Inspection on 14/06/05 for The Oakes

This inspection was carried out on 14th June 2005.

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 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Oakes 14/06/07

The Oakes 10/07/06

The Oakes 12/01/06

The Oakes 21/12/04

The Oakes 12/07/04

The Oakes 12/02/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 The Oakes 55 Railway Approach, Laindon, Basildon, Essex SS15 6JX. Lead Inspector Patricia Stanton Unannounced 14/6/05 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 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 Stationary 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. The Oakes I06 S18125 The Oakes V231707 140605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Oakes Address 55 Railway Approach Laindon, Basildon, Essex SS15 6JX. Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01268 441096 01268 455103 Kingwood Care Services Limited. Anthony Golding Care Home 6 Category(ies) of Learning Disability (6) registration, with number of places The Oakes I06 S18125 The Oakes V231707 140605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Adults with learning disability, six places, one service user who is under 18 years old and known to the Commission. Date of last inspection 12/7/04 Brief Description of the Service: The Oakes provides care and accomodation for six young adults with learning disabilities and complex needs such as autism/challenging behaviour. A high staffing level is maintained to meet the needs of the residents to enable them to access facilities in the community. The Oakes is a large detached house located in a wholly residential area in Laindon. There is a choice of two day rooms and a kitchen diner. There are five single bedrooms, three with en suite facilities in addition there is a self contained bedroom and dining area/longe for one resident. The home has two vehicles for transporting residents to activities in the community. There is a secure garden with seating, patio and shed. Laindon shopping centre is within easy reach and the home is close to local amenities. The Oakes I06 S18125 The Oakes V231707 140605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The routine unannounced inspection took place on the 14/6/2005. Four residents were spoken to, three of which were not able to verbalise plus three staff members and one senior carer. The registered manager and assistant manager were not on duty at inspection. The senior carer gave the inspector a tour of the premises and records and documents were looked at. Time was spent in the lounge and dining room with residents briefly chatting and taking note of all residents daily lives and wellbeing. Staff on duty were most helpful, and this was greatly appreciated. The inspector would like to take this opportunity to thank the residents’, staff and senior carer for their hospitality and cooperation during the home’s inspection. What the service does well: Residents can live a fulfilling life within their capabilities as they have access to many activities including trips and holidays. Residents usually have more than one holiday per year. The staff team work well together and ensure residents have choice and freedom in respect of activities and holidays. Staff help assist residents to be as independent as possible in respect of personal care giving them privacy, when required. The home employs sufficient number of staff who have a good insight into residents’ conditions. The home has decorated residents’ bedrooms to make them brighter and more modern. Residents are able to choose colours and personalise their own rooms. The Oakes I06 S18125 The Oakes V231707 140605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Oakes I06 S18125 The Oakes V231707 140605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Oakes I06 S18125 The Oakes V231707 140605 Stage 4.doc Version 1.30 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 standard(s) 1,2,3, Residents do not have suitable written information regarding the home to enable them to make an informed choice about where they live but know their individual aspirations and needs will be met by the homes staff. EVIDENCE: The home’s service users guide is not in a suitable format for residents and should be developed to include pictures to enable residents to understand what facilities the home provides including how to make a complaint with details of independent advocates and the CSCI. A statement of purpose is displayed in the entrance hall for relatives and friends to read. Care plans evidenced residents are individually assessed prior to admission containing good assessments. The Oakes I06 S18125 The Oakes V231707 140605 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9,10. Residents changing needs are assessed and personal goals reflected in care plans. Residents are able to make decisions about their lives and supported by the homes staff to take risks to lead independent lives. Residents are consulted about the decisions made in the home and participate in all aspects of life within their capabilities. Staff handle all information regarding residents in line with the Data Protection Act 1998. EVIDENCE: Care plans examined were detailed and informative regarding individual residents living in the home, including excellent profiles, medical details and individual photos. One placing social workers gave instructions for the home to give excessive reassurance, praise, and attention when a resident completed a task to encourage independence. Staff were seen at inspection to be supportive and praise the resident. The care plans did not include all the dislikes of residents and it was found one profile did not contain a resident dislikes regarding people coming within close proximity of her or dislikes regarding food preferences. The Oakes I06 S18125 The Oakes V231707 140605 Stage 4.doc Version 1.30 Page 10 Reviews included decisions made by residents and significant others and staff speak individually to residents to gain their views and opinions regarding decisions made in the home. Daily records evidenced residents attended activities and activity plans set by the home reflect placing authorities decisions. The registered manager reviews care plans monthly. Care plans included good risk assessments but one plan examined did not have risk assessments for the homes steep and wide staircase or the open front garden which may both cause a risk to residents if unsupervised. The Oakes I06 S18125 The Oakes V231707 140605 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16,17. Residents have the opportunity for personal development within their capabilities and participate in age, peer and cultural activities. Residents have the opportunity to access the community and develop personal relationships. The home offers a healthy diet to residents, which they enjoy. EVIDENCE: Care plans informed staff to encourage resident to achieve goals and try new activities, participate in the community and daily records confirmed this was carried out. At inspection one resident confirmed he was able to participate in activities of his choice as his hobby was buses. He showed the inspector photos’ of an exhibition of buses and cars he had attended, accompanied by staff. Other residents with individual interests are encouraged to pursue these in activity plans, which were varied and suited to each resident. This is good practice. Residents access the church, swimming pool, pub and local sport events. The Oakes I06 S18125 The Oakes V231707 140605 Stage 4.doc Version 1.30 Page 12 Residents are able to have personal relationships and contact with friends and family, as much as possible. The home currently does not have a policy for sexual relationships and should ensure individual residents have access to confidential sexual education as and when required. The home had a variety of activities for residents to enjoy including televisions, DVD, CDs, games and computers. The garden has a large paddling pool for the use of residents in the summer. Residents are able with assistance to participate in some daily living skills including laundry and personal shopping. The home has adequate transportation to take residents out and the home arranges holidays for individual residents to suit their individual needs. One resident confirmed they had visited centre parcs and Euro Disney. The menus were examined at inspection and were found to be varied and nutritious offering choice and alternatives for residents. The home keeps a record of residents diet intake and weighs residents monthly. One resident who was under weight had gained weight in the past six months according to her weight chart. The Oakes I06 S18125 The Oakes V231707 140605 Stage 4.doc Version 1.30 Page 13 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 standard(s) 18,19,20,21. Residents receive a good level of personal support and have their physical and emotional health needs met. Medication policies and procedures protect residents. The home does not have a policy regarding residents’ wishes in respect of illness, death and dying. EVIDENCE: The home is staffed to ensure adequate support is given to residents accommodated and the home accommodates residents with high complex needs. All staff at inspection had undertaken depression training as one resident had been admitted with this condition. Staff appeared very supportive of residents. The communication and atmosphere at inspection was mutually respectful and positive between residents and staff. Staff appeared to have a good understanding of individual residents needs and the key working system is in place assisted trusting relationships for residents. One resident informed the inspector the “staff are nice”. The Oakes I06 S18125 The Oakes V231707 140605 Stage 4.doc Version 1.30 Page 14 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 standard(s) 22,23 Service users views are listened to by staff who understand them. Residents are protected from abuse by the homes policies and procedures and the core staff employed in the home. EVIDENCE: Because of the limitation of residents’ verbal communication, the home do not hold regular resident meetings but staff meet with resident and their significant others’ on a regular basis to obtain their views. This needs to be evidenced. During inspection one staff member was able to recognise and voice her concerns regarding the behaviour of one resident enabling her to warn staff in case the resident had a seizure. This could only be achieved by staff who have a good understanding of the residents. The home has an appropriate protection of vulnerable adult (POVA) and whistle blowing policy and staff spoken to at inspection was conversant with the sign of abuse and procedures for reporting abuse. The Oakes I06 S18125 The Oakes V231707 140605 Stage 4.doc Version 1.30 Page 15 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 standard(s) 24,25,26,27,28,30. The home is homely comfortable and suits the needs of residents accommodated. Residents’ bedrooms meet their individual needs and promote independence. The home has adequate bathroom and toilet facilities and adequate communal space. The home is hygienic and clean. The home has a good size rear garden, which is easy to maintain, but lacks character. EVIDENCE: The home is welcoming and conformable. Furniture is of good quality in the home. At inspection the dining room needed new curtains. The rear garden is large but mainly laid to lawn and could be developed more. The front garden leads out onto a busy road without any fencing or gates which may be a risk to residents who abscond. The homes staircase is also very steep and wide and could prove to be a risk to residents who fall. Records evidence two accidents had occurred on the stairs involving residents. It was noted any resident who tried to abscond from the home may be at risk of approaching cars due to lack of fencing onto the road. No risk assessments were in place for the homes stairs or front garden. The Oakes I06 S18125 The Oakes V231707 140605 Stage 4.doc Version 1.30 Page 16 The stairs and front garden were discussed at inspection with the senior worker to try to find a solution. The senior carer was to address the concerns with the registered manager on his return to work and seek advise from health and safety. Residents appeared very happy with their bedrooms, which were personalised and furnished to meet their needs. Some rooms had been recently decorated and were bright and modern. One resident had her bedroom decorated in green, as this was her favourite colour. The Oakes I06 S18125 The Oakes V231707 140605 Stage 4.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35,36 Many of the standards regarding staff could not be inspected, as files were not available at inspection. Staff are supportive to residents but do not themselves receive regular formal supervision although they feel supported by the homes management. Staff rotas did not include codes of staff hours. EVIDENCE: Staff files were locked away and the senior carer in charge at inspection did not have access to files. This is a beach of regulations as all files must be available for inspection. The inspector advised the senior carer the registered manager must find ways to ensure files are available for unannounced inspection. One staff member spoken to at inspection who had worked in the home since October 04 had not received any formal supervision but stated manager are available and supportive. Staff appeared to work well together and supportive of each other. The home employ’s a core staff that appeared competent and supportive to residents. The staff rota matched the numbers of staff on duty at inspection but the rota did not include codes for hours staff work on each shift. The carer amended this at inspection. The Oakes I06 S18125 The Oakes V231707 140605 Stage 4.doc Version 1.30 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39,40,41,42. Residents and their significant other opinions are not formally sought to assist develop the service. Fire training and fire drills in the home along with records are not appropriately kept. The rear garden gate is locked unable to give fire access to residents and staff in an emergency. EVIDENCE: The registered manager or his assistant managers was not on duty at inspection. The senior carer informed the inspector that the registered manager is currently undertaking NVQ level 4 in care management. The home currently does not gather annual views and opinions from residents, or significant others regarding the quality of care in the home. Residents comments regarding the service should be developed to form part of a quality assurance and monitoring system including significant others, placing social workers and any visiting health professional. This should be collated into a report and used to develop the service. A copy should be sent to the CSCI. The Oakes I06 S18125 The Oakes V231707 140605 Stage 4.doc Version 1.30 Page 19 The homes fire record evidenced fire drill are not carried out regularly and not all staff had received updated fire training. The homes back gate giving the only exit from the garden was locked. Not all staff carry a key to the gate which may be a hazard to residents in the event of a fire. The senior carer was advised to advise the registered manager of the risk and advised regarding a combination lock or alternative. Residents have appropriate infringement of rights documents in files regarding safe working practices in the home. The home’s accident book was examined and most accidents were between resident to resident. Appropriate risk assessments were completed on file excluding the stairs and front garden. Feedback was given to the senior carer on duty and praise given for the homes quality of care to residents. The Oakes I06 S18125 The Oakes V231707 140605 Stage 4.doc Version 1.30 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 2 3 3 Standard No 31 32 33 34 35 36 Score x x 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Oakes Score 3 3 3 2 Standard No 37 38 39 40 41 42 43 Score x x 3 3 3 2 x I06 S18125 The Oakes V231707 140605 Stage 4.doc Version 1.30 Page 21 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 YA39 Regulation 24(1-3) Requirement Timescale for action previous tmescale not met 1/110/04. 2. YA1 5 3. YA3 5 4. 5. 6. 7. YP21 YP36 YP31 YP42 14 18 17 23 (4) 8. YP42 12 A quality assurance system, for monitoring the system must be developed with the inclusion of residents, significant others, placing authorities and visiting health professions. This should be collated into a report and sent to the CSCI. The home must produce a 1/11/05 service users guide suitable for residents with a learning disability. The home should ensure 1/11/05 residents have a suitable service users guide before admission to the home. 1/11/05 All staff must receive formal 1/8/05 supervision to identify further training needs. Staff files must be available at all 1/7/05 times for inspection in the home. The home must carry out regular 14/6/05 fire drills, ensure all staff have regualr fire training and the home ensures all fire exits can be opened without delay in an emergency. Risk assessments must be 14/6/05 completed for the homes front garden and staircase. Version 1.30 The Oakes I06 S18125 The Oakes V231707 140605 Stage 4.doc Page 22 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. 4. 5. Refer to Standard YA33 YA24 YP6 YP24 YA3 Good Practice Recommendations The homes staff rota should include tables to indicate number of hours staff work. This a repeat recommendation.. Residents should be encouraged to help develop the rear garden in the home. This is a repeat recommendation. Residents dislikes should be recorded in care plans. The home should find a way to reduce the risk to residents regarding the risk of residents falling on the stairs and risk of approaching cars at the front of the home. The home should keep a record of residents wishes in relation to ilness, death and dying. The Oakes I06 S18125 The Oakes V231707 140605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Kinswood House Baxter Avenue, Southend on Sea, Essex. 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 The Oakes I06 S18125 The Oakes V231707 140605 Stage 4.doc Version 1.30 Page 24 - 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!