Care Home: 56 Oakwood Road

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What the care home does well 56 Oakwood Road provides a homely domestic environment. The house is kept clean and pleasant for the people that live there. Each person has their own room, which is their own private space and bedrooms had been highly personalised to reflect the occupant`s choices and interests. The service has person centred plans and health action plans to record the needs, goals and aspirations of service users. The people living at the home are supported by a sufficient number of caring staff that are well trained to do their job. The staff follow care plans closely that are in place to support people with their everyday skills and to ensure they meet all their otherneeds. A survey respondent said, `my relative receives the best care possible.` All policies and documents used at the home are in a format which is accessible to service users and their representatives. There is a full activities programme and personal support needed for people to take part is well organised. Meals at the home offer both variety and choice. Individuals are included in the planning of menus by the use of pictures. The provider and manager check the quality of the service regularly and also ask the representatives and relatives of people who live in the home what they think. Relatives are encouraged to visit the home when they wish and to give their views. What has improved since the last inspection? The requirements in relation to the home`s environment issued following the last inspection have been met. The malodour in both bathrooms on the first floor has been investigated and the situation resolved. Exposed hot water pipes in all three of the home`s communal bathrooms have been guarded and in some instances completely boxed in to ensure service users are protected from excessive temperatures. Bath panels have been redecorated. In the main kitchen a wall mounted cupboard door that was assessed as dangerously loose at the hinges has been repaired. The sealant behind the sink and wash hand basin has been replaced. A new kitchen window has been installed and a new work surface. Some of the home`s aged kitchen cupboards have been repaired to provide surfaces, which can be more easily cleaned. The care office, which had previously suffered water damage to one wall and subsequent staining to the carpet, has been redecorated and the carpet replaced. The floor covering in the service users lounge and dining area has been replaced. Some new furniture and white goods have been purchased. The Fire Officers recommendations to install a gate key breakpoint and update risk assessments have both been addressed. What the care home could do better: The home`s kitchen is now aged and despite some recent remedial work requires total replacement. The home`s communal bathrooms are looking equally aged and tired. The enamel covering to the bath on the ground floor was chipped which makes cleaning the bath more difficult. The floor coveringin the ground floor bathroom requires replacement where the finish has been damaged following installation of a new toilet. These situations have the potential to compromise the home`s infection control procedures and therefore the safety and welfare of service users. CARE HOME ADULTS 18-65 Oakwood Road (56) 56 Oakwood Road Horley Surrey RH6 7BU Lead Inspector Marion Weller Key Unannounced Inspection 17th March 2008 10:30 Oakwood Road (56) DS0000013521.V359391.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 Oakwood Road (56) DS0000013521.V359391.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. Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakwood Road (56) Address 56 Oakwood Road Horley Surrey RH6 7BU 01293 775132 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) www.theavenuestrust.co.uk The Avenues Trust Ltd Mrs Karen Wilcox Care Home 6 Category(ies) of Learning disability (0) registration, with number of places Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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: 2. Learning disability. The maximum number of service users to be accommodated is 6. Date of last inspection 21/11/2006 Brief Description of the Service: 56 Oakwood Road is a residential care home providing accommodation, personal care and support to six adults with a learning disability. The home is run by The Avenues Trust Ltd, who manages a number of similar homes in Kent and Surrey. 56 Oakwood Road is located in a residential area, close to Horley town centre and is convenient for public transport and other community based facilities. The house is a detached, two storey property which is domestic in style and character. It has limited off street parking to the front of the building. There is a large, enclosed garden to the rear of the property. Service users bedroom accommodation is offered for single occupancy and is arranged across the first floor of the premises. Bedroom accommodation is accessible only by stairs. There is staff on duty 24 hours a day to meet individuals needs. Service provision includes a seven person ‘people carrier’ for the sole use of the home. The current fees charged for this service range from £959 to £1188 per week depending on people’s individual needs. Please contact the manager for further details. Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was a key inspection of 56 Oakwood Road. The Manager did not know we (the Commission) were coming to inspect the home. As part of the inspection process, surveys were sent out prior to the visit to some people involved with the home that were asked to give their views about the service. Surveys were also sent to some relatives of people living at the home. The inspector was in the home from 10:30 am to 2.30 pm and spent some time looking at records and documents, observed how the home was being run and how staff were supporting people. A complete tour of the premises was undertaken. Due to the degree of learning disability and communication needs of service users living in this home it was not possible to obtain their views about the home or their care. Judgements were made about them based on their mood, behaviour and information given by relatives, representatives and staff. The feedback regarding the service from survey respondents was very positive and included: ‘I am more than happy the way things are’ ‘I am always warmly welcomed by the manager and staff and I observe residents to receive close one to one attention’. ‘My relative is very well and happy, well cared for and it couldn’t be better’ ‘The carers do everything well as far as it is possible.’ The manager and the staff gave their full cooperation throughout the site visit. Feedback was provided at the end of the inspection to the manager. What the service does well: 56 Oakwood Road provides a homely domestic environment. The house is kept clean and pleasant for the people that live there. Each person has their own room, which is their own private space and bedrooms had been highly personalised to reflect the occupant’s choices and interests. The service has person centred plans and health action plans to record the needs, goals and aspirations of service users. The people living at the home are supported by a sufficient number of caring staff that are well trained to do their job. The staff follow care plans closely that are in place to support people with their everyday skills and to ensure they meet all their other Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 6 needs. A survey respondent said, ‘my relative receives the best care possible.’ All policies and documents used at the home are in a format which is accessible to service users and their representatives. There is a full activities programme and personal support needed for people to take part is well organised. Meals at the home offer both variety and choice. Individuals are included in the planning of menus by the use of pictures. The provider and manager check the quality of the service regularly and also ask the representatives and relatives of people who live in the home what they think. Relatives are encouraged to visit the home when they wish and to give their views. What has improved since the last inspection? What they could do better: The home’s kitchen is now aged and despite some recent remedial work requires total replacement. The home’s communal bathrooms are looking equally aged and tired. The enamel covering to the bath on the ground floor was chipped which makes cleaning the bath more difficult. The floor covering Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 7 in the ground floor bathroom requires replacement where the finish has been damaged following installation of a new toilet. These situations have the potential to compromise the home’s infection control procedures and therefore the safety and welfare of service users. 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 summary of this inspection report can be made available in other formats on request. Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 8 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 Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12 The people who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use this service have all the information they need to make an informed decision about moving in. They can be confident that the home will meet their needs. EVIDENCE: The home has developed a written statement of purpose and service users guide that is also made available in alternative formats. Information documents ensure that any prospective service user, their family or their representatives would have enough information to make an informed choice about moving in. Information documents are regularly reviewed and updated. The registered manager stated that most service users have been living at the home since it opened nine years ago. As explained at previous inspections, no assessments were undertaken prior to people transferring from long stay hospitals at that time. The home has since undertaken their own assessments. These were evidenced in care documentation and covered topics such as self-care, household tasks, physical needs, mobility, communication, social skills, cultural needs, hearing/sight, sleeping, health needs and family contact. Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 10 The home has not had any new admissions since the last inspection. The manager explained that a prospective service user would have a full assessment of their needs in which they would be fully involved before they were offered a place at the home. There is an organisational policy on admission and discharge. The format for pre admission assessments covers people’s emotional, physical, social and psychological needs. It also addresses any cultural or specific needs they may have. If the assessment shows that the home would be able to meet the person’s needs, they would be offered a place at the home. The assessment will then be used to develop the care plan for how their identified needs would be met. Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 679 The people who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents have individual health and person centred support plans that ensure their needs and choices are clearly identified and met. They are supported to take assessed risks as part of an independent lifestyle and to make decisions in their lives wherever possible. EVIDENCE: The home’s staff team have all received Person Centered Training (PCP) and they are working towards Person Centred Active Support (PCAS) training. The manager explained that a PCAS approach to supporting people enables individuals to ‘voice’ their choices, become more independent and be included in the planning for every aspect of their life. Residents do not have verbal communication, however, they are able to inform staff of their wishes and choices through body language, gesticulation and leading staff by their hand. This was observed throughout the site visit. Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 12 Staff provide just enough support and help to allow people to experience success and to enable them to participate successfully in meaningful activities and realtionships. The staff reported that a PCAS approach to support and care promotes independence, social inclusion and gives people control over their lives. The manager stated that active support/service user involvement has now become an integral part in the day to day lives of the service users at Oakwood Road. By staff being creative and innovative, service users are now taking a greater part in all aspects of their daily life and developing new skills. Any restrictions to service users choices are managed through their personal support plans and risk assesments which are reviewed every six months and up dated regularly. They are made available in a pictorial format to service users so they or their representatives become fully involved and are kept informed of their plan of care. Risk assessments were observed to be detailed and comprehensive and to adequatly secure the individuals welfare and safety. The staff spoken with said they encourage relatives and other people who matter to the person to be involved in care planning meetings and reviews. Staff were knowledgable about service users choices, needs and views and skilled in ensuring they were being met. Each service user has a named keyworker who works closely wih them. The Avenues Trust finance policy supports people to manage their own finances as well as providing clear guidelines for staff. People living in the home have individual bank accounts, and the home securely holds small amounts of money for people living there. The home has security tags on individual moneybags held. The manager stated residents’ monies are checked at staff handover time. No survey respondents raised any concerns about the home’s management of service users finances. Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 15 16 17 The people who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users are supported to take part in the activities they enjoy and which meet their needs. People also have opportunities for personal development and are well supported to maintain contact with their family and friends. Service users are offered a healthy nutritious diet and enjoy their meals. EVIDENCE: Due to complex needs the majority of people who live in the home are not in any form of paid employment. One of the service users is however employed by the Avenues Trust as a member of the “Our Say” group. This is a service user involvement group, which meets every 2 weeks and works to improve communications and to review Avenues practices. The staff team supports the service user to attend meetings and helps the individual to express what is important to them. Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 14 Service users individual support plans indicate that they take part in activities such as shopping with staff support in the town, attending day centres, line dancing and horse and cart sessions. On the day of the inspection one service user was observed enjoying a hand and foot massage. The home has a structured weekly activity programme, which is also offered in a pictorial format for service users. Observation confirmed service users clearly choose when to be alone or in company, and when not to join in an activity. Records of all activities undertaken are being maintained in individual care plans and daily records. The home has its own transport to enable service users to access community based facilities and activities. Comprehensive risk assessments are in place in to ensure the welfare of individuals and to allow then to take assessed risks in their lifestyle. The home supports service users to maintain family links and friendships. They are regularly supported to compile and send out newsletters to relatives and relatives are encouraged by the home to visit as often as they wish. The manager said relatives always visit for birthday celebrations and at Christmas. Routines of daily living were observed to be flexible. Service users help as much as they are able with the chores around the house and people had access to all communal parts of the home, which included a large dining room/lounge area, a garden with a summerhouse and access to the kitchen with staff support. The home has a 6 weekly menu plan and there were records of meals eaten by service users to monitor the provision of a healthy diet. Service users are involved in planning the menu by the introduction of a pictorial meal planner. The menus seen were nutritious and offered both variety and choice. Food was found to be appropriately stored in the kitchen area, and records of fridge/freezer and cooking temperatures were evidenced. A senior support worker stated that no one living in the home had any specialist dietary requirements. Care staff undertakes the cooking duties. Training in food handling and food hygiene is regularly arranged for staff. The lunchtime meal was observed to be relaxed and unrushed, with staff offering support to people as and when it was required. Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 21 The people who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users receive personal support in the way they prefer and they can be confident that their health care needs will be met in full. EVIDENCE: Details of people’s preferences in respect of their personal care and support needs are clearly recorded on individual care plans. All service users moving and handling risk assessments were seen to be comprehensive and had been regularly reviewed. The home also has comprehensive health action plans for each service user and all individuals have access to a GP, dentist, dietician, optician and chiropodist to maintain good health. All service users have annual health checks. Evidence of visits by the epilepsy nurse, monthly weight checks and hearing/ sight tests were evidenced. Staff had training in epilepsy management and some staff had undertaken training in nutrition. Staff stated they are aware of the health care needs of residents, and support them when attending the GP and other medical appointments. End of life and serious illness plans are in place for some individuals. Staff are able to access care of the dying training, which includes offering support to the bereaved. Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 16 It was observed that people who live in the home are cared for and supported in a way, which they prefer. The manager said that new staff do not support service users with personal care until both parties are confident with each other. The staffing roster provides for the availability of mixed genders and skills to be on each shift. Consistency and continuity for service users who need help and support with personal care is maintained by ensuring that there is always a shift leader on duty who is a core member of the staff team and who knows service users preferences well. Staff was observed to promote service users privacy and dignity. For instance, staff was seen to knock on doors before entering bedrooms and people were spoken to respectfully. The home has a robust policy for the safe storage and administration of medication. Staff receives comprehensive training and until they have satisfactorily completed the course they are not permitted to handle medication to fully protect service users from any potential for harm. Regular competency testing of staff in relation to medication administration is undertaken and exercises are recorded. Medication administration recording sheets were sampled, they were all dated and signed by staff, there were no unexplained gaps found. Protocols are in place for ‘when required’ medication is needed; this is mainly around the pain management needs of service users. The home keeps a record of medications returned to the pharmacy, which was signed and dated by care staff and the pharmacist. There is a list of homely remedies approved by service users GP’s. Annual pharmacy audits are carried out. Risk assessments around refusal of treatment are in place and known to staff. During monthly quality assurance visits, the provider organisation includes a check on one service users medication to regularly monitor service users welfare and safety. Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 The people who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who live in the home have their views listened to and they are protected from abuse, neglect and self-harm. EVIDENCE: The home’s complaints procedure is detailed within the home’s information documents and is available in a picture and audio format to better meet the needs of the people who live in the home. Each service user is given a copy of the pictorial version of the complaints procedure. Staff said they are able to tell if service users are unhappy by their body language, and each individual had their own unique way of communicating their mood to staff. Observation indicated that people living in the home were paid attention to and were clearly understood by the staff supporting them. Some staff had known individual service users for many years. The complaints book maintained by the home evidenced there had been one minor complaint received since the last inspection. Records indicated that complaints would be responded to within the provider’s guidelines and the manager evidenced a clear awareness of procedure. The Commission are not aware of any complaints regarding this service. Recruitment procedures for new staff are robust. Prior to employment all staff receive Pova and enhanced CRB checks to fully protect service suers from any potential for harm. Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 18 Records indicated that training is provided for all staff in safeguarding adult’s issues and procedures. Staff were able to explain the concept of whistle blowing and understood their role in the event of having to instigate such an action. All staff members, inclusive of bank and agency staff are made aware of safeguarding procedures during their induction. Residents care, support plans and risk assessments are in place which comprehensively cover abuse and protection issues. Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 30 The people who use the service experience adequate outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users live in a largely comfortable and homely environment that meets their needs but would clearly benefit further from some areas of the home being refurbished and updated. Improvements to the kitchen and communal bathrooms would ensure infection control measures in the home are fully met and the potential to place residents at risk of harm is eliminated. EVIDENCE: The requirements in relation to the home’s environmental shortfalls issued following the last inspection have now been met in full. Some improvements were evidenced on this site visit. The malodour in both bathrooms on the first floor of the premises has been investigated and the situation resolved. Exposed hot water pipes in all three of the home’s communal bathrooms have been guarded and in some instances Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 20 completely boxed in to ensure service users are protected from excessive temperatures. Bath panels have been redecorated. The care office, which had previously suffered water damage to one wall and subsequent staining to the carpet, has been redecorated and the carpet replaced. The floor covering in the service users lounge and dining area has been replaced. There is a new floor covering in the entrance hall and the upstairs landing area of the home. Some new furniture and white goods have been purchased. Some areas of the home have been redecorated. The flooring in the ground floor communal bathroom was observed on this visit to need replacement. A new toilet had been fitted with a much smaller base, resulting in a gap between where the old toilet had previously been fixed and the new one. The area would be difficult to keep clean and will compromise infection control procedures in the home. The manager said she has this work in hand. The manager provided information to show that the Fire Officers recommendations to install a gate key breakpoint and update risk assessments had both been recently addressed. In the home’s main kitchen, a wall mounted cupboard door that was previously assessed as dangerously loose at the hinges has been repaired. The sealant behind the sink and wash hand basin has been replaced. A new kitchen window has been installed and a work surface repaired. Some of the home’s aged kitchen cupboards have been repaired to provide surfaces, which can be more easily cleaned. Despite this recent remedial work the home’s kitchen is aged and requires total replacement. The home’s communal bathrooms are looking equally aged and tired. The enamel covering to the bath on the ground floor was observed to be chipped which makes cleaning the bath more difficult. This situation has the potential to compromise the home’s infection control procedures and therefore the safety and welfare of service users. Following our last inspection in 2006 the registered provider, Avenues Trust forwarded an action plan with time scales, which indicated how the identified issues to the kitchen and care office were to be attended to. Although issues in relation to the care office have now been resolved, there remains slippage in timescale to fully resolve the shortfalls noted in the home’s kitchen. A housing organization owns the home. A letter seen from them and addressed to Avenues Trust states that it had not been possible to begin the necessary refurbishment work to the kitchen during the financial year 2007/08. The home will be advised if they are to be included in planned work for 2008/09. It was discussed with the manager that although this situation is noted and we, (the Commission) are aware that the provider continues to liaise with the housing association, the Registered Persons are responsible for providing a safe, wellOakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 21 maintained and comfortable environment which encourages independence for the people living in the home and demonstrates to the Commission the suitability of the premises for the provision of service. The Registered Persons must work closely with the housing organisation to resolve outstanding refurbishment work to the benefit of the people who live in the home and to fully discharge their regulatory duty. Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32 34 35 The people who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from a competent and qualified staff team who understand their roles and responsibilities. They are further protected by the home’s robust recruitment practices. EVIDENCE: Staff spoken with evidenced a comprehensive understanding of service users needs and preferences. Throughout the site visit they were observed to be skilled in practice, respectful and caring towards the service users. The Avenues Trust has a rolling training programme. Mandatory training is planned and undertaken by all staff. The manager confirmed that the home exceeds the 50 standard for NVQ qualified staff which is to the benefit of service users. The manager stated that as a NVQ internal verifier and assessor she actively promotes NVQ standards and encourages staff to undertake a qualification, which most of her team have already achieved or were busy working towards. Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 23 New staff are subject to a 6 monthly probation periood. During this time they receive structured induction and fundation training. This is supervised by the manager. The induction checklist reflects Skills for Care competency elements. There was sufficient staff on duty to meet the needs of the service users on the day of the visit. The home has a full compliment of 9 full time and two part time staff. The duty rota was viewed and evidenced a minimum of three members of staff on duty each shift. With one waking night staff. There are clear lines of accountability in the home and staff are aware of the demands of their role and the providers expectations of them. The Avenues Trust maintains recruitment files at their head office; this was in agreement with the Commissions Provider Relationship Manager. Evidence kept in the home indicates robust recrutiment procedures for the protection of service users. All staff found to be appointable are required to have at least two satisfactory references and all gaps in employment are explored. They must be POVA checked prior to employment and also have a satisfactory enhanced CRB check. All staff have a copy of the code of conduct.and the practises set by the GSCC available to them. Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 42 The people who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from having a person in charge that provides clear leadership, is qualified and competent and whose aim is to consistently improve and develop the service and outcomes for people who live in the home. EVIDENCE: The manager, Karen Wilcox was registered with the Commission in April 2007. She has worked at a senior level in the field of learning disability for the last six years. She has obtained a NVQ Level Four in Management and the Registered Managers Award. Additionally she holds a Level Four V1 in conducting internal Quality Assurance. She is also an NVQ Assessor and Internal Verifier. Karen is aware of her strengths and weaknesses and Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 25 evidenced throughout the visit her commitment in providing a high quality service at Oakwood Road for the benefit of the people who live there. The home has quality assurance monitoring systems in place. Monthly regulation 26 visits are conducted; the most recent report was viewed. There was evidence of minutes taken at monthly staff meetings. Due to the low levels and complex needs of the service uses it is not possible to have residents meetings at this home. To ensure the service users rights and best interests are safeguarded, annual surveys are undertaken to ascertain the views of families, relatives, advocates and other professional visitors. The contents of returned questionnaires indicated high levels of satisfaction with the standards of care provided at the home. Pre inspection survey responses returned to us, the Commission equally indicated that the home is being managed in a way that shows it has the best interests of the people living there at heart and puts them at the centre of what they do. Policies, procedures and systems were in place to ensure safe working practices. Risk assessments were carried out and recorded for all safe working practice topics. Fire risk assessments were in place for the home. The Fire Officers recent recommendations to install a gate key breakpoint and update risk assessments had been addressed. The nominated support worker responsible for health and safety in the home undertakes monthly checks. The Avenues health and safety adviser conducts an annual Health and Safety audit. The report of their audit for 15th January 2008 was viewed. This equally noted that the kitchen work surfaces and cupboards would not pass an EHO inspection, with the added note that ‘some areas were blown and the kitchen needed replacement’. This document would have been shared with senior managers within The Avenues Trust. It was discussed with the manager that the registered persons must work closely with the housing organisation that owns the home to resolve outstanding refurbishment work. The home must evidence the maintenance of a safe environment for the benefit of the people who live there and to fully discharge their regulatory duty. It is the responsibility of the provider to demonstrate to the Commission the suitability of the premises for service provision, as reflected in the home’s Statement of Purpose. Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 26 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 X 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 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 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 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X X 2 X Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 27 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. 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 YA30 YA24 YA42 Good Practice Recommendations The registered provider is recommended to fulfil the stated intention of replacing the flooring in the ground floor communal bathroom. The Registered Persons are strongly recommended to fulfil their stated intention of working closely with the housing organisation that owns the home to resolve outstanding refurbishment work. Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 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 © 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 Oakwood Road (56) DS0000013521.V359391.R01.S.doc Version 5.2 Page 29 - 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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