Inspection on 18/07/06 for The Oaks

This inspection was carried out on 18th July 2006.

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

Other inspections for this house

The Oaks 12/11/05

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 Ms J Hartley Key Unannounced Inspection 18th July 2006 11:45 The Oaks DS0000014786.V304193.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 The Oaks DS0000014786.V304193.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. The Oaks DS0000014786.V304193.R01.S.doc Version 5.2 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 *** Post Vacant *** Care Home 6 Category(ies) of Learning disability (6) registration, with number of places The Oaks DS0000014786.V304193.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th November 2005 Brief Description of the Service: The Oaks is a care home registered to provide personal care and accommodation 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 accommodation consists of five bedrooms 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 Oaks DS0000014786.V304193.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out over a period of three and a quarter hours. The inspector examined information held on the service file since the last inspection in November 2005, and read the previous two inspection reports, the Service User Guide and the Statement of Purpose. The home also returned a pre-inspection questionnaire. Information from this is also included in this report. During the inspection the inspector spoke to two members of staff and the acting manager. The inspector was unable obtain the views of the residents during the visit due to their communication difficulties. The inspector undertook a tour of the premises and looked at all the care plans and four staff files. Various record books, policies and procedures were also examined. The current scale of charges ranges from £1,132.32 to £1,6761.84. What the service does well: What has improved since the last inspection? Since the last inspection the garden has been improved to provide a sensory environment that is accessible to all the residents. Soundproofing has been fitted in one bedroom to ensure that neighbours are not disturbed at night. The home is developing pictorial formats of important documents such as the Service User Guide so they can be communicated to residents. The Oaks DS0000014786.V304193.R01.S.doc Version 5.2 Page 6 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 DS0000014786.V304193.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 The Oaks DS0000014786.V304193.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4 The Statement of Purpose and Service User Guide are up to date and available in pictorial format, to provide information that prospective service users need to make an informed choice about where to live. Service users needs and aspirations are assessed prior to moving in. Service users are able to visit the home to “test drive” it. The outcome for service users is good. EVIDENCE: The Oaks has an up to date Statement of Purpose and Service User Guide. Both are available in pictorial format to make them more accessible to people with learning disabilities. They both include all the required information. Current service users’ files include a full assessment and individual care plans. Any restrictions on freedom or choice are clearly recorded with reasons given. The residents at The Oaks have lived there for nine years. There is currently one vacancy. The acting manager said that following a referral a suitably experienced person would assess the prospective service user. If it was found that the home would be a suitable placement the prospective service user would be invited to visit the home for a few hours, an overnight stay and then for a week. The Oaks DS0000014786.V304193.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 Service users’ assessed and changing needs and personal goals are reflected in their individual care plans. Where possible service users are assisted in making decisions about their lives. Due to the high level of needs and lack of communication skills of the current service users it is difficult to consult them in aspects of life in the home. Service users are supported to take risks where possible. The outcome for service users is good. EVIDENCE: All five care plans were seen during the inspection. They were seen to be comprehensive and included short term and long-term goals. Care plans are person centred and clearly state what the individual resident is able to do and what help is needed. Any restrictions to choice and freedom are clearly recorded. Individual procedures and risk assessments are in place for residents who are likely to be aggressive or self-harm. Each resident has a The Oaks DS0000014786.V304193.R01.S.doc Version 5.2 Page 10 key worker. Evidence was seen of regular reviews of care plans by the home and yearly reviews by the placing authority. 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. Within the limits of their abilities residents are supported in making decisions about their lives. Due to the high level of needs and lack of communication skills of the current service users it is difficult to consult them in aspects of life in the home. Residents are supported in being as independent as possible, (e.g. taking their laundry to the laundry room), within their individual capabilities. Risks for each resident are clearly documented in their care plans. Strategies for staff to follow to limit risks when working with residents are in place. The Oaks DS0000014786.V304193.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 Where possible residents are supported to take part in age, peer and culturally appropriate activities, be part of the local community and maintain contact with their families. Service users are offered a healthy diet. The outcome for service users is good. EVIDENCE: Due to the level of disability experienced by residents at The Oaks, they are unable to undertake employment outside of the home. A college tutor visits the home three times a week to do “speak and sign” sessions with the residents to encourage communication. Residents visit shops and the local town. Residents are unable to take part in political elections, as they have no concept of politics. Staff have received race, faith and diversity training to help them understand the diverse needs of people in the home. The Oaks DS0000014786.V304193.R01.S.doc Version 5.2 Page 12 Records seen during the inspection show that residents are able to take part in activities provided by the home that include carriage driving, trampolining, music, aromatherapy, drives in the car, visits to the countryside and parks. Two residents go on holiday each year. The other three residents are distressed at being away from the home for long periods so have day trips out in lieu of a holiday. Relatives are able to visit the home, and residents are supported in visiting family outside of the home. Residents independence is promoted through person centred care plans which set out what residents are able to for themselves and what support they need to achieve their goals. The menu seen on the day of the inspection was well balanced and included fresh fruit and vegetables. Nutritional needs of residents are assessed and recorded in their care plans. Special diets are catered for. One resident has to have a dairy free diet. The home consulted a nutritionalist for assistance with menus for this resident. The Oaks DS0000014786.V304193.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 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. The home has thorough policies, procedures and recording practices for dealing with medicines. The outcome for service users is good. EVIDENCE: Care plans and daily records show that staff provide levels of support needed by each resident to maintain levels of independence whilst encouraging development. Specialist support is provided where needed, e.g. a nutritionalist was provided for a resident with lactose intolerance. Each resident has his own keyworker. A record is kept of every service users’ health appointments, the outcomes of the appointments and any action that needs to be taken. Medication records were examined during the inspection and found to be in order and clearly recorded. Training records show that staff receive training in the safe handling of medication on a regular basis. Due to the level of learning disability experienced by the residents at the home they are unable to selfmedicate. The Oaks DS0000014786.V304193.R01.S.doc Version 5.2 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 the following standard(s): 22, 23 The home has clear policies and procedures regarding complaints. Service users are protected from abuse, neglect and harm as far as possible by the home’s policies, procedures and staff training. The outcome for service users is good. EVIDENCE: The complaints book and procedures were inspected. No complaints/concerns have been recorded since the last inspection. The procedures were clear and included recommended timescales. The home’s procedures on abuse, Adult Protection and whistle blowing were seen. They were detailed and included descriptions on different types of abuse. Staff files contained certificates for attending Adult Protection training. The Oaks DS0000014786.V304193.R01.S.doc Version 5.2 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 the following standard(s): 24, 29, 30 The home is suitable for its stated purpose. It provides a homely, comfortable, clean, hygienic and safe environment for residents. Residents have the specialist equipment they require to maximise their independence. The garden has been made accessible to residents and measures have been taken to make one bedroom more soundproof as required at the last inspection. The outcome for service users is good. EVIDENCE: The Oaks is a comfortable and homely house that is situated in a residential area near to the town centre of Crawley. The home has a communal lounge, dining room and a quiet/sensory room that is in the process of being updated. The decoration and furnishings of the home are in good condition. Residents have their own possessions in their rooms. The Oaks was seen to be clean and tidy throughout and free from offensive odours. Laundry facilities are appropriately sited away from food preparation and storage areas. Double-glazing has been fitted in one bedroom to make it more soundproof as the resident who lives there can make a lot of noise at night. The Oaks DS0000014786.V304193.R01.S.doc Version 5.2 Page 16 Since the last inspection the garden has been improved and is now accessible to residents. The garden has an access ramp, places for people to sit, a grassed and a gravelled area to provide contrast and different textures. There are brightly coloured windmills and garden ornaments to provide sensory stimulation. The Oaks DS0000014786.V304193.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 35, 36 Service users are supported by competent and qualified staff who are appropriately trained to meet their needs. The home has thorough recruitment policies and procedures in place. The home is working towards having fifty percent of staff with an NVQ level 2 or equivalent qualification. The outcome for service users is good. EVIDENCE: Throughout the inspection staff were observed interacting well with the residents. During the inspection staff took different residents out for activities. Staff were observed to be comfortable with residents and spent time assisting with tasks when needed. Training records seen during the inspection show that residents are supported by competent and qualified staff. The home has a comprehensive training programme available to staff which includes courses specific to the needs of service users within the home. Training that staff have undertaken includes Health and Safety courses, Medication, Adult Protection, Bereavement, Person Centred Practice, Manual Handling, Epilepsy, Diabetes, Autistic Spectrum Disorder, and Behaviour Management. Evidence was seen that all new staff receive an induction within six weeks of employment and foundation training within six months. The home also has an induction for senior support workers. The Oaks DS0000014786.V304193.R01.S.doc Version 5.2 Page 18 The home is working towards having fifty percent of staff with an NVQ level 2 or equivalent qualification. The Oaks has thorough recruitment policies and procedures in place. Three staff files were examined during the inspection, including that of the most recent staff member to be employed. All files examined contained the required information including two written references, CRB and POVA checks. The Oaks DS0000014786.V304193.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 There is currently no registered manager in place at The Oaks. The acting manager is about to apply to The Commission to be registered. The home has a quality assurance and quality management system in place that seeks the views of service users, relatives and staff. The health, safety and welfare of service users are promoted and protected by the home’s working practices and procedures The outcome for service users is good. EVIDENCE: There is currently no registered manager in place at The Oaks. The acting manager is about to apply to The Commission to be registered. Allied Homecare has a Quality Assurance manager in post and has set up a quality monitoring system, which seeks the views of residents, staff and relatives. The Oaks DS0000014786.V304193.R01.S.doc Version 5.2 Page 20 Training records show that the home provides compulsory training for staff in safe working practices, including Moving and Handling, First Aid, Fire Safety, Food Hygiene and Infection Control. Evidence was seen that safety checks of electrical equipment, fire alarm systems and water temperatures are carried out on a regular basis. The gas boiler was last serviced in February 2006. During the tour of the home it was noted that all radiators have covers, and windows in all the first floor rooms have window restrictors. The Oaks DS0000014786.V304193.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X The Oaks DS0000014786.V304193.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Oaks DS0000014786.V304193.R01.S.doc Version 5.2 Page 23 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. 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