Inspection on 09/05/06 for Severn Oaks

This inspection was carried out on 9th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Severn Oaks 04/08/09

Severn Oaks 25/06/07

Severn Oaks 12/12/05

Severn Oaks 05/04/05

Severn Oaks 11/01/05

Severn Oaks 07/05/04

Severn Oaks 03/12/03

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Severn Oaks 6 Jesmond Road Clevedon North Somerset BS21 7SA Lead Inspector Paul Grey Unannounced Inspection 9th May 2006 10:00 Severn Oaks DS0000008135.V291932.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 Severn Oaks DS0000008135.V291932.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. Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Severn Oaks Address 6 Jesmond Road Clevedon North Somerset BS21 7SA 01275 878447 01275 873775 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) Cintre Community Limited Mr Robert Michael Hogan Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age of persons who may be received in the home is 18 - 35 years Date of last inspection 12th December 2005 Brief Description of the Service: Severn Oaks is a small home based in the community, which provides support to young people with learning disability and complex needs. The home strives to promote independence and acts as a springboard for service users to move toward independent living. Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted over a five-hour period in the presence of Rob Hogan, the manager and for a short duration, Martin Button, Cintre general manager. The Inspector spoke with service users, staff, both managers and had a tour of the premises. The Inspector audited care files, and general policies and procedures. Severn Oaks has progressively updated and improved the service provided to its service users. The result has been a very strong service, capable of meeting the needs of service users with learning disabilities and challenging behaviour. The Inspector noted the service has evolved to exceed national minimum standards in a range of areas which are noted later in this report. During inspection the Inspector noted excellent staff/service user communication. A high standard of documentation throughout care notes and policies and procedures. Most importantly, the Inspector noted evidence of a high standard of care outcome for the service user group. The Inspector commends the manager and the staff team on the standard of care provided. What the service does well: What has improved since the last inspection? What they could do better: The Inspector observed no significant flaws during inspection. At present, the service is expanding to offer supported activities, namely woodworking and achieving the European computer driving licence on the premises. Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 Page 6 When the new I.T suite and woodworking shop a complete, the service will be enhanced further. 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. Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The outcome for service users in this area is excellent. The Inspector noted evidence of a comprehensive process to assess service users needs and aspirations. EVIDENCE: The Inspector sampled two service user care files, and discussed the assessment procedures with the staff team. On auditing service user files, the Inspector noted extensive and in depth assessments of service users potential needs. This is particularly important where service users needs may be complex or particularly challenging. The Inspector noted the assessments were detailed covering a wide range of service users needs, from sexual issues through to other assessed needs such as education and training. The Inspector noted that the assessments were of a particularly good quality. The Inspector noted evidence that the service users family and social background was taken into account, as were cultural and faith needs. This is in addition to the more usual needs identified in assessments. The Inspector noted evidence that the homes assessment was used to develop a service users plan of care. Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 Page 9 Given some of the complex and challenging needs the service meets, there were potential restrictions on service users freedoms. These were exceptionally well documented, risk assessed and agreed by the service user. This was good practice. The Inspector also noted that any involved carers or family who had expressed an interest, were involved where possible in the programme and drawing up of the service users plan of care. The home exceeded national minimum standards. Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Outcome for service users was excellent. The Inspector noted service users needs are assessed and reflected in the service offered. Service users receive a support in making decisions about their daily lives. Service users are supported to take normal risks as part of an independent lifestyle. EVIDENCE: The Inspector audited to service user plans of care. The Inspector spoke with staff and with 2 service users. The Inspector noted that the homes comprehensive assessments were used to create individual service user plans. The Inspector noted that the service user plans were comprehensive and in depth and addressed a wide range of social, psychological and mental health issues. Given some of service users had quite Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 Page 11 complex needs some service user plans did an outline a restriction on service users freedom and choice. The Inspector looked at these in some detail. The service user had been involved and have agreed to these restrictions. Staff had consulted with appropriate external professionals or sought agreement from involves carers. Where there were restrictions on service users freedoms there was a risk assessment and clear rationale to outline these restrictions. The Inspector noted that the restrictions on freedom were not unduly onerous and reasonable given the risk assessments and potential consequences to service users. Service users plans of care outlined procedures in the event of the service user becoming aggressive or behaving in a manner likely to cause harm to themselves or those around them. The home has minimised any incidents involving violence and aggression, historically this has been an issue with some service users. The Inspector noted a focus on positive outcomes the service users in the event of the home having to manage violent or aggressive behaviour. All service users have a key worker and they were aware of who that person is. The Inspector noted the service was mindful of service users racial heritage and had addressed this issue. The Inspector noted the service was particularly good at providing service users with information and assistance in making decisions about their own lives. This is particularly important for the service as their task is to encourage service users to move on and live independent lives. The service is also supporting service users in work, or to obtain work and is also in the process of establishing a woodwork shop. The Inspector noted further support for service users who will shortly be able to obtain the European computer driving licence at the service. This was good practice. The services risk assessments were particularly robust. Service users are risk assessed throughout a range of activities by the home. The home also has clear risk management strategies for all service users and staff. The Inspector also noted staff health and safety training for staff who are about to run the wood workshop. The Inspector noted the whole process was particularly wellorganised and documented. Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13, 15, 16 The outcome for service users in this area was excellent. Service users are able to take part in age, peer and culturally appropriate activities. Service users are supported to be involved in the local community. Service users have appropriate personal, family and sexual relationships. Service users rights are respected. EVIDENCE: Service users are supported to find and keep appropriate jobs. One service user is supported to engage in their own occupation outside of the home by the staff team. Service users are encouraged to work outside of the home should they wish. This helps provide a springboard towards independent living at a later date. Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 Page 13 At present, the home is expanding to offer woodworking and computer training facilities for service users. Service users would be supported to take place in therapeutic work schemes by the staff team. Service users are supported to be part of the local community. Staff support service users to use local facilities such as the cinema, pubs or engage in activities at local leisure centres. Staff support service users to do this as independently as possible. Service users are provided with information and advice about local activities and support. The staff team provide a flexible level of support outside of 9 to 5 hours. This includes weekend’s back, days and Christmas. The Inspector noted evidence that the home and the staff team address racial and cultural diversity issues of the service user group. The Inspector noted evidence on the part of the staff to research and meet needs of those with different racial or cultural needs. This was good practice. Service users are supported to maintain family links by staff at the home. Service users will receive support to maintain links through visits or phone calls. Family and friends are welcome into the home within reasonable sociable hours. Service users are able to choose who they wish to see and when. Service users are supported to meet people and make friends outside of the service, and meet people without the service users and disability. Where appropriate, service users are supported to develop and maintain intimate personal relationships. Appropriate support and guidance will be provided for service users should they require it. The Inspector noted that the daily rules and routines at the house are relaxed and flexible. This was good practice given the age range of the service users. Service users bedrooms are private areas and the staff only enter after knocking and requesting information to enter. Service users have a key to their own rooms. Service users are addressed respectfully and by their preferred term of address. The Inspector noted that the staff team talk to and interact with the service users well. Service users are included in all aspects of care at the home and have a good relationship with the staff team. With a few notable exceptions, namely the office and downstairs woodworking area, service users have free access to the building. Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, Outcome for service users in this area was good. Service users are supported in a way they prefer and require. Service users and physical and emotional health needs are met. EVIDENCE: Service users are physically able requiring minimal support. The staff team however provide sensitive and flexible support for service users helping each individual maximise their privacy and independence. Whilst this may not take the form of physical care, this could involve prompting for hygiene, advice and support on sexual health matters, support in helping service users attend the day care activities, all supporting service users over issues that may arise in everyday life. The Inspector noted this was well documented throughout service user assessments and care plans. On inspection the manager was able to outline how the service user was supported by staff. The staff team help service users manage their own health care. This is particularly important as service users are being supported to move on to Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 Page 15 independent living. The service users are supported with obtaining GP appointments, dentist appointments, or appropriate specialist support when necessary. This may take the form of accessing social work support or obtaining appropriate counselling when necessary. This is good practice Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 The outcome for service users was excellent. Service users views are listened to and acted on. Service users are protected from abuse, neglect all self harm. EVIDENCE: The Inspector audited care records, spoke with service users and staff. The Inspector noted the home has a clear and effective complaints procedure. There are no outstanding complaints. Service users are supported by the staff team to raise issues, concerns or complaints they have. Any issues that service users are unhappy with a generally resolved informally. Service users were aware of the homes complaints procedure and have used it previously. The Inspector noted documentary evidence that all complaints are responded to within 28 days. Service users are able to complain to staff on a one-to-one basis should they wish and indeed are encouraged to do so. The Inspector noted evidence that a record is kept of any issues or complaints made by service users. Service users are supported in their steps towards independence by the home. Whilst encouraging service users independence the staff team attempt to safeguard them from physical, financial or psychological abuse or treatment. The home has robust procedures for reporting any issues of concern to an appropriate authority. Staff at the home are provided with training to identify what would constitute abuse. Any allegations off abuse are clearly noted by the home, which has a range of robust policies and procedures for dealing with it. Staff at the home are trained to deal with physical and verbal aggression. Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 Page 17 The Inspector noted an emphasis by the staff team on understanding and dealing with physical and verbal aggression positively and an emphasis on protecting the human rights of the service user at all-time. This was good practice. Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 The outcome of the service users was good. Service users live in a homely, comfortable and safe environment. The home was clean and hygienic throughout. EVIDENCE: The home’s premises are suitable for their purpose. The Inspector noted the home was accessible to service users, safe and well maintained throughout. Service users were provided with pleasant homely accommodation appropriate to their needs and number. The premises were clean and hygienic throughout. Service users live in an environment that was pleasant, free from offensive odours and systems to control/prevent the spread of infection were in place. Service users have access to laundry facilities with which to clean their clothing. The Inspector noted appropriate hand washing facilities were cited prominently in areas where the food would be prepared. The laundry floor finishes are in Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 Page 19 permeable and readily cleanable. The home had policies and procedures for the control of infection. Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 The outcome of the service users was good. Service users are supported by a competent staff team. Service users are protected by the homes recruitment policy. Service users needs are met by appropriately trained staff. EVIDENCE: The Inspector noted from observation, that the staff team were highly accessible to service users. The Inspector noted numerous interactions between staff team, service users and the manager. The Inspector noted during inspection, that service users were involved in all aspects of care and that staff were approachable my service users. Staff appeared interested, motivated and appeared to have good therapeutic interactions with the service user group. The Inspector noted a program of ongoing training to encourage staff and to support them in their knowledge of learning disabilities. The home is presently seeking input for specialist skills, such as woodwork teaching to support the service users in their search for jobs outside of the home. The Inspector noted that a wide range of training is provided by Cintre community, particularly with regards to learning disabilities, understanding violence and aggression and diversity. Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 Page 21 The home has an appropriate recruitment procedure designed to protect service users from exposure to inappropriate people. The home processes CRB, POVA and references for staff to ensure that a robust procedure of screening is available. Inspector noted a rolling scheme of staff training for Cintre employees. The Inspector also noted evidence of a comprehensive induction that complies with sector skills Council workforce training targets. The home has a training and development plan in place. Staff at the home have received equal opportunities training and disability equality training. Staff are aware of race equality and anti racism issues. Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 42 The outcome the service users was good . Service users benefit from a well-run home. Service users benefit from ethos, leadership and management of the home. The health and safety and welfare of service users are promoted and protected. EVIDENCE: The homes existing manager, Rob Hogan is qualified and experienced to run the home. The Inspector has noted on previous inspections that the home has improved and continues to meet its stated purpose under his management. The existing manager has appropriate supervisory experience within the home. During his tenure the home has achieved its written aims and objectives. The Inspector Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 Page 23 noted policies and procedures are implemented. It is the Inspectors understanding that the homes budget has been appropriately managed. A particular strength of the home is its open and inclusive atmosphere with staff and service users. The Inspector noted service users benefit from an open and transparent management style. Service users are able to discuss any concerns or complaints with the manager or staff and evidently appear happy to do so. Service user feedback from the home remains excellent. The Inspector has seen evidence of staff innovation and creativity in drawing up and delivering care. This has been good practice. The Inspector noted that staff are appropriately trained in safe working practices. The Inspector noted fire safety records were up-to-date and fire equipment was maintained with appropriate certification. Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 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 x 2 4 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 4 23 4 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 4 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 x x LIFESTYLES Standard No Score 11 x 12 4 13 3 14 x 15 4 16 4 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 x x 4 4 x x x 3 x Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 Page 25 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Severn Oaks DS0000008135.V291932.R01.S.doc Version 5.1 Page 27 - 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!