Inspection on 13/06/05 for The Oaks

This inspection was carried out on 13th 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 but made no statutory requirements on the home.

Other inspections for this house

The Oaks 18/07/06

The Oaks 12/11/05

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 Diane Peel Announced 13th June 2005 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 Oaks H60- H11 S14786 The Oaks V222574 130605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Oaks Address 20 Normanhurst Close, Three Bridges, Crawley, West Sussex, RH10 1YL 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) 01293 543828 Alliance Home Care (Learning Disabilities) Limited Mrs Jacqueline Mary Swingler Care home only (PC) 6 6 Category(ies) of Learning Disability (LD) registration, with number of places The Oaks H60- H11 S14786 The Oaks V222574 130605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th January 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 currently on leave. The Oaks H60- H11 S14786 The Oaks V222574 130605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 4 hours on 13th June 2005. The inspector arrived at 9am and was greeted by the deputy manager and residents living at the home. During the visit a tour of the home took place with all private and communal areas being visited. All residents were met; however the inspector was unable obtain the views of the residents during the visit due to their communication difficulties but observed interactions between members of staff and residents. The care records of three residents were examined along with other records, which showed how care needs were to be met. Five relative comment cards were returned to the inspector prior to the visit which all gave positive feedback about the service. During the visit the records of three staff were examined and staff were spoken with informally. The acting manager and deputy manager were present throughout the visit to discuss the running of the home. What the service does well: What has improved since the last inspection? The management team have made many improvements to the environment since the last visit to the home. Some areas have been redecorated and new floor coverings have been laid. Security to the rear of the building has been increased by the replacement of the old doors to the rear garden and a downstairs window; there is no longer access to the rear garden by the side of the house. The rear garden has been cleared and is now available for use by residents. The Oaks H60- H11 S14786 The Oaks V222574 130605 Stage 4.doc Version 1.30 Page 6 Procedures for the recording of administration of medication have been reviewed and records seen were in good order. Staff are of the opinion that residents are much more relaxed since the sixth person who was living at the home left. 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 Oaks H60- H11 S14786 The Oaks V222574 130605 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 Oaks H60- H11 S14786 The Oaks V222574 130605 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,and4 Prospective residents and their families are provided with the information they need to make an informed choice about the home. Residents are assessed prior to moving into the home to make sure that the home can provide a care plan which residents or their families know will meet their needs. Prospective residents, their relatives and friends have an opportunity to visit the home to look at the facilities available and assess its suitability before moving in. EVIDENCE: The residents living at the home moved to the home 8 years ago and had lived together previously. Information about the service is provided in the Statement of Purpose and Service user Guide available to all prospective residents and their families and friends. Staff explained that when residents were moving to the home eight years ago they all visited The Oaks, had a visit for tea and then had overnight stays to see how they would settle in. After regular visits four residents moved into the home on the same day and another resident moved in the following day. The Oaks has an admissions process, which they follow when offering vacant rooms to a new residents. The acting manger explained that this would include visiting the prospective residents, carrying out an assessment of need and visits to The Oaks. Care records viewed at this visit included assessments for each resident. The Oaks H60- H11 S14786 The Oaks V222574 130605 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 and 9 Staff make every effort to make sure that an individual’s needs and choices are promoted and respected. Residents are supported to make decisions and relatives are consulted and kept informed about the care and support required and provided. Risk management strategies are in place, which allow residents to take limited opportunities in the day-to-day running of the home. EVIDENCE: Residents are able to make limited choices and decisions about their lives. Staff rely on good communications systems and informative care plans to ensure that residents are able to make some choices about what they want to eat, when they want to go to bed and when they want to take part in activities and trips out. Care plans examined were clear 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 in the last 6 months. 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 Oaks H60- H11 S14786 The Oaks V222574 130605 Stage 4.doc Version 1.30 Page 10 Relatives returning comment cards to the inspector prior to the visit to the home all reported that they felt that they were kept informed about matters affecting their relative living at The Oaks and that they are consulted about their relatives care. 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 H60- H11 S14786 The Oaks V222574 130605 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) 12,13,14,15,16 and 17 Activities are well managed and offer variety for some residents whilst for others; activities are confined to the home. Residents, who are able, are encouraged to maintain contact with their family and friends so that they can satisfy their social and emotional needs. Residents are treated with dignity and their rights and responsibilities are recognised. 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 work hard to offer a stimulating structured activity programme at home, which includes regular staff attention on a one to one basis. Care plans detail family contacts and relationships and goals set were seen to include supporting residents to maintain contact with families. One relative returning a comment card commented that they had very high regard for the staff and that the communication between them and the family The Oaks H60- H11 S14786 The Oaks V222574 130605 Stage 4.doc Version 1.30 Page 12 is excellent. During the visit to the home three residents went out for lunch whilst two residents had a meal at home, which consisted of corned beef hash and spaghetti. Both residents need a soft diet to aid their ability to eat and digest food. The Oaks H60- H11 S14786 The Oaks V222574 130605 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, and 20 Clear information is provided to staff 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 The systems for the administration of medication ensure that resident’s medication needs are met. EVIDENCE: The three care plans viewed showed that all aspects of heath and personal healthcare have been considered. Plans are reviewed by the full staff team on a six monthly basis to ensure that any changes to a residents needs are recognised and plans developed to meet their changing need. Accidents records seen during the visit to the home provide informative information about accidents sustained by residents. All residents living at the home have to be assisted with taking their medication. There have been some problems with the recording of medication taken in the past but systems have been reviewed and medication records seen during this visit were in good order. All comment cards returned prior to the visit to the home by relatives reported that relatives were satisfied with the overall care of their relative living at the home. The Oaks H60- H11 S14786 The Oaks V222574 130605 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 and 23 The clear complaints procedure enables those using the service to have the confidence that their compliant will be responded to within a maximum of 28 days. Residents are protected by the homes policies and procedures to prevent residents being harmed, neglected or suffering from abuse. EVIDENCE: There is a complaints procedure included in the Service User Guide and on display in the home. The acting manager explained that it is unlikely that the present residents would be able to make a formal complaint themselves. It was observed that the home has a formal process for dealing with and recording complaints, which are made directly to the home. There have been no complaints made to the Commission for Social Care Inspection since the last visit. Four out of five comments cards returned prior to the visit recorded that the relatives knew about the homes complaints procedure but had not had to use it. One relative did not know about the complaints procedure but had not had a reason to make a complaint. Training records show that the majority of staff have attended adult protection training and that the organisation has an ongoing programme for staff to update their understanding of adult protection procedures. There are clear guidelines for staff to use at the home, which are used alongside the West Sussex Multi Agency Guideline reporting abuse. The Oaks H60- H11 S14786 The Oaks V222574 130605 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, and 30 The home is clean and residents have a comfortable, safe, and homely environment to live in. 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. EVIDENCE: All areas of the home were seen during the visit to The Oaks. The home was clean, comfortable and well maintained. Since the last visit three bedrooms have been redecorated and two have had new carpets. The dining room has been redecorated and along with the kitchen has new flooring. The first floor bathroom has also been decorated. New doors and windows have been installed on the ground floor at the rear of the house to increase security. 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 and are decorated to a good standard. Since the last visit to the home there had been some clearing work done to the rear garden, which allows more sunlight onto the area. The garden is still in The Oaks H60- H11 S14786 The Oaks V222574 130605 Stage 4.doc Version 1.30 Page 16 need of further attention to make it a safer more enjoyable place for residents to use. It is hoped that this will be done before the end of the summer. The Oaks H60- H11 S14786 The Oaks V222574 130605 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) 31,32,33,34,35 and 36. Staff have clear roles and defined areas of responsibility to ensure that all aspects of residents needs can be met. Recruitment procedures safeguard and protect residents at the home. Staff are supported and residents are able to benefit from staff that are well supported by the management team at the home. EVIDENCE: The care plans seen at this visit showed that residents have a variety of complex needs and require assistance with personal care and taking part in activities. To be able to meet these needs staffing levels have to be flexible enough to be able to offer one to one support to one resident. Staffing rotas show that there are a minimum of three staff on duty between seven am and two thirty pm. Between one thirty pm and nine pm there are three staff on duty and between eight forty-five and seven fifteen am the next morning there are two staff on duty, one remaining awake and one asleep. The acting manger said that there is often four staff on duty during the daytime to allow for residents to take part in activities outside the home. During the visit the recruitment records of three staff were examined along with evidence that Criminal Record Bureau (CRB) and Protection of Vulnerable Adult (POVA) clearance had been acquired to safeguard the residents living at the home. The Oaks H60- H11 S14786 The Oaks V222574 130605 Stage 4.doc Version 1.30 Page 18 Staff training records showed that staff are given the opportunity to take part in regular training provided by the organisation. An induction programme is in place and staff are encouraged to take part in the NVQ programme. Those staff not doing an NVQ should be encouraged to find others ways of demonstrating their competences to do the job. Staff records and supervision schedules showed that staff working at the home are supported by the management team through regular supervision. The Oaks H60- H11 S14786 The Oaks V222574 130605 Stage 4.doc Version 1.30 Page 19 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) 37, 41,42 and 43 The home is well managed and staff have individual areas of responsibility, which ensures that residents benefit from an organised home. Residents best interests are safeguarded by the homes record keeping which ensures that up to date information is available for use by staff. The Oaks is well maintained and provides a safe environment for residents to live in. EVIDENCE: During the visit it was clear that the acting manger and deputy manager have worked hard to establish systems and procedures to show continuity in the home during the absence of the registered manager. Relatives have the confidence that their relative living at the home is cared for in a safe environment by dedicated staff. Records seen at this inspection were clear and kept up to date. Staff are provided with health and safety training and have clear guidelines to use when responding to difficult or challenging behaviour. The Oaks H60- H11 S14786 The Oaks V222574 130605 Stage 4.doc Version 1.30 Page 20 The Oaks was observed to be reasonably safe but the rear garden area could be made safer by levelling of the ground for easier access to residents. The Oaks H60- H11 S14786 The Oaks V222574 130605 Stage 4.doc Version 1.30 Page 21 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 3 3 3 3 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 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 2 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Oaks Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x x 3 2 3 H60- H11 S14786 The Oaks V222574 130605 Stage 4.doc Version 1.30 Page 22 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 24,42 32 Good Practice Recommendations The rear garden area needs further attention to provide a safer more pleasant area for residents to use. Those staff not doing an NVQ should be encouraged to find others ways of demonstrating their competences to do the job. The Oaks H60- H11 S14786 The Oaks V222574 130605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 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 H60- H11 S14786 The Oaks V222574 130605 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. 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