Inspection on 14/06/07 for The Oakes

This inspection was carried out on 14th June 2007.

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

The inspector found 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Oakes 10/07/06

The Oakes 12/01/06

The Oakes 14/06/05

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 Oakes (The) 55 Railway Approach Laindon Basildon Essex SS15 6JX Lead Inspector Ms Vicky Dutton Unannounced Inspection 14th June 2007 09:00 Oakes (The) DS0000018125.V342739.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 Oakes (The) DS0000018125.V342739.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. Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakes (The) Address 55 Railway Approach Laindon Basildon Essex SS15 6JX 01268 441096 01268 455103 kingswood@donna-higby.freeserve.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Kingswood Care Services Limited Vacant Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 10th July 2006 Brief Description of the Service: The Oakes provides care and accommodation for up to seven young adults with learning disabilities and complex needs such as autism and challenging behaviour. Although the home is registered for seven residents, only six have ever been accommodated. The seventh bedroom is used by staff as a sleeping in room. The Oakes is a large detached house located in a residential area of Laindon. The home is close to local amenities. Laindon shopping centre is within easy reach. The home has two vehicles for transporting residents to activities in the community. The communal accommodation comprises of a large lounge area, a dining/activity area and a kitchen diner. There is a secure garden with seating, patio and shed. There are five single bedrooms, three with en suite facilities. A sixth bedroom has an adjoining dining/leisure area that is used by both staff and residents. Due to the nature of residents needs, items cannot be left easily on display. There was a notice on display advising people of how to access inspection reports for the home. A statement of Purpose, a Service Users Guide and pictorial Service Users Guide were available in the home’s office. The weekly charges at the home range from £1316.00 to £1973.30. These fees reflect the complex needs of residents, and that care is often provided on a one or two staff to one resident ratio. Additional charges to residents include personal requirements, activities and holidays Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced ‘key’ site visit. The visit took place over a six and a half hour period. At this inspection all the key standards were considered and the homes compliance with previously made requirements assessed. Prior to the site visit the home had been sent a pre-inspection questionnaire (PIQ). This was not returned to CSCI as requested. At the site visit a tour of the premises took place, care, staff, medication and other records and documentation were selected and various elements of these assessed. A staff handover was attended. During the site visit time was spent interacting with residents, and observing staff interactions with them. Most residents at The Oakes have limited verbal abilities. Prior to the site visit pictorial surveys for use with residents, and surveys for relatives and visiting professionals were sent to the home. At the site visit some staff were spoken with and staff surveys distributed to staff. The views expressed at the site visit and on survey responses have been incorporated into this report. The inspector was assisted at the site visit by an assistant manager and other members of the staff team. Feedback on findings was summarised at the end of the site visit. The opportunity for discussion or clarification was given. The inspector would like to thank the assistant manager, staff team, residents, relatives and visiting professionals for their help throughout the inspection process. What the service does well: The Oakes provides a high level of care and support to residents with complex needs. Shifts are well organised on a day to day basis. Staff know what residents they are to assist, and what other tasks they need to carry out. Staff are aware of residents’ individual needs and their likes and dislikes. Residents are supported to make choices in their daily lives. A relative said ‘they treat the clients as individuals and design care to meet their needs.’ Residents lead active lives, use the local community and undertake different activities according to their individual preferences. A relative said ‘they are good with outings and social gatherings.’ The Oakes provides residents with a warm and homely environment that has spacious and individualised bedrooms. One relative said ‘they are a people orientated home. They try and make it just that for the clients ‘a home’.’ Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Potential residents and their families will not have to up to date written information about the home, but useful pictorial information will be available. Residents previously admitted to the home had their needs assessed and a phased introduction to the home. EVIDENCE: The home’s Statement of Purpose and written version of the Service Users Guide date from 2004. These need to be updated so that they contain accurate and up to date information for people. Since the previous inspection the home has developed an excellent pictorial Service Users Guide. Currently only one copy is available and the format is bulky so that copies could not easily be sent out to prospective residents. However it would be a useful tool to use as part of the assessment/admissions process. No residents have been admitted to the home since the previous inspection. The home has previously demonstrated their robust and thorough approach to the admission process. Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents at The Oakes can expect to receive good care, and will be encouraged to make choices in their daily lives. They cannot however currently expect that care plans and risk assessments to assist in meeting their needs will be robust and up to date. EVIDENCE: Residents at The Oakes receive good care. Staff have a good understanding of residents’ needs and were observed to approach their role in a calm and competent manner. It was clear that work on reviewing and updating residents’ care plans is underway. The need to do this was highlighted at the previous inspection, and it was disappointing that further progress had not been made. A wealth of information was available in individual residents’ files. Some of the care plans, relating for example to assisting a resident with personal care, were current and excellent in the level of detail and instruction for staff that they contained. Other aspects were not so good. For example goal plans on one residents’ file Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 Page 10 dating from 2004 with a note on saying ‘needs updating,’ monthly behavioural information not transferred to the ‘yearly plan’ since January 2007, and an activity programme dated 2005. Although residents have complex needs there was no indication of if/how they or their families are encouraged to be involved in the care planning process. The assistant manager was not sure about this area. Care plans, other records and observations showed that residents are encouraged to make choices in their daily lives. Minutes of a recent residents’ meeting showed that their opinions on their lifestyle and future plans are sought. The home is proactive in minimising risks to residents, and staff know what high risk areas and items, such as the laundry, and kitchen knives need to be kept secure. So that residents are cared for safely however, the approach to risk assessment needs to be backed up by better documentation. Some individual risk assessments in care files had been reviewed and updated. Others, had not been reviewed, dated from 2004 and had noted that ’needs updating.’ This again was raised at the previous inspection. Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to lead an active life and have their personal preferences understood. They will be supported to maintain contact with their families. EVIDENCE: Where appropriate residents are supported to attend educational opportunities in the community. On the day of the site visit one resident attended a cookery class. Residents enjoy using the local community and lead active lives. The home has two vehicles and adequate staffing resources available to support this. During the site visit residents went out and about undertaking activities that reflected their individual preferences. One resident went out on a train, another was taken swimming. Information was on display relating to local resources and clubs. Residents felt that there were good activities in the home. Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 Page 12 In house there was plenty of equipment for activity and occupation available. Since the previous inspection the home has acquired a large trampoline for the home’s garden. Residents were observed to enjoy using this. Care plans include a ‘family contact sheet.’ These showed that residents are encouraged and facilitated to maintain contact with their families. Some residents go on regular ‘home leave.’ Residents can access all communal areas of the home and the garden. During the site visit residents moved around the building as they wished. Staff spoke about how they encourage residents to be independent and engage in activities of daily living. Due to residents’ high level of needs, they are closely supervised by staff at all times. However, as observed during the site visit, within this regime, staff understood and respected residents need for privacy and personal space. Staff at the home said that residents had plenty of fresh fruit and vegetables, and that some residents enjoyed salads on a regular basis. Records showed that residents are offered choices in what they eat. Menus and nutrition records showed that often the food preferred and eaten by residents tends to be things like pizza, curry, sausages, and take away. The assistant manager said that a new member of staff is waiting to start. They will take a lead role in preparing the menus and cooking the evening meal. This will take the pressure off staff who currently prepare the evening meal in between monitoring and caring for residents. Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents can expect to receive appropriate support to make sure that their healthcare needs are met, but are not currently cared for safely by the home’s management of medication. EVIDENCE: A care plan viewed showed that personal care is to be delivered in a caring and sensitive way. During the site visit, staff assisted residents in a calm and helpful manner. Routines, plans and staff support at the home was observed to be flexible according to residents’ needs at any given time. Records show that residents’ health is monitored and appropriate actions taken when needed. Residents at The Oakes have a range of healthcare professionals involved with their care and are supported by staff to attend appointments and other healthcare checks. Positive feedback was received from a health professional involved with the home. They felt that the home ‘deal compassionately and flexibly with very challenging residents.’ On the day of the site visit one resident was staying in away from the home having their Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 Page 14 medication re-evaluated. The home was continuing to offer support by visiting them on a daily basis. Most medication at the home is managed through a monitored dosage system. The rest is boxed/bottled medication. It was unclear what level of staff training had been undertaken in respect of medication. The assistant manager had no medication training identified on the homes training matrix, but said that they had undertaken basic training offered by the supplying pharmacist. This related to how to use the monitored dosage system in use at the home. They also said that in house training and monitoring had been undertaken, and that refresher training was due to take place soon, (28/06/07.) The person in charge of the afternoon shift also had no medication training identified on the homes training matrix. Where training is identified for staff this dates from 2003, and in one case 2004. On viewing the medication system a number of issues were identified. For one resident the administration of one medication had been changed from am to pm. This had been altered by hand by staff for several months, rather than the medication administration record (MAR) being properly altered by the pharmacist in line with a doctors instructions. Where handwritten entries had been made these were not signed/countersigned by two staff. Protocols for the administration of medication prescribed as and when required (PRN) were not always in place for current medication, or were in place for a medication no longer prescribed. The temperature in the medication storage area was not monitored to ensure that medication maintains optimum effectiveness by being stored at correct temperatures. Boxed/bottled medication was not always dated when opened. Residents care files contained ‘consent to manage/administer medication’ forms but these had not been signed. The home has a system for auditing the medication system practice, with the advice on the form that an audit should take place at least twice within each (monthly) cycle. This had last been completed on 12/11/06. Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People know that they care raise concerns about the home and be listened to. but cannot be sure that they are fully protected from abuse. EVIDENCE: The home has a complaints procedure in place, and a pictorial version to assist residents understanding. Residents said that they knew who to speak to if they were unhappy. The homes ‘new’ complaints folder contained one complaint dating from October last year. Another ‘old’ folder found contained a complaint dating from February this year. Details of two further complaints made to the home, and known about by CSCI, did not appear to be recorded in the home. Recent complaints and an anonymous call to CSCI have related to management, care and cleanliness issues at the home and the feeling that the home was deteriorating. Management in the organisation has responded appropriately to complaints and held meetings with parents on an individual and a group basis. In feedback families felt that they could raise concerns but one said ‘they did seem to listen, but things were not always followed through.’ Another said ‘they have acted promptly to rectify things.’ At the end of last year a safeguarding adults alert was raised in relation to the home. The concerns were raised by staff and relatives at the home. The allegations related to the then acting manager and two other members of staff. Kingswood Care were proactive in trying to deal with the situation, and sought advice from CSCI and the local Social Services department. The Company investigated the allegations, and appropriate actions were taken. Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 Page 16 At the site visit it was seen that a safeguarding adults training package was available. The assistant manager said that the acting manager was going to undertake this training package with staff soon. The homes training matrix showed that newer staff had undertaken more recent training in the protection of vulnerable adults, but that most other staff had not undertaken this training/update training since 2004 or 2003. The home’s whistle blowing policy dates from 2002. A member of staff spoken with had an adequate understanding of what to do if a POVA incident arose. Care plans identified that residents’ challenging behaviour is understood and that staff are given instruction about how to assist and support residents with this. Most staff at the home have received recent training in conflict management, and on one member of staffs training file ‘SCAPE’ training had been undertaken in October 2006. However the home’s training matrix shows that for most staff training in managing challenging behaviour and physical intervention techniques dates from 2004 at best. Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Oakes will provide a homely and safe environment. EVIDENCE: The Oakes provides residents with a homely and comfortable place to live. Since the previous inspection some communal areas of the home have been redecorated and new flooring put down in some areas. The handrails and balustrades on the home’s staircase and landing have been replaced and strengthened to keep residents safe. At the moment there are insufficient comfortable seats in the lounge are for all residents. It was understood that a new sofa is on order. Kingswood Care employs a handyperson who works across all the groups’ homes. This ensures that minor repairs are dealt with in a timely manner. However, as identified at the previous inspection of July 2006, and not yet rectified, the bathroom flooring was in poor condition, the bath panel in need of replacement, and the paintwork above the shower area was peeling. Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 Page 18 Residents’ bedrooms were spacious, personalised and reflected their individual needs and interests. The home has a suitable laundry area. On the day of the site visit care staff were undertaking cleaning tasks and the home appeared to be cleaned to a reasonable level. The assistant manager said that night staff cleaned the kitchen area and that cleaning schedules were in place. According to the homes training matrix only one member of staff has completed training in infection control. This needs to be improved so that residents are cared for safely by staff with a good knowledge base in this area. Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents cannot be assured that staff at the home are fully and appropriately trained to meet their needs, and up to date with current best practice. EVIDENCE: Staff and residents were observed to interact well with one another. Staff showed patience, understanding and a caring attitude towards residents. Some staff at the home have completed recent training in inclusive communication to assist them in their role. Newer staff confirmed that they had completed training in epilepsy and in managing challenging behaviour. However the home’s training matrix and three staff training files viewed showed that overall the level of staff training and update training at the home is poor. Key courses identified on the home’s training matrix such as Learning Disability Awareness and Principles of Care have only been completed by three and two staff respectively. Of these only one of the training sessions took place in 2006, the rest being undertaken in 2002/3 and 4. Out of 17 care staff identified on the home’s rota, two hold a National Vocational Qualification (NVQ) at level 2. A further three staff are undertaking NVQ level 3. Two of the Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 Page 20 three relatives who sent n surveys felt that staff did not always have the skills and training that they needed and that the home needed more ‘trained staff.’ Staffing levels at the home appeared sufficient to meet residents’ complex needs. Residents at the home are funded on a one to one or two to one staff to resident ratio. Care is taken to ensure the right skills, such as drivers, are available on each shift so that residents’ needs can be met. Day to day shifts are well organised. Tools such a daily allocation sheet assist this process and ensure that everyone knows what they are doing. At the previous inspection it was identified that there were five and a half full time staff vacancies at the home. The home currently has seven full time staff vacancies, this includes the manager’s post. This does not assist in providing residents with consistency and stability. The home uses agency staff to help cover the rota, and the homes own staff work extra shifts. The assistant manager said that the same four agency staff are generally used and are ‘like the home’s own staff.’ However some relatives felt that the reliance on agency staff was not good. As pointed out at the previous inspection the full names of agency staff should be recorded on the homes rotas. The assistant manager identified the two staff who had been most recently recruited. These files were viewed. One showed that recruitment had been carried out to a good standard with appropriate references taken up, a Criminal Records Bureau (CRB) check and other checks to safeguard residents being in place. A recent photograph of the member of staff was however not available. The second member of staff had a copy of a CRB check in place that was dated after they had commenced work at the home. A POVA first check was not in place. There was no evidence of identification. The most recently recruited member of staff (seven months ago) had no previous experience in care. They said they had received an induction when starting at the home and identified that some training had been undertaken. However this had not been properly documented. The homes induction document identified specific items numbered from one to forty eight relating to staffs’ induction. Only items one to eight had been signed off as completed. A Staff Statutory Training Record on their file was blank. Staff files and staff spoken with confirmed that staff supervision at the home has been erratic or non existent. The last supervision session identified on one file was dated 22/01/06, another had no evidence of supervision. Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents cannot currently be assured that they live in a well managed home. EVIDENCE: The findings of this inspection show that the home is not currently being run in a clear and effective manner that benefits residents. One relative summed it up by saying that ‘The Oakes has the potential to be an excellent care provider,’ but that ‘the house needs a competent manager who can lead and manage staff.’ Staff recognised that that the moment things are run on a day to day basis and some aspects of ‘paperwork’ have fallen behind. The home is without a manager. The Operational and Development Manager for the Company is currently standing in as acting manager, but it is understood that they are not present in the home on a full time basis. The office at the home Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 Page 22 has been refurbished and reorganised and it is clear that attempts are being made to get the home back on track after an unsettled period. Since the previous inspection no further work has been undertaken in developing a quality assurance strategy for the home. The last quality assurance audit took place in August 2005 with a Quality Assurance and Development Plan for 2005/2006 following on from this. The audit undertaken did not include trying to incorporate the views of residents. A recent residents meeting was held in March 2007. Minutes of this had been well prepared and symbols added to assist residents understanding. The previous residents meeting recorded had been in December 2005. The last visit undertaken as required under Regulation 26 of the Care Homes Regulations was completed in January 2007. The regulation requires that the registered provider undertake these visits on at least a monthly basis to ensure that the home is being run effectively, in line with current regulations and standards. The visit was undertaken by the person who is now the acting manager. If this role continues someone else will have to undertake future visits, so that an independent view is expressed. The home’s fire records were satisfactory and showed that regular drills are undertaken and the system regularly tested. A fire risk assessment was in place. Risk assessments relating to safe working practices at the home need reviewing and updating so that they are fully effective in guiding staff practice and keeping residents safe. Many risk assessments were not dated or signed. Others, including the one for water safety and legionella, date from 2004 and have not been reviewed. From the staff training matrix and training files viewed it appears that most staff at the home requite training/update training in many core areas so that their practice is current and safe. This includes fire safety, health and safety and moving and handling. Some staff have yet to complete training in food safety. Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 Page 23 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 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 3 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 3 34 2 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 2 X X 2 X Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 Page 24 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 YA6 Regulation 15 2 (b) Requirement So that residents know that their complex care needs will be met, care plans and risk assessments should be regularly reviewed and updated to meet their changing needs. This is a repeat requirement with a previous compliance date of 01/08/06. 2. YA20 13 (2) Residents must be cared for safely, and should know that their medication is being managed safely by well trained staff. 01/08/07 Timescale for action 01/09/07 3. YA23 13 (6) Residents must be properly 01/08/07 protected from abuse. Staff must receive training in this area. Policies and procedures relating to safeguarding adults and whistle blowing must be up to date and understood by staff. Staff must receive training, and updates when appropriate, so that their understanding and practice enables them to properly meet residents specific DS0000018125.V342739.R01.S.doc 4. YA32 18 01/09/07 Oakes (The) Version 5.2 Page 25 needs relating to their disabilities and behavioural issues. 5. YA34 19 So that residents are protected 01/08/07 and cared for by appropriate staff, recruitment must be carried out to a consistently high standard. Records as required by regulation such as evidence of identification must be maintained at the home. New staff must receive a proper induction into the home to enable them to understand the home, and care properly for residents’ needs. Staffs’ induction and training must be properly documented. 01/08/07 6. YA35 18 7. YA42 12 Health and safety at the home 01/09/07 needs to be better managed so that residents and staff are protected. Staff require training/update training in core health and safety areas, including infection control. Risk assessments need to be reviewed and updated. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA1 Good Practice Recommendations The homes Statement of Purpose and Service Users Guide need to be updated so that they provide up to date information and reflect the current situation at the home. A record of all complaints, actions taken and outcomes should be properly maintained at the home. 2. YA22 Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 Page 26 3. YA24 Where shortfalls in the environment are identified these should be dealt with in a timely manner. This refers to items that need attention in the homes communal bathroom that were identified a year ago and not yet attended to. 50 of care staff should be trained to NVQ level two or above. Staff at the home should receive regular formal supervision to support them in their role. A qualified and competent manager should be recruited for the home at the earliest opportunity. Management of the home should develop a clear and robust strategy for quality assurance that consults with all stakeholders and identifies a development plan for the home. 4. 5. 6. 7. YA32 YA36 YA37 YA39 Oakes (The) DS0000018125.V342739.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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. 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