Inspection on 13/10/06 for Paks Trust Oaston Lodge

This inspection was carried out on 13th October 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Paks Trust Oaston Lodge 08/01/10

Paks Trust Oaston Lodge 25/08/07

Paks Trust Oaston Lodge 03/01/06

Paks Trust Oaston Lodge 18/07/05

Paks Trust Oaston Lodge 22/03/05

Paks Trust Oaston Lodge 30/11/04

Paks Trust Oaston Lodge 12/03/04

Paks Trust Oaston Lodge 16/09/03

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Paks Trust Oaston Lodge Oaston Lodge 82 Oaston Road Nuneaton Warwickshire CV11 6LA Lead Inspector Sheila Briddick Unannounced Inspection 13th October 2006 08:15 Paks Trust Oaston Lodge DS0000004323.V316417.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 Paks Trust Oaston Lodge DS0000004323.V316417.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. Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Paks Trust Oaston Lodge Address Oaston Lodge 82 Oaston Road Nuneaton Warwickshire CV11 6LA 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 Susan Elaine Dore Care Home 7 Category(ies) of Learning disability (7), Physical disability (2) registration, with number of places Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. NVQ Level 4 That NVQ Level 4 in Care and Management is achieved by 2005. 3rd January 2006 Date of last inspection Brief Description of the Service: Oaston Lodge is a domestic style detached house in a residential area of Nuneaton and close to the towns shops and leisure facilities. Ground floor accommodation comprises of a lounge, kitchen, dining room, shower room with toilet and two single bedrooms. Five further bedrooms and a small office are situated on the first floor of the house. There is a mature garden that is wheelchair accessible with some raised beds and a barbecue and parking to the front of the property. The current scale of charges is £538 - £637. Additional costs for hairdressing, chiropody, toiletries, holidays and social activities have to be met by service users. Transport costs are charged per mile. Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for service users and their views of the service provided. This process considers the care home’s capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. Prior to the inspection visit the manager had forwarded to the Commission a pre-inspection questionnaire, a staffing rota and menu records for the home. Service user and relative questionnaires were sent out; four service users and three relatives completed and returned these. All pre-requested documentation was examined as part of the inspection process and the evaluation included in this report. The survey information from service users and relatives concluded that lifestyle in the home was good, that people felt safe and well cared for. The inspection visit was unannounced and took place on Thursday, October 12, 2006. at 08.15 am and ended at 1.00pm. The inspection involved: • • • Discussions with the manager and two care workers. Observation of working practices and of the interaction between service users and staff. Two service users were identified for close examination by reading their, care plans, risk assessments, daily records and other relevant information. This is part of a process known as ‘case tracking’ where evidence is matched to outcomes for service users. A tour of the environment was undertaken, and home records were sampled, including staff training, health and safety, rotas, complaints and fire records. • The inspector had the opportunity to meet all service users and was able to talk with two of them about their experience of the home. Service users were able to express their opinion of the service they received through general discussion. Comments during the visit from service users included; I have been very happy since I moved here. I was able to visit before I came to live here for lunch and tea. My friends can come and visit me. If I have a problem I will tell the manager. What the service does well: Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 6 The home is well managed with service users, staff and the manager having good, open and honest relationships with each other. The environment is homely and the people living there have the aids and equipment they need to ensure and promote independence. Staff members have a sound understanding of individual needs and are involving service users in planning daily routines and promoting lifestyle opportunities that are fulfilling and meaningful. Service users appeared happy and relaxed and in conversation with them expressed satisfaction with life in the home and the opportunities they have in the community. This service has a strong belief that it is essential to support and encourage service users to exercise their rights and make their own decisions and choices. What has improved since the last inspection? What they could do better: The service has made the decision to care for people living in the home as they grow older, for as long as they are able to safely do so. The manager therefore needs to make an application for a Variation to the Registration of the Home so that the Certificate of Registration reflects the service provision including people over the age of 65 years. The manager said that the Statement of Purpose for the home would be reviewed so that this information is available for prospective service users. Record management is generally good however key workers must date all entries made on care plans and complete the review documentation so that the Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 7 service can demonstrate service user’s aims and objectives are being met within acceptable timescales. A number of good practice recommendations were discussed with the manager who was keen to implement some of these with specific regard to gender care provision, medicine management, and staff training. 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. Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 8 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 Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 9 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): Standard 1 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in this home can be sure that the service has sufficient resources for whom the service is intended however in the event of prospective service users wishing to know about the services in the home it is not clear from information in the Statement of Purpose, or on the Certificate of Registration, which is currently for Younger Adults, that there may at times be both older and younger people living there. EVIDENCE: Examination of care plans, observation of care practice and discussion with staff clearly demonstrated that the service is meeting and understanding the changing needs of the of the older people living in the home and the impact growing older may can have on a persons lifestyle. The pace of daily routines and daily activities were seen to be appropriate to current needs and records show that involvement and independence as people grow older, i.e. in shopping and home activities, continues to be promoted. It is the intention of the service to continue to provide care for people as they grow older for as long as they can meet needs safely. The manager said they would be making an application for a Variation to the Registration Certificate Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 10 for the home to reflect the care provision currently being offered to three older people. It is recommended that the manager also amend the home’s Statement of Purpose so that any prospective younger person wishing to consider living in the home would be aware that at times there may be older people living there are also. There have been no new service users coming to live at the home since the last inspection visit therefore Standard 2 was not looked at on this occasion. Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 11 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): Standard 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are involved fully in the decision making process but cannot be sure that their changed needs will be reflected on their care plan so that staff have up to date information to meet changed needs, wishes and choices. EVIDENCE: Two care plans were examined in depth during this visit as part of a process known as case tracking when all aspects of care are looked at through reading care plans, talking with service users and staff and observing care practices. Care plan documentation had thoroughly been audited at the last inspection, this visit therefore looked at the care plan review process to determine how the changing needs of service users are reviewed and evaluated so that the service can be sure care offered continues to be safe and appropriate to needs. Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 12 The service has a documented review format, which is to be completed when care needs are reviewed, and the care plan amended to reflect the changing needs. It is the key workers responsibility for completing this process. It was evident on the two care plans examined that care plans are being amended from information recorded in daily records and following professional input, such as physiotherapists and GPs however, amendments made had no date of entry and review documentation was not completed to show why any amendment had been necessary to the care plan or who had been involved in the decision-making. Without this the service cannot demonstrate consistent evaluation or that reviews are regular and involve the service user and other people involved in care planning. All notes made however on care plans were legible and informative. A third care plan was looked at and this clearly evidenced that the key worker completing it understood the review process. The reviewed document was descriptive in its evaluation of the care plans and whether any amendment was required to the plan to reflect any changed need. All amendments were dated and the date of the next review had been identified and noted. This care plan clearly demonstrated ongoing review and evaluation and forward planning to maintain and promote the service use’s health and well-being. Observation and discussion with staff demonstrated that risks to individuals are known and managed safely. Care plans looked at recorded the risks to service users, although the guidelines for staff to follow in the management of risks is kept separately to the care plan. The manager agreed that it would be good practice to indicate on care plans where guidelines for staff to follow to minimise risk can be found. New staff coming to work in the home would require this direction. One service user has an advocate and talked about how their advocate is involved in their life at the home. It was clear from this discussion that the service user felt they would be able to communicate their concerns with their advocate if they had any. Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 13 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): Standards 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The people living in this home are able to make choices about their lifestyle, and supported to develop their life skills. Social, cultural and recreational activities meet individuals expectations and promote ordinary and meaningful lifestyles. The meals in this home are good offering both choice and variety and catering for special dietary needs. EVIDENCE: The home continues to provide service users with the support they need to live a fulfilling and meaningful lifestyle in the community and at home. Service users were getting ready for the days activities when I arrived, with five going off to their day service and two staying at home. The pace of preparing for the day was relaxed and appropriate to individual needs. Service users appeared comfortable with the routine of the morning. Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 14 One of service user is employed at a local supermarket for two days each week, this is paid work and they receive staff benefits, which include a staff discount card. They said that they enjoyed their time there. Two service user’s daily records looked at showed that routines at home are relaxed and of the individuals choice, i.e. times for getting up and going to bed, going out or staying at home. Activities in the community were looked at over the two weeks prior to the visit and had included, day service attendance, a group outing to Walsall Illuminations, shopping activities, church attendance and visiting the dentist. Service users told me about the holiday they had enjoyed in Cumbria earlier this year and of where they were hoping to go next year. They talked about the holiday cottages that they rent when on holiday and had particularly enjoyed staying in a converted chapel last year. Service users are supported to attend a church of their choice if they wish. One service user said, my church friends pick me up in the morning to go to church and when I come home I bring them in for a cup of tea. Friends and family visit regularly and three comments received by the Commission prior to this visit identified that they are made welcome when they visit, can see their friend or family member in private, are kept informed and satisfied with the overall care given in the home. There are two designated smoking areas in the home, one outside for staff use and one of the shared rooms, (the dining room), for service users who smoke. A service user said that people, i.e. service users, do not smoke when we are eating, I go out of the room and either into the lounge or my bedroom when XXX has a cigarette. They appeared happy with this agreement. Service users said that the food was good and if they do not like something they say so. The menu record for the previous two weeks showed meals to be varied, well balanced and nutritious. The dietary needs of individual service users were indicated on their care plan and specific dietary needs are met appropriately with written guidance for staff to follow. Specialist foods such as thickening agents to assist swallowing and dietary compliments for older people are provided as necessary. Staff have accessed training in nutrition and diet with reference also to dietary needs for people as they grow older. Staff were observed to offer sensitive and appropriate support to people at breakfast time, which included ensuring the person, was in a comfortable sitting position and had the equipment necessary to eat their food independently, i.e. cutlery and cups. Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 15 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): Standards 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive in this home is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Medicine management is safe and not placing service users at risk. EVIDENCE: Observation of care practices during the visit demonstrated that personal care offered to service users continues to be sensitive, safe and respectful. Staff explain their actions to service users when supporting mobility for example, when supporting service users to move from a chair to a wheelchair and when putting on coats prior to going out. There continues to be an all-female staff team working in the home however, the manager said that when a vacancy occurs they will endeavour to employ male staff if they apply and meet the criteria. Service users do have support from male staff through their day services and friends and acquaintances are across the gender spectrum. The manager said they will discuss the balance of Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 16 the gender of the staff team occasionally at house meetings with service users to be sure that they continue to be satisfied with the current situation. Service users were all smart in their appearence, their clothes were clean and fresh and appropriate to their individual lifestyle and needs. Care plans looked at recorded all identified health-care needs and health-care records continued to evidence service users have ready access to a GP and other health professionals locally including, physiotherapists, psychiatrists, dentists, speech and language therapists, occupational therapists and chiropodists. Service users said that they like the chiropodist who visits the home and the GP was nice. Two service users talked about it being time for flu jabs and wishing to have these as they didnt want to be ‘ill’. Medicine management continues to be good with records looked at being upto-date and in good order. A staff member talked about the recent introduction of photographs on each individuals medication record saying that, agency staff would need this information so that medication would be administered to the right person, as agency staff may not be as familiar as regular staff with service users. Staff are currently completing long-distance training courses in the safe administration of medicine, which includes observation of their practice. The manager is keen to develop an ongoing competency audit of staff skills in medicine administration and of medicines held in the home, although medicines held in the home are audited by the Provider on a monthly basis. Medicine is securely stored in a metal cabinet which is kept in the staff sleeping room. Only medication and medication records are stored in this. Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 17 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): Standards 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in this home are able to express their concerns, and have access to a robust, effective complaints procedure. People are protected from harm, and have their rights promoted by a staff team with a good understanding of their role and responsibility in the protection of vulnerable people. EVIDENCE: Discussion with service users and reading responses from returned questionnaires confirms that the process of how to make a complaint is known and understood by them and their family members. The manager said that in response from one relative to a recent service questionnaire, which stated they did not know there was a complaints policy for the home, a copy of the complaints policy and of the last inspection report had been forwarded to them. Staff have recently attended training in the Protection of Vulnerable Adults, (POVA), and described the content of the training programme to me which included, what to look for and different types of abuse. Staff said that different scenarios of abuse were also discussed. The staff team have ready access to a copy of the local multi-agency POVA policies and procedures. Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 18 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): Standards 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within this home is good providing service users with an attractive and homely place in which to live. EVIDENCE: The environment continues to be warm, welcoming, clean and safe and the staff are to be complimented on their commitment to ensuring this is maintained. Three service users were happy for me to see their bedrooms, which were bright and cheerful, clean and fresh. Specialist equipment used by one service user such as a hoist, weighing chair, walking frame and commode was located safely and unobtrusively in their bedroom so that the bedroom itself reflected the lifestyle of the service user rather than their physical needs. Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 19 The laundry area is well equipped and clean and tidy and away from food preparation areas. Laundered clothing was folded neatly awaiting ironing. Bathrooms, toilets and a shower room were clean and airy although the downstairs shower facility is beginning to show signs of wear and tear. This will require some refurbishment in the near future, i.e. replacement of the flooring so as to maintain good infection control. Infection control procedures are robust and includes training for staff in safe working practices. Equipment for managing the control of infection is provided, i.e., disposable gloves and aprons, and mops and buckets were labelled for use in appropriate areas. The garden area was tidy and safe and would provide a welcoming place for service users to sit in warmer weather. Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 20 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): Standards 32 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support people who use the service. Staff have a very good understanding of the service user’s support needs and this is evident from the positive relationships, which have been formed between the staff and service users. EVIDENCE: Training opportunity were discussed with two staff members and the manager and training records examined. This process confirmed that training is planned for against service user needs, considers staff development to meet identified needs, the ongoing development of the service provision and principles of good care practices. In the last 12 month period training has included health and safety, fire safety, epilepsy awareness, dementia care, food hygiene and the protection of vulnerable adults. Further training is planned for in first aid, medication and the protection of vulnerable adults. Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 21 There continues to be a commitment towards all staff achieving an NVQ in Care with over 50 of the staff team having achieved this. Ongoing NVQ accreditation is taking place with one staff working towards an NVQ at Level 3, one staff towards an NVQ Level 2 and one staff towards achieving Learning Disability Award Framework, LDAF. Staff spoken with felt training opportunity for them was good and during discussion they demonstrated a commitment towards training development and pleasure in their success towards achieving NVQ qualifications. The manager is keen to ensure that staff skills, knowledge and awareness continues to meet the changing needs of people as they grow older and to this end will be resourcing training for staff in tissue viability and pressure sore awareness. There has been no new staff coming to work in the home since the last inspection therefore Standard 34 was not looked at on this occasion. Staff continue to demonstrate a commitment to their job and it must be noted that staff see themselves as ‘support’ workers rather than ‘carers’ which further demonstrates the ethos in the care planning and service provision towards promoting and enabling independence so that service users can live meaningful and interesting lifestyles. Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 22 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): Standards 37, 39, 41 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect, with an ethos of promoting meaningful and ordinary lives for the people living there. People have opportunity to give feedback about the service they are receiving. Health and safety management is generally good and ensures people living and working in the home are safe. Record management could be improved upon so that care planning reflects the high standard of care practice there is in this home. EVIDENCE: The manager advised that she has now achieved the Registered Manager Award and NVQ Level 4 in Management, this was a Condition to the Registration of her as the Registered Manager for the home, which can now be removed. During conversation she demonstrated a clear understanding of the Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 23 way the service should continue to ensure ongoing development so that service users can continue to live ordinary and meaningful lives as they grow older. It was observed that service users and staff feel they can talk comfortably with her and discussions heard between service users and the manager were open and respectful. There continues to be steady progress in the development of a quality monitoring system and this now includes a process for seeking the views not only of service users but their family members and other professionals involved in the service provision. A survey recently completed was examined and comments from professionals, i.e. the community nurse, physiotherapist, day services staff and family members were all complimentary about the service. Relative’s comments indicated that they were pleased to see their family members happy, contented and well cared for. Currently staff are completing a Lifestyle audit with service users, which has been designed by the PAKS Trust. The document is in symbol and written format and supports effective communication with service users when being completed with them. Health and safety management continues to be robust with all records relating to health and safety management being maintained up to date including, fire safety, hoist maintenance checks and fridge and freezer temperature records. Service users appear to have a good awareness of safety procedures in the home and one service user was overheard to remind staff dont forget to test the fire alarms today. People were seen to move around the home safely and easily and had the aids and adaptations necessary to do so, including, a stair lift, hoist and hand rails where needed. A service user told me that they find the stair lift useful when their knees are aching. Outcomes for service users in general are good in this home, and excellent in many some areas of care however, staff must be attentive to ensuring care records are maintained up to date and in good order, with specific attention necessary to dating all entries made on care plans when changes are made. Staff new to the service may benefit from specific training in planning, reviewing and evaluating care plans so that the service can demonstrate the ongoing development of service users as a result of the effective care practice that is taking place in this home. Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 24 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 N/A 3 2 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 N/A 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X 2 3 X Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 25 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 YA3 Regulation Requirement Timescale for action 15/11/06 2. YA41 Registration The registered provider must Reg.12.2. make an application for a Variation to the registration of the service to reflect the categories of service users living there. 17.3(a) The registered manager must ensure that all entries made on care plans are dated and that a record is maintained of any review of the care plan that takes place. 15/11/06 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 YA1 YA9 YA18 Good Practice Recommendations The Statement of Purpose should include information for prospective service users that older people may be living in the home. Care plans should direct staff to where guidelines for managing risk can be found. The manager should discuss the balance of the gender of DS0000004323.V316417.R01.S.doc Version 5.2 Page 26 Paks Trust Oaston Lodge 4. YA20 5. YA41 the staff team with service users on a regular basis to ensure that this is satisfactory with them and make a record of their views. The manager should develop a process for monitoring medicine management in the home to include staff competency and that medicine supplies are compatible with records held. The manager should make arrangements for key workers to access training in the principles of care planning, review and evaluation. Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Paks Trust Oaston Lodge DS0000004323.V316417.R01.S.doc Version 5.2 Page 28 - 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!