Inspection on 12/11/05 for The Oaks

This inspection was carried out on 12th November 2005.

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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Oaks 18/07/06

The Oaks 13/06/05

The Oaks 07/01/05

The Oaks 14/06/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 The Oaks 20 Normanhurst Close Three Bridges Crawley West Sussex RH10 1YL Lead Inspector Mrs D Peel Unannounced Inspection 12th November 2005 10.00a The Oaks DS0000014786.V265109.R01.S.doc Version 5.0 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 The Oaks DS0000014786.V265109.R01.S.doc Version 5.0 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. The Oaks DS0000014786.V265109.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Oaks Address 20 Normanhurst Close Three Bridges Crawley West Sussex RH10 1YL 01293 543828 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) Alliance Home Care (Learning Disabilities) Limited Mrs Jacqueline Mary Swingler Care Home 6 Category(ies) of Learning disability (6) registration, with number of places The Oaks DS0000014786.V265109.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th June 2005 Brief Description of the Service: The Oaks is a care home registered to provide personal care and accomadation for up to six residents between the ages of 18 and 65 years of age who have a leaning disability. The property is detached and situated in a residential area on the outskirts of Crawley. Communal areas consist of a dining area, a lounge and a sensory room. Private accomadation consisits of five berooms on the upper floor and one bedroom on the ground floor.Two bedrooms have en suite facilities. There are sufficient additional toilets and bathrooms throughout the home. The Oaks is currently occupied by five male residents who have lived together for many years . They are supported by a team of support workers, a deputy manager and an acting manager. The registered manager is remains on leave. The Oaks DS0000014786.V265109.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 2 hours on the 12th of November 2005. This was the second visit to the home this year and it was carried out to complete the annual inspection programme for the year 2005 required by the Care Standards Act 2000. The visit was carried out on a Saturday morning to enable the inspector to see that staffing levels were being maintained at weekends and to take the opportunity to meet the five residents currently living at The Oaks. During the visit a tour of the home took place with all private and communal areas being visited. The inspector was unable obtain the views of the residents during the visit due to their communication difficulties but discussed care practice with the three staff on duty and staff were seen working in a dignified way with residents. The care records of all five residents were examined along with other records, which showed how care needs were to be met. What the service does well: What has improved since the last inspection? What they could do better: The Statement of Purpose, service user and contract/terms and conditions of residency and complaints procedure, could be developed into a user-friendly format. The rear garden area needs further attention to provide a safer more pleasant area for residents to use. The Oaks DS0000014786.V265109.R01.S.doc Version 5.0 Page 6 Further sound proofing is needed to at least one residents bedroom to ensure that other residents and neighbours are not disturbed at night. 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 Oaks DS0000014786.V265109.R01.S.doc Version 5.0 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 The Oaks DS0000014786.V265109.R01.S.doc Version 5.0 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): 1,2,3,4,5 A Statement of Purpose and Service User Guide is provided however it should be redesigned for the benefit of residents. Residents have a contract/statement of terms and conditions, and again this should be redesigned for their benefit. EVIDENCE: The five residents living at the home moved there 8 years ago and had lived together previously. At the time assessments were carried out and a process of gradual moving to the home was undertaken which included tea visits and overnight stays. Each resident has been given a Statement of Purpose and Service Users Guide, which is kept safe in the office for them. The documents provide sufficient information for relatives and advocates to make an informed choice about where to live but they are not available in a format suitable for the residents. A recommendation has now been made that the documents are developed into a suitable format for residents. It was noted that the Service User Guide did not include the most up to date inspection report. A contract / statement of terms and conditions of residency has been provided for each resident and signed on their behalf by an advocate. These contracts are not provided in a format which can be understood by residents and now need to be developed into a user-friendly format. The Oaks DS0000014786.V265109.R01.S.doc Version 5.0 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 the following standard(s): 6,7,9,10 Care plans are comprehensive to make sure that resident’s needs are addressed through short-term goal setting. Risk management strategies are in place, which allow residents to take limited opportunities in the day-to-day running of the home. EVIDENCE: All five care plans were sampled during this visit to the home. They were seen to be comprehensive and had established short term and long-term goals. Those care plans seen had been regularly reviewed and Social Services Care Management reviews had been carried out for most residents in the past year. Care plans had clear information about each resident’s abilities and disabilities to ensure that staff know how each resident should be supported. In addition to care plans each resident had a laminated care book called “About me” for daily use by staff and visitors to the home. The risks for each resident are clearly documented in their care plans and strategies for staff to follow when working with residents inside and outside the home to limit risks are explained. The Oaks DS0000014786.V265109.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13,14,15 Residents, who are able, are encouraged to maintain contact with their family and friends so that they can satisfy their social and emotional needs. EVIDENCE: Three residents are able to access activities in the community which include trampolining, horse/carriage riding, music therapy, trips out shopping, going out for meals, use of a hydrotherapy pool and holidays. Two residents do not have the skills to use community facilities and therefore staff offer an activity programme at home, which includes one to one supervision for one resident. A complaint received via the environmental health officer earlier in the year about noise level coming from a resident at the home should be acted upon by soundproofing the bedroom as suggested in that residents care plan, so as to maintain relationships with the community. One the morning of the visit one resident was escorted to his family home to spend the day with a relative and another resident was taken for a drive out in the car. The Oaks DS0000014786.V265109.R01.S.doc Version 5.0 Page 11 The Oaks DS0000014786.V265109.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19, Information is provided to staff in care plans to ensure that residents are assisted with all aspects of health and personal care needs whilst promoting independence. Records are in place to monitor the health care needs of residents to make sure that any signs of residents being unwell are recognised EVIDENCE: The care plans viewed showed that all aspects of heath and personal healthcare have been considered. The plans and “about me “books provide information which inform staff about the levels of support needed by each resident to maintain levels of independence whilst encouraging development. Records showed that where a concern had been raised by staff about a residents weight loss, this had been followed up with GP visit and visits to see a Consultant. Accidents records seen during the visit to the home provide informative information about accidents sustained by residents. The Oaks DS0000014786.V265109.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The complaints procedure enables those using the service to have the confidence that their complaint will be dealt with, but this format is not helpful to residents. Residents are protected by the homes policies and procedures to prevent residents being harmed, neglected or suffering from abuse. EVIDENCE: The home has a written complaints procedure but it is in a format that is not helpful for residents. A recommendation has been made that an attempt is made to simplify the procedure into a format, which is more likely to be understood by the residents. Staff confirmed that it would be unlikely that a resident would be able to make a complaint without the assistance of an advocate. There have been no complaints made to the Commission for Social Care Inspection (CSCI) since the last visit to the home. The Complaints book showed a complaint made by neighbours about the noise being made by a resident earlier in the year. There are adult protection guidelines for staff to use at the home, which are used alongside the West Sussex Multi Agency Guideline reporting abuse. Staff training records seen showed that the majority of staff have attended adult protection training and one member of staff told the inspector that they had been on the course but was going to do another course soon. The Oaks DS0000014786.V265109.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30 The home is clean and residents have a comfortable, safe, and homely environment to live in. Residents cannot use the rear garden safely due to uneven surfaces. Bedrooms are comfortable and meet the needs of the residents. Residents are encouraged to contribute to making their bedrooms and staff have tried to reflect their personalities by the décor in the rooms. The rear garden needs attention to make it safe for residents. EVIDENCE: A tour of the home took place with all areas being visited except for the one bedroom, which is currently not being used. The home was clean, tidy and reasonably well maintained. Since the last visit to the home the lounge has been redecorated and staff commented that they are awaiting a fire, which will add to the homely surroundings in the lounge. Staff have assisted residents to make the home feel homely by having their possessions and photographs around them. Bedrooms are decorated to reflect individual personalities and interests. The rear garden is still in need of attention surfaces are uneven and a danger to residents. The Oaks DS0000014786.V265109.R01.S.doc Version 5.0 Page 15 Care records and a complaint to the home via the environmental health, show that there has been an acknowledgement that one resident’s room should be sound proofed to avoid disturbance to other residents and neighbours at night. A Statutory requirement has now been made to ensure that this is carried out so that a neighbourly relationship with the community can be maintained and other residents are not disturbed at night. The Oaks DS0000014786.V265109.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 Deployment of staff allows for the complex needs of five residents who are highly dependent on staff support. EVIDENCE: There were three staff on duty on the Saturday morning to assist and supervise the five residents living at The Oaks. One resident has an assessed need to have one to one support and this has to be considered when planning to meet the needs of all residents. In order to maintain a high level of supervision the one –one support is rotated through the staff on duty hourly. The Oaks DS0000014786.V265109.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality assurance system is in use enables the service to measure the success in achieving the aims and objectives of the home. The Oaks is well maintained and provides a reasonably safe environment for residents to live in. EVIDENCE: The manager of the home remains on extended leave and an acting manger and assistant manager are providing continuity within the home. A recommendation has now been made that the providers consider the management arrangement for the home and provide written confirmation to the CSCI, as to the intended return date of the Registered Manager. The quality assurance system is established and feedback has been sought from relatives, advocates and staff. Policies and procedures were viewed during the visit. The home was considered to be reasonably safe for the needs of the residents but the rear garden has still to be repaved to make it safe for residents. This has now become a requirement after two visits to them home when it has been a recommendation. The Oaks DS0000014786.V265109.R01.S.doc Version 5.0 Page 18 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 3 2 Standard No 22 23 Score 2 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 1 3 LIFESTYLES Standard No Score 11 x 12 x 13 2 14 3 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Oaks Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 2 x 3 3 3 1 x DS0000014786.V265109.R01.S.doc Version 5.0 Page 19 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 2 Standard YA29 YA42 Regulation 16.2 (c) 13.4 Requirement Sound proofing must be carried out to the bedroom identified in a care plan as a need. The rear garden area must be made safe Timescale for action 01/04/06 01/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Refer to Standard YA1 YA5 YA22YA13 YA22 YA37 Good Practice Recommendations The statement of purpose and service user guide should be available in a format suitable for residents. The contract should be available in a format suitable for residents. The providers and staff should ensure that every effort is made to maintain good relationships with the community. The complaints procedure should be available in a format suitable for residents. The providers should inform the CSCI as to the intended date of when the manager will be returning to work. 1 2 3 4 5 The Oaks DS0000014786.V265109.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Oaks DS0000014786.V265109.R01.S.doc Version 5.0 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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