Care Home: Oak House

What the care home does well What has improved since the last inspection? Improvements to the environment are continually being carried out to ensure that the premises are kept up to the required standards. Staff personnel files inspected on this occasion contained the necessary documents and evidences that a robust recruitment procedure is operational to ensure the safety of the people using the service. What the care home could do better: Procedures and processes are in place to monitor the provision of the service on a continual basis with action taken when room for improvements are identified. The home continues to provide good outcomes for people in residence. CARE HOME ADULTS 18-65 Oak House 46-50 Lysways Street Chuckery Walsall West Midlands WS1 3AQ Lead Inspector Joy Hoelzel Key Unannounced Inspection 11th December 2007 10:00 Oak House DS0000020831.V353331.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 Oak House DS0000020831.V353331.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. Oak House DS0000020831.V353331.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oak House Address 46-50 Lysways Street Chuckery Walsall West Midlands WS1 3AQ 01922 720118 01922 722781 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) Caldmore Area Housing Association Limited Ms Julie Wakefield Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12) of places Oak House DS0000020831.V353331.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th December 2006 Brief Description of the Service: Oak House provides residential accommodation for 12 adults who have a mental disorder. The home aims to assist its service users to live independently in the community. Service users and staff at the home have close links with the mental health multi disciplinary team. The accommodation at Oak house is over three floors and there is no lift. All bedrooms are single and three have an en suite facility. There is one bed-sit, with a kitchen area. There are ample communal areas, including a conservatory. To the rear there is a large, well-tended garden. Information of the home and the provision of the service are available in the statement of purpose and service user guide, both documents have been revised and are readily available. Information on the current level of weekly fees is available directly from the home. Commission for Social Care Inspection reports for this service are available from the provider or can be obtained from www.csci.org.uk Oak House DS0000020831.V353331.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over four hours on Tuesday 11th December 2007. It was conducted by one Commission for Social Care Inspection regulation inspector. Twenty three of the forty three standards of the National Minimum Standards for Care Homes for Adults (18-65) were inspected as they are viewed as key standards for services. Ten people are currently living at the home and during the inspection were engaged in various activities. The registered manager was on the premises supported by a team leader, two support workers and a housekeeper. A look around the home took place, which included a number of bedrooms as well as communal areas. The care documents of a number of people using the service were viewed including care plans (support plans), daily records and risk assessments. Other documents seen included medication records, service records, some policies and procedures and staffing records. Discussions were held with people living and working at the home. Prior to this inspection an Annual Quality Assurance Assessment (AQAA) document was posted to the home for completion. The AQAA is a selfassessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for providers to share with us areas that they believe they are doing well. It is a legal requirement that the AQAA is completed and returned to us within a given timescale. The registered manager completed this document and comments from the AQAA are included within this inspection report. What the service does well: Information on the service is provided in a statement of purpose and service user guide, both documents have been recently reviewed and are readily available. A robust admission procedure is operational ensuring the home is suitable for the individual and that the assessed needs of the person can be fully met. Oak House DS0000020831.V353331.R01.S.doc Version 5.2 Page 6 The support plans (care plans) are based on an individuals needs, agreed and reviewed with the person, multi disciplinary teams and/or their representative whenever possible and are based on a person centred approach. Numerous leisure and recreational activities are available to suit individual preferences. The home has a robust complaints procedure that is displayed at the home and is readily available. The home is comfortable, warm, and homely. The manager and staff demonstrated a good in depth knowledge of the client group and the dilemmas associated with mental ill health. People commented ‘Best thing about the home – took away a lot of the stress’ ‘ Fully involved with the care planning process, staff are very good very laid back and helpful’, ‘Feel very comfortable here’. What has improved since the last inspection? 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 summary of this inspection report can Oak House DS0000020831.V353331.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. Oak House DS0000020831.V353331.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 Oak House DS0000020831.V353331.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): YA 1, 2 Quality in this outcome area is excellent. The pre admission needs assessment focuses on achieving positive outcomes for people and before agreeing admission the service carefully considers the needs of each individual prospective person and the capacity of the home to meet their needs. Prospective people who use services are given the opportunity to spend time in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Details of the service provision are available in the statement of purpose and service user guide; both documents have been reviewed in February 2007, and are available on request. The home has adopted a robust admission procedure for all prospective clients with many multi agency meetings and discussions arranged to ensure that the home is able to fully meet a persons needs and to ensure the suitability of the placement for the person. People are encouraged to stay at the home on several occasions to get a taste of life at the home. Oak House DS0000020831.V353331.R01.S.doc Version 5.2 Page 10 One person recently moving into the home described the many meetings and visits to the home before being offered and accepting the placement and stated ‘I am very well settled, I like it here, can do what I want when I want to do it’. Oak House DS0000020831.V353331.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): YA 6,7,9, Quality in this outcome area is excellent. The care plan is developed with, and owned by, the individual, based on a full and up to date holistic assessment. The plan is person centred and focuses on the individual’s strengths and personal preferences. It includes a persons life experiences and sets out in detail how all their current requirements and aspirations are to be met through positive individualised support. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All people living at the home have a support plan (care plan) that is developed and reviewed with the full involvement of the person and any other interested relevant party i.e. social worker, relative etc. The persons consent is always sought for the inclusion of other people in the support programme process. Oak House DS0000020831.V353331.R01.S.doc Version 5.2 Page 12 One person confirmed – ‘I am fully involved with the care planning process’ And went on to discuss the recent discussions held with the key worker regarding administering medication with an agreement being reached. This assessment and recording of the process was documented in the support plan. The plan is based on the person centred approach and includes the persons aspirations and what is to be achieved, mental and physical well being and crisis and intervention plans. Clients are fully consulted and take an active part in the day-to-day life and running of the home and are fully supported by the staff with decision making. Risk assessments are carried out for any identified or potential hazards and the action need to reduce the risk discussed, agreed with the person and recorded in the support plan. One person commented – ‘Very well settled like it here can do what I want when I want to do it’. The AQAA completed by the manager indicates the improvement made during the last twelve months in the care planning and assessment processes with imminent plans to complete a ‘participatory appraisal’ and to implement the findings. Oak House DS0000020831.V353331.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): YA 12,13,15,16,17 Quality in this outcome area is good. The service has a strong commitment to enabling people who use services to develop their skills, including social, emotional, communication, and independent living skills. Individuals are supported to identify their goals, and work to achieve them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A member of staff has the responsibility of coordinating and organising leisure, recreational and social activities based on the individual preferences of the clients. Activities are numerous with lots of individual and group functions to suit the individual. Sometimes staff are involved in the community based activities at other times they are not. One staff member explained that because good relationships Oak House DS0000020831.V353331.R01.S.doc Version 5.2 Page 14 have been developed between the staff and clients there are opportunities to go out socially on many occasions. Regular visits are made to the local drop in centres, one person attends the men’s and sports groups each week, others attend for support with numeracy and literacy. Other further educational and vocational opportunities are facilitated when required. The AQAA completed by the manager confirms that one person is being supported to undertake a university degree course with another person looking for volunteer work. A green house was purchased this year with people endeavouring to grow their own vegetables the manager discussed the plan to start preparations earlier next year and discussed the site of the proposed vegetable patch in the garden. Clients are fully consulted in all aspects of the home, including any additional equipment that is needed, the colour and decoration of their private rooms as well as the communal areas. Discussions are currently ongoing as to the redecoration and colour scheme of the hall stairs and landing. People plan and prepare their own lunch at the home with varying degrees of support and guidance from the staff. The main meal during the week in served in the evening and is prepared and served by the staff. Two people stated they were satisfied with this arrangement with one person commenting ‘ I prepare my own lunch each weekday go shopping for groceries then the staff support and assist me with cooking the meal’. Currently the training kitchen is being refurbished and being fitted with domestic cooking and laundry equipment. When completed clients will have further opportunities to develop their skills in this area. Oak House DS0000020831.V353331.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): YA 18,19,20 Quality in this outcome area is excellent. People who use services receive effective personal and healthcare support using a person centred approach, the individual plans clearly record their needs and detail how they will be delivered. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Personal support if offered following assessments and when needed as part of the rehabilitation programme. A key worker system is in operation to ensure that people are supported with a consistent approach. One person stated that they were satisfied with their key worker and found them to be very ‘ helpful and understanding’. People’s healthcare needs are very well met with plenty of input from other professionals, GP, Psychiatrists, community psychiatric nurses and social workers. The support plans document this multi disciplinary approach. Oak House DS0000020831.V353331.R01.S.doc Version 5.2 Page 16 One person had previously lived in another area of the county and was being supported with registering with a local GP to ensure that his medical needs would continue to be met. Inspection of medicine storage and administration records, demonstrated the home’s practices meet the guidelines of the Royal Pharmaceutical Society. The staff demonstrated a good knowledge and competence of medication procedures and discussed the recent improvements made to ensuring the accuracy of the procedures. Following an assessment some clients are supported and assisted to self medicate and are provided with a lockable space in their private rooms for safe storage. One person has a history of non-compliance of medication previously resulting in deterioration of their mental health. It is documented in the support plan that following discussion and agreement, the staff will administer the medication for the time being. This person discussed this and confirmed their full agreement with this decision. Oak House DS0000020831.V353331.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): YA 22,23, Quality in this outcome area is good. The home has an open culture that allows clients to express their views, and concerns in a safe and understanding environment, the complaints procedure is supplied to everyone living at the home and is displayed in a number of areas within the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The concerns and complaints procedures are included in the statement of purpose and service user guide and a copy is displayed on the notice board in the home. The AQAA completed by the manager indicates that the complaint procedure is included in the induction programme of the home, with numerous opportunities for formal and informal discussions with the staff and/or members of the multi agency teams. Since the inspection in December 2006 the home has received one complaint. A full investigation into the concerns was conducted by the Head of Services and was referred to the safeguarding adults team for advice and guidance. The manager discussed the concern and stated that although a satisfactory conclusion is yet to be reached arrangements are in place for safeguarding Oak House DS0000020831.V353331.R01.S.doc Version 5.2 Page 18 vulnerable people. Of the ten permanent members of staff, eight have received recent training in adult protection and awareness. The home offers a facility for residents to deposit personal monies for safekeeping; records relating to this have been maintained and fully receipted. Oak House DS0000020831.V353331.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): YA 24,30 Quality in this outcome area is good. The home provides a physical environment that is appropriate to the specific needs of the people who live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well maintained with a rolling programme for the redecoration and refurbishment of the premises. The manager discussed the recent improvements and the plan for further improving the facilities. The main kitchen was fully redecorated and refitted with new equipment two months ago. Work is ongoing with refitting the training kitchen and people are being consulted on the colour scheme for the hall stairs and landing. Oak House DS0000020831.V353331.R01.S.doc Version 5.2 Page 20 The lounge has recently been redecorated with plans during the next financial year for the dining room and smoke room to be redecorated. The premises are not suitable for anyone with a physical disability, with no lift to access the rooms above ground floor level and narrow staircases and corridors. The statement of purpose and service user guide clearly document this information. During the tour of the premises a selection of the private areas were seen and were all very individualised and contained many personal belongings. One person stated that they were ‘Very satisfied with the accommodation’ And confirmed they had very recently been involved with choosing the colour scheme for the redecoration of the room. At the time of the inspection all areas of the home were spotlessly clean; the staff responsible for the household cleaning must be commended on maintaining such high standards. A domestic style laundry is provided where clients attend to their own laundry with support from the staff when needed. Oak House DS0000020831.V353331.R01.S.doc Version 5.2 Page 21 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): YA 32,34,35 Quality in this outcome area is good. The service ensures that all staff receives relevant training to ensure they are skilled, competent and focussed on delivering good outcomes for people using the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager and team leader demonstrated an in depth knowledge of the client group and the challenges that are associated with mental ill health. Other staff spoken with also had a good understanding of the clients’ individual needs. One person living at the home stated ‘The staff are very good, very laid back and helpful’ A training programme has been developed to ensure that all staff receive the training required in the core and specialist topic areas. Oak House DS0000020831.V353331.R01.S.doc Version 5.2 Page 22 The AQAA completed by the manager indicates that all staff are trained at National Vocational Qualification level 3 or are working towards it. Student nurse and trainee social workers placements continue throughout the year. A student nurse made the following comment after completing a ten-week placement ‘ Overall it has been a very valuable and positive placement’. Two staff personnel files were looked at; the records examined showed they contained all the necessary information, which demonstrates potential staff are well screened before they are deemed suitable to start work at the home. Certificates and accreditations of training are included in the files. Oak House DS0000020831.V353331.R01.S.doc Version 5.2 Page 23 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): YA 37,39,42 Quality in this outcome area is excellent. The manager communicates a clear sense of direction, is able to evidence a sound understanding and application of ‘best practice’ operational systems, particularly in relation to continuous improvement, customer satisfaction, and quality assurance. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Julie Wakefield has been the registered manager of the home for a period of time and throughout this inspection demonstrated a sound knowledge of the individual care needs of the people living at the home and is providing Oak House DS0000020831.V353331.R01.S.doc Version 5.2 Page 24 direction and leadership which staff and clients understand and relates to the aims and purpose of the home. Ms Wakefield has undertaken periodic training to update and maintain her skills and knowledge and has accreditation of National Vocational Qualification level 4 and the Registered Managers Award. Quality assurance of the service continues with satisfaction surveys, regular audits and monthly visits by the area manager with reports produced. Regular staff and client meetings are held together with numerous opportunities for informal discussions and chats. All documents, client, management and business records are very well organised, kept secure and are up to date. Weekly, monthly and annual testing of the equipment and premises are conducted with records kept and readily available for inspection. The fire risk assessment for the premises was reviewed in January 2007. Oak House DS0000020831.V353331.R01.S.doc Version 5.2 Page 25 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 4 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 3 25 X 26 X 27 X 28 X 29 X 30 4 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 4 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 4 3 x 4 X 4 X X 3 x Oak House DS0000020831.V353331.R01.S.doc Version 5.2 Page 26 No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Oak House DS0000020831.V353331.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Oak House DS0000020831.V353331.R01.S.doc Version 5.2 Page 28 - 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. 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