Care Home: 27 Islip Road

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What the care home does well The home provides a safe supportive environment for the people living there. Only people whose needs can be met at the home are admitted, and a safe trained team support individuals to manage their personal and healthcare needs. People living at the home are encouraged to be as independent as they can be, and they are supported to take reasonable risks and to experience personal and family relationships. They are supported to be responsible for the tasks of their lives, and are encouraged to make their views known. Complaints are responded to in a timely way, and there is a system in place to maintain the home`s environment in a reasonable way. People living at the home told us that they enjoy their social lives, and two people said that they enjoy the work they do outside the home. One person said that the transport provided to take him/her to some activities was appreciated. Where individuals have no family support the staff team organises special celebrations for individuals, such as birthday parties. The staff team knows the needs of the people living in the home, and works to support them become increasingly independent. What has improved since the last inspection? The home has been improved by new furniture and fittings, and by adaptations to the bathroom to meet the personal needs of one individual. The outstanding safety checks on the electricity supply have been completed. The home has improved the way people living in the home are involved in the running of the home, including attending all the staff team meetings and contribution to the staff recruitment procedures. More entertainment has been provided within the home, in response to the wishes of the individuals living in the home. What the care home could do better: The registered manager has identified in the AQAA how the service is planning to improve, and is negotiating how to improve the staffing levels over the weekends. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 27 Islip Road 27 Islip Road Oxford Oxfordshire OX2 7SN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kate Harrison     Date: 1 1 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 23 Information about the care home Name of care home: Address: 27 Islip Road 27 Islip Road Oxford Oxfordshire OX2 7SN 01865554920 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : sue.fawcett@advanceuk.org Advance Housing and Support Ltd care home 9 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 9 The maximum number of service users to be accommodated is 9. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home 27 Islip Road is a large house in a residential street in north Oxford, with good access to local amenities. The home is operated by Advance Housing and Support Limited, and provides support and accommodation for up to 9 people with learning disabilities, and some associated physical impairment. Oxfordshire County Council refers people to the home. The home is larger than would be accepted currently as best practice for this client group, and consideration is being given to its long-term future, in this context. There is a garden at the rear with greenhouse and garden furniture. Staffing support is provided 24 hours a day. Care Homes for Adults (18-65 years) Page 4 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was an unannounced Key inspection and was conducted over one day by one inspector. It was a thorough look at how well the service is doing. The inspection took into account the detailed self assessment information, the Annual Quality Assurance Assessment (the AQAA) provided by the service, and any information that we had received about the service since the last inspection. We spoke to the manager about the systems in place, and we spoke to several of the people living in the home about their experience of the home. We looked at care needs assessment and planning, information about complaints, quality audit information, staff recruitment files, training records and other documents and records kept at the home about the service provided. We saw all the communal areas of the home, including the kitchen and laundry room, and one private bedroom at the individuals invitation. The Care Homes for Adults (18-65 years) Page 5 of 23 home is considering how the needs of the people living in the home can be better met, by offering support other than in a care home setting. We looked at how the home is meeting the standards set by the government and in this report we make judgements about the outcomes for the people living in the home. Our last inspection of this home was on 11 December 2006, and the fees are GB pounds 513.07 per week. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A full assessment of need is carried out before a person is admitted to the home. Evidence: The most recent admission to the home was in 2007. We looked at the preadmission assessments for two people and discussed the procedure with the registered manager. Individuals are usually referred to the home by a care manager from the local authority. The preadmission assessment involves gathering information from the individual and from the people most involved with the individual, so that the home knows that they can meet all the individuals needs. The process involves several visits to the home by the individual, so that he or she becomes familiar with the environment, the staff team and the other people living there. The views of the people already living in the home and the staff team are taken into account before a decision is taken to admit a new person. Care Homes for Adults (18-65 years) Page 9 of 23 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are able to live the life they choose, supported and enabled by the homes risk assessments and care planning. Evidence: The individual needs are documented in the Essential Lifestyle Plan for each person living in the home, and we checked the detail of two plans. We saw that the needs were recorded in a personalised way, for example headings such as These things must happen in my life and What are my mornings like give staff the details of how to support the individual manage daily tasks. We saw that individuals are supported to make their own decisions about complex issues such as intimate relationships and are supported by the home through good risk assessments. Risk assessments are in place for daily tasks when necessary, for example using scissors, managing finances and food hygiene. Some staff members have attended training about Inclusion and Empowerment, so that they are better able to support individuals to take on more responsibility if they want to. Care Homes for Adults (18-65 years) Page 10 of 23 Evidence: The home has a variety of ways keeping information about the people living in the home, and the manager is aware of the need to rationalise and archive documents, so that it is easy for the staff team and for the individual to get the information they need. Recently a House Speaker role has been developed, and one person living in the home has been selected by the other individuals and has volunteered to represent the views of the people living in the home. This is done by using a suggestions book and by attending the staff team meetings to represent the views Care Homes for Adults (18-65 years) Page 11 of 23 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to enjoy the activities they choose, have the relationships they want and be part of the local community as they choose. Evidence: We saw that individuals are supported to do the activities they like and choose, such as attend a day centre, go on holiday or go to a computer class, and two individuals work as volunteers in a charity shop. All have their own keys to the house and choose how to spend their time. The homes philosophy is to encourage individuals to choose what they would like to do and as far as possible to support them to achieve their goals. Individuals are supported to try new things, to make new friends and to form relationships. The home is responsive to the individuals needs regarding culture, religion, age, disability and gender, and would be able to respond to issues about race if individuals of differing races were living at the home. This is because there is a focus Care Homes for Adults (18-65 years) Page 12 of 23 Evidence: on the individuals needs, and the staff have an understanding of differing needs. Documentation is in place to record and support the individuals, through the Reviews and Action Plans. During the past year the House Speaker role has been developed, and one person attends the staff team meetings to represent the views of all the people living in the home. Care Homes for Adults (18-65 years) Page 13 of 23 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to manage their personal and healthcare needs, in the way they prefer. Evidence: Personal support is provided in private and in the way preferred by the individuals, as documented in the Essential Lifestlye Plan. Individuals can choose if they want to manage their medication or if they want the home to manage it for them, and some manage their medication well with staff support. The home has policies and procedures about medication, including risk assessments for those who want to take responsibility for their own medication. Only trained people can administer medication. The medication is stored securely and recorded when received. We checked the medication for an individual, and found it was managed and recorded appropriately. Care Homes for Adults (18-65 years) Page 14 of 23 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are able to make their concerns and complaints known, and they are safeguarded by the homes policies and procedures. Evidence: The people living in the home know how to complain, and have a copy of the homes complaints procedure in the living area. The registered manager had training in managing complaints recently. We saw the log of complaints and noted that the home responds quickly to concerns. The complaints procedure has been revised recently, and was missing our contact details, and the registered manager quickly addessed this. We have not received information about complaints made to the home since our last inspection. The home has a safeguarding policy and procedure, and all new staff members have training at induction about recognising abuse and neglect in a learning disability setting, and have regular update training. Care Homes for Adults (18-65 years) Page 15 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is comfortable and homely. Evidence: The home is comfortable and homely, and has been adapted over the years to meet the needs of the people living there. Repairs and maintenance are carried out by the organisation, and staff use a special repairs telephone line to report faults which are usually quickly responded to. New furniture has been provided, and one individual is awaiting delivery of a new chair. Individuals have their own rooms and two people share a room through choice. We saw one private room and this was personalised and met the needs of the individual. There is one bathroom and one shower room, and four toilets for the eight people living there. The laundry room is appropriately equipped, but was missing handwashing and drying equipment on the day of our visit. This was quickly provided so that staff were able to wash and dry their hands, and so minimise the risk of spreading infection. Staff receive training about infection control, and recent sessions have been held. The organisation is in negotiations to change the nature of the service, so that the people are able to live more independently elsewhere. Care Homes for Adults (18-65 years) Page 16 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are supported by a trained safe staff team. Evidence: The home has an induction and training programme to meet the needs of the home. The homes Induction training for new staff includes shadowing a competent carer, completing an appropriate workbook and reading policies and procedures. Further training includes updates on all mandatory areas such as moving and handling, epilepsy, the Mental Capacity Act and Diversity and Equality. There is a training department responsible for alerting individuals when training updates are due, and training needs are discussed at annual appraisal. New staff are supported to take the National Vocational Qualifications (NVQ) in Care, and the home has achieved the national minimum standard of 50 of NVQ trained staff. We saw three staff files to check the recruitment procedure. We saw that all the necessary information was available, apart from information why one individual left the previous job in a care setting, and the manager sought this information promptly. The home supports people living in the home to have a say about who is employed to help support them, including being on an interview panel. At the last inspection a requirement was made that the staffing levels be reviewed to meet peoples wishes to go out over the weekends, and this has been done. There is a Care Homes for Adults (18-65 years) Page 17 of 23 Evidence: staff rota showing who is on duty over the 24 hours, and the manager is discussing and negotiating how to permanently improve staffing levels over the weekends, so that it is possible for all the individuals who want to go out are supported to do so. Care Homes for Adults (18-65 years) Page 18 of 23 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the best interests of the people living there. Evidence: The registered manager has been in post for several years and is skilled and competent in running the home and empowering the individuals who live there. She is restarting the Registered Managers Award soon. She has met all the requirements from the last inspection. She provides an open supportive management style so that the people living in the home are able to feel at home, and staff are encouraged to take responsibility. She is supporting the staff team and the people living in the home to develop skills so that the move to the Supported Living model will be smooth. There is an annual quality assurance survey to the people living in the home, and action is taken as a result of the outcome. Information about the response is given to the individuals in the home on a one to one basis. Other quality audits are undertaken, regarding care records and the homes environment. The Advance organisation has a health and safety department to support the manager carry out health and safety tasks. The home has a fire risk assessment, and the home Care Homes for Adults (18-65 years) Page 19 of 23 Evidence: has installed a sounder to help protect one individual in case of fire. Care Homes for Adults (18-65 years) Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 22 of 23 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 23 of 23 - 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!