generally very positive. The inspection took place late on a weekday late afternoon, and lasted two and a half hours. The inspection was cut a little bit short, as everyone was preparing to go out the theatre that evening. All the people living at the home were seen, as well as the two staff on duty. All were welcoming and helpful. 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. Paks Trust - Oaston Road, 66 DS0000004457.V283490.R01.S.doc Version 5.1 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 Paks Trust - Oaston Road, 66 DS0000004457.V283490.R01.S.doc Version 5.1 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): 5 The blank contracts and agreements of residency show that terms and conditions are in place; individuals should have ready access to completed copies of these. EVIDENCE: There have been no service users since the previous inspection, and no changes are anticipated. Blank contracts were seen, including an Agreements of Residency, setting out clearly what are the obligations and expectations of both the provider of the service at Oaston Road, and the recipient of the service. Staff advised that the individual copies of these were kept locked in the filing cabinet, to which the only the manager had access. These will be examined on another occasion, as the timescale set from the last inspection, for completion of these, has not yet elapsed. Paks Trust - Oaston Road, 66 DS0000004457.V283490.R01.S.doc Version 5.1 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 Service users assessed and changing needs are currently not fully reflected in accessible and available individual plans of care. Service users’ dignity and well-being is not assisted by the use of judgemental terms such as ‘temper tantrums’ in written profiles. EVIDENCE: A sample of individual files of residents was looked at. The amount of information in these varied, and much of it was out-of –date, or undated. Staff advised that the manager was currently reviewing and updating all care plans, but that these were locked away, with only the manager having access. The individual daily records were good, giving brief details of what a person had done that day, with comments by that person, if wished, and giving a clear guide to that person’s week; their activities, highlights, what has been enjoyed, and what difficulties, if any, there have been. Some files had lots of photos of, and in some instances, pictures by, residents. Others had records of dental appointments of three years ago, and some had personal profiles that were useful but which needed updating, or in some cases, dating. Paks Trust - Oaston Road, 66 DS0000004457.V283490.R01.S.doc Version 5.1 Page 9 Some service user assessments were seen; again, some of these needed dates, in some cases, information was sparse, with dates of admission not filled in. One profile wrote of a person having ‘temper tantrums’. Paks Trust - Oaston Road, 66 DS0000004457.V283490.R01.S.doc Version 5.1 Page 10 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): 12,13,15,17 The impression was of a busy, lively household, with people taking part in a variety of stimulating activities. EVIDENCE: All the people living at the home were out at a variety of day services, which, from comments made in conversation, they all appeared to enjoy and find fulfilling. Everyone was looking forward to going to see a show that evening. One person, who enjoyed football, told me of the football match he had been to recently, and of others planned for the future. Everyone enjoyed a home cooked meal together before getting ready to go out. Staff explained the menu system whereby everyone takes it in turn to choose a meal, and also demonstrated how specific individual likes and dislikes were catered for. A typical comment was the straightforward “I like living here!” One resident was pleased to show me a picture of herself at her day service which was recently in the local newspaper. Paks Trust - Oaston Road, 66 DS0000004457.V283490.R01.S.doc Version 5.1 Page 11 Service users were seen to willingly do chores, making sure all was clean and tidy after the main meal, with little or no prompting. Staff advised that local amenities, such as shops, were used, made easier by the fact that the home is within walking distance of the local town. Families and friends visit; at present, there is a room set aside for people to meet. This is the room that is also used as the staff sleep-in room. Paks Trust - Oaston Road, 66 DS0000004457.V283490.R01.S.doc Version 5.1 Page 12 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 Service users are generally supported in having their health needs met. This is compromised in at least one case by a health issue not being fully explored or documented. EVIDENCE: Daily records, appointments, some details in personal plans, and comments from staff and service users showed that service users receive personal support appropriately and that their health needs are met. One ‘service user assessment’ mentioned, under ‘health needs’ a dairy products allergy, but there was no evidence that this had been followed up. Staff stated that this person avoided dairy products at breakfast, but not at other times. Paks Trust - Oaston Road, 66 DS0000004457.V283490.R01.S.doc Version 5.1 Page 13 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 The positive, easy-going atmosphere within the home enables service users to feel confident that their views will be listened to and heeded. Procedure and practice for looking after service users monies is much improved. EVIDENCE: A complaints procedure was seen, as were complaints logs and complaints books for individuals. These largely consisted of expressed preferences, such as ‘did not want to go to P.E. today’, but which form a useful indicator of choices being made and preferences being heeded. Comments made by people living in the house were overwhelmingly positive, and where there were concerns, primarily in the area of wanting new things, people were confident enough to address the staff directly with these. A staff member was able to explain and demonstrate the system for supporting service users in the handling of their personal monies. This was subject to a requirement previously, and is now far more safely and transparently handled. Each person now has an individual book, with a running total, and each transaction is signed by both the service user and staff, and receipts for purchases are numbered for reference. Paks Trust - Oaston Road, 66 DS0000004457.V283490.R01.S.doc Version 5.1 Page 14 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 The house provides a warm, homely environment. Some minor environmental improvements and some rethinking on staff sleeping–in arrangements would help ensure it remains homely, safe and comfortable. Thought needs to be given to making staff sleeping-in facilities more suitable; more comfortable for staff, and more integrated with the main body of the house. The only long-term solution may be to use an existing bedroom if and when a service users leaves. EVIDENCE: Service users were clearly at home in the comfortable and domestic-scale environment. Service users were all happy for me to see their bedrooms. All are personalised, well-decorated and suitably decorated and furnished, except for one, which is due for imminent re-decoration. The hall has been over-painted (including decorative paper) a bright yellow. The fan in the downstairs shower was not working. The downstairs toilet has no hand drying facilities. There is a dispenser for paper towels in the kitchen by this toilet door. Paks Trust - Oaston Road, 66 DS0000004457.V283490.R01.S.doc Version 5.1 Page 15 Staff explained the difficulties in having towels in this toilet, and agreed that a hot air hand dryer might be suitable. Staff expressed reservations about the current sleeping-in arrangements, namely, the room now used being isolated from the main body of the house, also used as an entrance and a smoking and visitors room, and being cold and poorly insulated. Paks Trust - Oaston Road, 66 DS0000004457.V283490.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,35 Service users are supported by competent staff who are appropriately trained and gaining appropriate qualifications. EVIDENCE: The manager was not available to confirm training across the staff team, but staff on duty were able to confidently discuss the mandatory training they had undertaken, and informed me they were undertaking National Vocational Qualification level 2 in Care. Staff were confident and thoroughly at ease with the service users, as they were with them. Paks Trust - Oaston Road, 66 DS0000004457.V283490.R01.S.doc Version 5.1 Page 17 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): 42 The home was able to demonstrate how service users’ health, safety, and welfare are protected. This is, however, potentially compromised at night, by the current sitting of the staff sleeping-in room. EVIDENCE: Records in respect of Health and Safety were clearly set out in a cabinet, and were able to be examined in the absence of the manager. Gas, electric, insurance and fire safety records were all seen to be up-to date. Portable electrical appliance testing records were available. Fridge freezer temperature records were up-to-date, and showed temperatures within a safe range, once the alarming habit of staff of leaving out the decimal point, so that 4.5c read as 45c, had been discounted. Staff and service users showed a good awareness of fire safety and evacuation procedure, hazardous substances were secure, and no risks to health and safety of individuals were noted. The one area of concern, already noted, is the difficulties caused by the sitting of the staff sleep-in room. Paks Trust - Oaston Road, 66 DS0000004457.V283490.R01.S.doc Version 5.1 Page 18 As well as concerns noted by staff, they also worried that they were isolated from any noise or occurrence in the main body of the house. Procedures to ensure, for example, safe bathing routines for the downstairs shower, were seen. Paks Trust - Oaston Road, 66 DS0000004457.V283490.R01.S.doc Version 5.1 Page 19 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 X 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 2 28 2 29 x 30 x STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 X X X X X X X 2 X Paks Trust - Oaston Road, 66 DS0000004457.V283490.R01.S.doc Version 5.1 Page 20 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 YA5 Regulation 5(1)(b) Requirement Copies of the written terms and conditions in respect of the accommodation provided must be available to residents. Timescale for action 31/03/06 2 YA6 3. 3 4 5 YA19 YA27 YA28 YA42 15,12(4)(a) Up to date and accessible care plans must be available, dated, regularly reviewed, and not feature judgemental language. 12 Where identified, health needs must be clearly addressed. 23(2)(c) The extractor fan in the downstairs shower must be fixed. 23 The hall must be re-decorated. 23 More satisfactory arrangements for staff sleeping-in must be considered. Current sleeping arrangements must be fully risk assessed. 21/03/06 21/03/06 21/03/06 21/05/06 21/03/06 Paks Trust - Oaston Road, 66 DS0000004457.V283490.R01.S.doc Version 5.1 Page 21 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. 5. Refer to Standard YA27 YA34 Good Practice Recommendations It is recommended that a hand dryer is installed in the downstairs toilet. It is recommended that copies of documents such as criminal bureau checks, birth certificates and passports are signed and dated by the person who had seen the original copies. Paks Trust - Oaston Road, 66 DS0000004457.V283490.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Paks Trust - Oaston Road, 66 DS0000004457.V283490.R01.S.doc Version 5.1 Page 23 - 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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