Inspection on 24/05/05 for The Oaks

This inspection was carried out on 24th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 27/11/07

The Oaks 28/11/06

The Oaks 05/10/05

The Oaks 13/01/05

The Oaks 29/07/04

The Oaks 15/03/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 The Oaks Blaydon Bank Gateshead Tyne and Wear NE21 4PU Lead Inspector Eileen Hulse Unannounced 24 May 2005 11:45am 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 B52-B02 S7434 The Oaks V233491 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Oaks Address Blaydon Bank Gateshead Tyne and Wear NE21 4PU 0191 414 1742 not known not known Miss Fiona Karen McCoull 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) Miss Fiona Karen McCoull Care home only 9 Category(ies) of LD Learning disability (9) registration, with number LD(E) Learning dis - over 65 (4) of places The Oaks B52-B02 S7434 The Oaks V233491 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 13/01/05 Brief Description of the Service: The Oaks provides personal care and support for 9 people with learning difficulties, with an age range between 50 to 71 years of mixed genders. It is privately owned and managed by one of the proprietors. The home is situated on a steep bank in Blaydon close to local amenities, including a shopping mall, library, medical health centre, local churches and public houses. Access to public transport to the City of Newcastle, Gateshead and the Metro Centre is a short distance away and there is a bus stop close to the home. The premises itself is a converted 2 storey Victorian building offering single bedroom accommodation. The ground floor provides the communal facilities, 3 bedrooms and a bathroom fitted with an over the bath hoist. The home does not have lift facilities and there is no space available to install one, therefore the home remains unsuitable for people with physical disabilities. Internal access to the second floor level is by means of a wide staircase to further bedrooms, bathroom and WC, which are directly off the staircase onto a mezzanine level. The home has a small garden to the front and a paved area to the rear. There are plenty of on-street car parking spaces to the side of the home; parking is restricted to the front. The Oaks B52-B02 S7434 The Oaks V233491 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and took 7hrs 15mins to complete; this included two hours to prepare for the inspection. A tour was made of the building to all communal areas and in service users bedrooms, time was spent talking with service users that were in the home throughout the day and other service users as they returned home from day services. Some of the time was spent inspecting care plans, daily records regarding service users, fire records and medications that are stored in the home. The requirements made in previous inspection reports were discussed with the Senior care member of staff on duty and discussions took place with other staff members who were on duty at various times throughout the inspection. No visitors came to the home during the inspection. What the service does well: What has improved since the last inspection? There has been little improvement since the last inspection. The bathrooms and toilets have not been replaced and some service users bedrooms have not been decorated despite the Manager drawing up an action plan to make decoration better. However, a lot of work on the building has taken place over the past couple of years Some improvements have been made on the storage of medication. However, the home has more work to do before medication is stored in a satisfactory way. The Oaks B52-B02 S7434 The Oaks V233491 240505 Stage 4.doc Version 1.30 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 B52-B02 S7434 The Oaks V233491 240505 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 B52-B02 S7434 The Oaks V233491 240505 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) 2 and 5 An assessment /care plan completed by a Care Manager prior to a service user being admitted into the home was not completed with enough information that would ensure the care needs would be met on a daily basis. Not all service users have a written contract/statement of terms and conditions. EVIDENCE: For one person living in the home, the assessment/care plan is out of date and was originally written for a different care home and does not include sufficient or up to date information that would enable staff to implement a care plan based on the assessment information. The information recorded does not give any guidance or important information to staff. Therefore, the care needs of the service user may not be known and therefore cannot be met at all times. All service users must have a copy of the terms and conditions of their stay in the home so that they are aware of what is expected of them, what services they can expect to be included within the fees they pay and how much it will cost for them to live in the home. The records indicate that reviews are held between the service user and Gateshead Community Based Services annually. The Oaks B52-B02 S7434 The Oaks V233491 240505 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) 6,8, and 9 All service users have care plans in place, however, they have either no information or limited and out of date information. Some daily records regarding service users, were completed by staff using inappropriate comments. Depending on service users capabilities, they are consulted and involved in the day to day routines of the home. Service users are able to take risks as part of their everyday activities. EVIDENCE: Of the care plans inspected, some of the information recorded was out of date with risk assessments dated November 2001 and September 2003. An activity sheet stated, ‘the service user goes to a day centre 4 days a week’ staff confirmed the service user goes two days a week. Some of the care plans commenced in 2000 but records showed they have not been reviewed, monitored or evaluated since their implementation. Without detailed up to date information, staff have no guidelines to follow to ensure the care needs are being met. The Oaks B52-B02 S7434 The Oaks V233491 240505 Stage 4.doc Version 1.30 Page 10 Records evidenced service user meetings are held regularly. They are minuted for future reference and showed that past discussions included planning of the menus, preferred weekly activities and plans for holidays. This demonstrates that service users are encouraged to be involved in making decisions in their everyday lives. Some service users are able to go out independently. During the inspection, one service user went for a walk to the local wildlife pond taking his binoculars to spend time observing the wildlife. On his return he discussed what he had seen and some of his comments were: ‘I like to be by myself when I go out walking’ ‘You see all sorts down at the pond’ ‘I always take my binoculars’ The Oaks B52-B02 S7434 The Oaks V233491 240505 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) Not Inspected EVIDENCE: The Oaks B52-B02 S7434 The Oaks V233491 240505 Stage 4.doc Version 1.30 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 standard(s) 18 and 20 Throughout the day it was observed that service users interact well with staff. Medication systems used were examined and although some discrepancies have been addressed a number are still outstanding. EVIDENCE: Service users were given appropriate levels of support in a sensitive and discreet manner whilst promoting the service user’s independence at all times, staff continually gave service users choice in all tasks carried out. It was evident staff know the service users well and a good rapport was observed between them. Stocks of some medications are excessive and no longer fit for use, some medicines were out of date and no longer able to be used. In some instances, staff have not signed the medicine administration records after supporting service users to take their prescribed medication. Staff authorised to give medications stated they have not received accredited medication training. Staff would benefit from this training and safer medication systems would be in place The Oaks B52-B02 S7434 The Oaks V233491 240505 Stage 4.doc Version 1.30 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 standard(s) 22 and 23 The home has a policy and procedure to guide staff and protect service users from abuse. However, staff have not been trained to recognise abuse, therefore, service users are not adequately protected. This leaves service users unprotected as staff without training may not always recognise an abusive situation. Complaints and compliments records were not available for inspection. EVIDENCE: Discussions with staff during the inspection highlighted they have received no training in the protection of vulnerable adults. Staff spoken with were aware of the homes policy and procedure regarding abuse. The complaints and compliments records are stored in the Managers office, therefore, when the Manager is not on duty the staff have no access to information held in a locked office. The office must be accessible to the senior on duty at all times to have access to documentation that may be required in the absence of the Manager. All records must be accessible in an inspection. The Oaks B52-B02 S7434 The Oaks V233491 240505 Stage 4.doc Version 1.30 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 standard(s) 24 Although the home is nicely furnished it is decorated to a poor standard and not maintained very well. The home is odour free and some systems are in place to control the spread of infection. EVIDENCE: The Oaks B52-B02 S7434 The Oaks V233491 240505 Stage 4.doc Version 1.30 Page 15 Some time ago, the Manager submitted to the Commission for Social Care Inspection, a programme of planned maintenance and renewal in respect of the refurbishment of the home. This included the now much needed replacement of bathing and toilet facilities, however, none of this work has been carried out. Repairs to the fabric of the building have had to be prioritised and this has led to a delay in carrying out what was initially considered as cosmetic work. A wall in the communal lounge has bare plaster that has been like this for a considerable long time. On a tour of the building, a service users bedroom was being used to store a roll of lino, a hoist, the home’s moving and handling equipment and an unused wheelchair. This compromises the safety of the person living in that room. The laundry facilities are sited in an area that is away from where food is prepared and cooked. However, the laundry flooring is damaged and no longer impermeable and could pose as a hazard for germs. The Oaks B52-B02 S7434 The Oaks V233491 240505 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,34,35, and 36 Personal staff files, job descriptions and a training and development plan were not available for inspection. The care staff are experienced and have a good mix of skills to provide appropriate levels of support to service users. Staff induction takes place but not in a consistent way and sessions are not recorded. EVIDENCE: The staff on duty had no access to information held within the office. Staff spoken with are not familiar with the standards of conduct set by the General Social Care Council and have not been given copies of the code of conduct that would familiarise them with social care practice. Throughout the inspection, staff were observed to communicate well with service users whilst providing necessary levels of assistance but at the same time encouraging independence. One member of staff explained she had received a supervision session from the Manager some ago but had no recorded information to support this. Another member of staff stated she had received two sessions but stated The Oaks B52-B02 S7434 The Oaks V233491 240505 Stage 4.doc Version 1.30 Page 17 ‘I can go to the Manager if I have a problem’ Records would confirm when sessions had taken place and what issues were discussed. The Oaks B52-B02 S7434 The Oaks V233491 240505 Stage 4.doc Version 1.30 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 The Manager is currently on maternity leave and no staff have been given the role as the responsible person in her absence. EVIDENCE: Many records could not be inspected as staff members have no access to the office where the records are held. The management arrangements are poor as there is currently no leadership within the team to ensure that day to day issues are addressed and that the staff have some support to ensure the service users receive a good quality of care. The Oaks B52-B02 S7434 The Oaks V233491 240505 Stage 4.doc Version 1.30 Page 19 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 x 1 x x 1 Standard No 22 23 ENVIRONMENT Score 1 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 1 x 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x x x x x x Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score 1 3 x 1 1 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Oaks Score 3 x 2 x Standard No 37 38 39 40 41 42 43 Score 1 x x x x x x B52-B02 S7434 The Oaks V233491 240505 Stage 4.doc Version 1.30 Page 20 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 5 Regulation 5 Requirement Each Service User or their representative must be issued with a written contract/statement of terms and conditions with the home, to keep for their own reference. Individual Plans must be drawnup in conjunction with all Service Users living at the home Planning must be holistic and set out how current and anticipated personal, social and healthcare needs and specialist requirements will be met, describing the services and facilities to be provided by the home. Risk assessments must be updated regularly.· Individual Plans must be reviewed on an at least six monthly basis and updated accordingly to reflect changing needs and goals.· Service User reviews must take place at least six monthly to reflect changing needs. · Records required by Regulation must be kept securely in the home.· Confidentiality of information must be ensured through compliance with Data B52-B02 S7434 The Oaks V233491 240505 Stage 4.doc Timescale for action Immediatel y 2. 6 15 30 August 2005 3. 10 12 Immediatel y The Oaks Version 1.30 Page 21 Protection legislation. 4. 20 13 · storage arrangements for medications must be upgraded;· All medicines no longer required (even within the safe use by date) must be properly disposed of without delay;· Accurate records must be kept of all medications received, administered and disposed of by the home; · Ordering systems must be reviewed;· Suppositories must not be used for the ‘homely’ remedy of constipation· Accredited staff training must be sourced for each worker authorised to administer medications. All Service Users, supported by a representative where required, must be given the opportunity to express their wishes in relation to dealing with growing older, terminal illness and death. This information must be recorded as part of each person’s individual assessment. Where a person declines the opportunity to discuss this subject, or where there is no relative or supporter available to assist with assessment, this too must be recorded. · Both bathrooms and the separate WC facilities require refurbishment as part of a longterm refurbishment plan.· The over bath hoist requires repair or replacement.· Bathroom/WC privacy locks require repair or replacement. · The laundry floor is no longer impermeable and requires replacement.· Storage arrangements for vacuum cleaners and floor cleaning equipment must be reviewed.· Separate toiletry items and B52-B02 S7434 The Oaks V233491 240505 Stage 4.doc Immediatel y 5. 21 12 30 August 2005 6. 24 16 30 August 2005 7. 30 13 30 August 2005 The Oaks Version 1.30 Page 22 8. 31 18 9. 32 18 10. 34 19 11. 35 18 12. 36 18 13. 14. 37 39 9 24 15. The Oaks 40 sched 1 and 4 sponges must be provided for each individual Service User. Job descriptions for care workers must be reviewed and amended by the Manager in consultation with her employees to reflect the scope of the service provided by the home. 50 of staff must be qualified to NVQ Level II by 2005. Underpinning knowledge should be Learning Disability Award Framework accredited. · Criminal Records Bureau clearance must be secured for every prospective worker and the tear off strip retained for examination by the Commission for Social Care Inspection;· Checks must be made against the POVA list;· Two satisfactory written references must be sourced.· The Manager must ensure satisfactory Criminal Records Bureau checks have been received prior to recruiting staff. The Manager must produce a training and development plan for the home, linked to individual training needs assessment for each worker and with the aim of developing the service and meeting specific Service User needs. A staff supervision programme must be implemented to ensure staff receive regular and structured supervision. The Manager must hold an appropriate qualification in management by 2005. The Manager must introduce a formal system of self-monitoring, upon which an annual development plan is based. Each of the policies and procedures specified at Appendix 30 August 2005 2005 Immediatel y 30 August 2005 30 August 2005 2005 30 August 2005 30 August 2005 Page 23 B52-B02 S7434 The Oaks V233491 240505 Stage 4.doc Version 1.30 16. 41 17 2 of the revised Care Homes Regulations 2003 must be in place, reviewed and updated to reflect current legislative and best practice guidance. The home’s business and financial plan must be available for Inspection. 30 August 2005 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 5 Good Practice Recommendations Some thought should be given as to how the home’s contract/statement of terms and conditions of residency might be developed in a format suitable to the needs of the people who live there. It is recommended that Individual Plans drawn up with/for Service Users over the age of sixty-five be reviewed on a monthly basis (in line with Older Persons Standards). Service Users should be consulted about the review of policies and procedures, which shape the running of The Oaks and therefore have the most noticeable impact on people’s daily lives. · Although the first floor bathroom window is not directly overlooked, privacy screening may be inadequate and an alternative should be provided. · It is recommended that some thought be given as to how Service Users might be able to make telephone calls whilst enjoying a greater degree of privacy. It might be necessary to consider relocating the telephone. Individual laundry baskets should be provided in each Service User’s bedroom. · In order to properly safeguard Service Users and in the interests of equality of opportunity, the home’s recruitment procedures should be reviewed to embrace the best practice guidance offered by the Inspector. The home’s interview panel should consist of two people. 2. 3. 6 8 4. 18 5. 6. 30 34 The Oaks B52-B02 S7434 The Oaks V233491 240505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Baltic House Port of Tyne, Tyne Dock South Shields NE34 9PT 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 B52-B02 S7434 The Oaks V233491 240505 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!