Care Home: Oak House

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What the care home does well Oak House provides a homely and safe environment for the people who live there. People who use the service told us they `chose to live here`, `live with my friends` and said that they are happy. We saw some good relationships between staff and people who use the service. There is good information about the services provided in accessible formats. The organisation has a clear complaints procedure and people who use the service told us they are aware how to make a complaint. Staff said they have the training and support to carry out their role. What has improved since the last inspection? Medication Administration Record Sheets are clear and easy to understand with medication profiles up to date, ensuring staff have the right information to meet peoples health needs. Staff have completed training in safeguarding vulnerable adults and have had refresher core training, to keep them up to date and enable them to provide good quality of care. The bathroom has been refurbished, making the environment better for the people who live there. The portable electrical appliances and fire extinguishers have been tested every year, to ensure people who use the service, staff and visitors are safe. These issues were requirements at the last inspection. What the care home could do better: The plans for the future of the service should continue to be discussed with the people who use the service and their representatives. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Oak House 1 Draycot Road Surbiton Surrey KT6 7BL     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: Emma Dove     Date: 2 9 0 7 2 0 0 9 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 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2010) 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Oak House 1 Draycot Road Surbiton Surrey KT6 7BL 02083908206 02082871950 richard@thefircrofttrust.org 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) : The Fircroft Trust care home 3 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 3 Oak House is a care home providing accommodation for three adults with learning disabilities. It is located in a residential road close to facilities in Tolworth and Surbiton. Local bus and train routes are available nearby. The service is managed by The Fircroft Trust, who have three similar services in the local area. Information about Oak House is available in a detailed Statement of Purpose and easy to read Service User Guide. Fees are £627.14 per week. Care Homes for Adults (18-65 years) Page 4 of 26 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 unannounced inspection was carried out over three hours on the 29th July 2009 by one regulation inspector. We spoke with people who use the service and staff and looked at records. We received the annual quality assurance assessment (AQAA) from the manager when we asked for it. This contained good information about the service, what it does well and areas they plan to develop over the next year. We looked at other information received from the service since the last inspection in July 2007. Care Homes for Adults (18-65 years) Page 5 of 26 Care Homes for Adults (18-65 years) Page 6 of 26 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 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 26 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. The service understands the importance of having accessible information when choosing a care home. The Statement of Purpose and Service Users Guide detail the services and facilities available and give people information about the organisation. Assessments are completed before admission. Evidence: People who use the service told us they chose to move into the home and are happy living here. The manager told us they have good information for people looking to move into the home. We saw the service has developed information in accessible formats, telling people about the services provided, staff and facilities available. The manager told us that new people are invited to visit and meet other people using the service and staff before deciding to move in. People who use the service confirmed that they had visited before they moved in. We saw assessments completed before people move in, ensuring the service is Care Homes for Adults (18-65 years) Page 9 of 26 Evidence: appropriate to meet the individuals needs. Care Homes for Adults (18-65 years) Page 10 of 26 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. The service involves individuals in the care planning process and ensures documents and information is available in accessible formats. The service is person centred and individuals are involved in the day to day running of the home. Risk assessments are completed and kept under review. Evidence: The manager told us all people who use the service have a care plan which is available in an accessible format. People who use the service confirmed that they meet with their keyworker regularly. We saw clear care plans which are person centred, developed from assessments and kept up to date with any changes in need. Details of how care and support should be completed are included in the care plan. Keyworkers meet with people each month and complete a report which includes details of the individuals health, leisure activities, communication, any achievements and their feedback on the service. These reports are used to keep the manager informed of changes and to prepare for annual reviews. Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: We saw risk assessments which include any areas of risk and how to minimise risks for individuals. People who use the service understand why risk assessments are completed and dont feel they miss out on activities or outings to keep themselves safe. Care Homes for Adults (18-65 years) Page 12 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a strong commitment to enabling people to develop and maintain their skills around social, emotional, communication and independent living skills. People who use the service have the opportunity to maintain and develop important personal and family relationships. People are involved in activites during the day and are members of different clubs and groups depending on their wishes and choice. People access local community facilities and are a part of the community. People who use the service are involved in the domestic routines of the home, including shopping, cooking and cleaning. Evidence: The manager told us that the service has good staff ratios which means they are able to offer the people who live there a flexible service. People told us they go out to day centres, clubs, groups and football and said I do what I want. People told us they can Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: have visitors and go to see friends and family. The manager told us they have applied for buddies/befrienders for people who use the service, to provide more individual support and ensure peoples individual needs are met. The manager said an area they could improve is looking for more different activities to meet peoples needs. We saw a varied menu which takes into account any dietary needs and individuals preferences. People told us they like the food and being involved in food preparation and clearing away. Care Homes for Adults (18-65 years) Page 14 of 26 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. Personal care is provided using a person centred approach, taking into account peoples privacy, dignity and preferences. The service is responsive to peoples health needs and individuals have access to community and specialist health professionals. Medication is well managed. Evidence: The manager said they deal appropriately with peoples health issues, ensuring individuals have access to health care professionals as required. People who use the service confirmed that staff are available to support them to attend health appointments. We saw case files contain details of individuals health needs including any assistance or support they require, with this information updated when any changes occur. We saw medication appropriately stored and records up to date and signed by staff. The manager told us they do a weekly audit of medication, which would identify any issues quickly. Staff are aware of the importance of individuals medication and have Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: completed training in medication administration. Medication profiles are in place and are updated when required. The manager told us they have worked with people who use the service and their representatives to find out their wishes regarding terminal care and death, which are recorded. Care Homes for Adults (18-65 years) Page 16 of 26 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. The service has an open culture, giving people who use the service a number of opportunities to comment on the quality of the service and raise any concerns or complaints. The complaints procedure is accessible to people who use the service and their representatives. Staff complete training in safeguarding vulnerable adults and are aware of their responsibilities. Evidence: The organisation has appropriate complaints procedures, which are accessible to the people who use the service. People confirmed that they would speak with the manager, their keyworker or family members if they had any worries or concerns, although they said they have not needed to make a complaint. The manager said they have not received any complaints during the last year. The commission has not received any concerns about the service in the last year. The service uses the local authorities safeguarding policy. The manager told us staff have completed training in safeguarding. Staff confirmed that they have completed safeguarding training since the last inspection. Care Homes for Adults (18-65 years) Page 17 of 26 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 provides a physical environment that is appropriate to the needs of the people who live there. The home is in a good standard of repair and redecoration. Bedrooms are single and there is a bathroom and toilet, which is sufficient for the number of people who live there. Evidence: The manager told us that due to the planned closure of the home in the future, they do not intend to do any work to the environment, although they will make all repairs required for health and safety reasons. People who use the service have access to a lounge with sofa, armchairs and a television, a kitchen and conservatory with dining table and chairs. We saw bedrooms are single and have been personalised to individuals taste. People told us I have all I need in my room and I like my room. We saw that the bathroom has been refurbished which provides a better environment for the people who live there. All areas of the home were clean and fresh. Care Homes for Adults (18-65 years) Page 18 of 26 Care Homes for Adults (18-65 years) Page 19 of 26 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 have confidence in the staff who care for them. Staffing levels are sufficient to meet the needs of the people who live there. The organisation has good staff recruitment policies and practices. Staff have access to relevant and appropriate training to help them carry out their role. Staff receive regular supervision. Evidence: We saw enough staff to meet the needs of the people who use the service with one member of staff on duty during the day and asleep but on call at the home at night. People who use the service and staff said there are enough staff to meet peoples needs. Staff said they had the appropriate checks before they started work. Staff files were seen at a previous inspection and showed all the required checks had been completed. The manager told us the organisation has a training programme which is accessible to all staff and includes core training. All staff have updated their core training since the last inspection. Staff said they have opportunities to complete training with one member of staff recently completing NVQ to level 3 and one member of staff has started NVQ at level 2. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: Staff said they receive supervision and support to carry out their job. There are weekly staff meetings. Care Homes for Adults (18-65 years) Page 21 of 26 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 manager has the knowledge and experience to run the home and is fully involved in the organisations strategic planning. Good systems are in place to monitor the quality of care provided. The annual quality assurance assessment contains clear and relevant information which lets us know about changes they have made and any improvements still being worked through. Health and safety is well managed. Evidence: The manager has been at the home for a number of years and has the knowledge and experience needed. The manager is registered with the Commission to manage this small home, another small home and a larger home owned by the organisation, all within a short drive from each other. There is a team leader who manages the home on a day to day basis and reports to the registered manager daily or weekly as required. The service has an annual development plan and a business plan, the manager told us these are being worked to. There are regular meetings which give people who use the Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: service the opportunity to raise any issues, make suggestions and be involved in planning for the future. A representative from the organisation visits every month and asks people about the care and support they receive, checks some records and speaks with staff then writes a report with any comments or areas to be addressed. We saw health and safety checks completed at the required times. Care Homes for Adults (18-65 years) Page 23 of 26 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 24 of 26 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 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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 © (2010) 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 26 of 26 - 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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