Care Home: Oak House

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What the care home does well People`s needs are assessed and recorded in their personal files. In some cases these documents are written by the person themselves with staff support. People living in the home commented, "staff are nice", and "they are always there if I need them" Activities are recorded in daily diary notes. Comments from people during the day included "we go out a lot". People have choice about what they eat and commented about how nice the food is. People`s medication is managed by trained staff and minimises the risk of medication errors. The home is maintained to a high standard. Comments from relatives of people living in the home were very positive and included "Oak house is absolutely wonderful, a caring home". What has improved since the last inspection? The management team have continued to review their practices with the aim of enabling people living in the home to have more choices about their day-today lives. What the care home could do better: The home must ensure that care documents are reviewed within the timescales dictated by their own procedures. CARE HOME ADULTS 18-65 Oak House Newland Nr Coleford Glos GL16 8NJ Lead Inspector Mr Paul Chapman Key Unannounced Inspection 5th December 2007 09:00 Oak House DS0000016516.V344814.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 DS0000016516.V344814.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 DS0000016516.V344814.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oak House Address Newland Nr Coleford Glos GL16 8NJ 01594 832218 01594 810374 oakhousetrustltd@aol.com 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) Oak House Trust Limited Mr Stephen Horne Care Home 16 Category(ies) of Learning disability (16), Learning disability over registration, with number 65 years of age (3), Sensory Impairment over of places 65 years of age (1) Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st November 2006 Brief Description of the Service: Oak House is a large detached property in the village of Newland, near Coleford. The home is registered to provide accommodation for up to 16 adults with learning disabilities; currently there are 12 male residents. The home has extensive grounds with grassed areas, vegetable plots and outbuildings. The service users are extensively involved in the up keep of the garden and growing vegetables. In addition to this they also make birdhouses and other similar items in the workshops. The home is staffed at all times. There are domestic and care staff. The manager and his family live in flats in the property and provide the majority of the care. The registered manager was present throughout the inspection. One of the registered manager’s sons is the deputy manager. Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. This site visit was completed over a period of 8.5 hours on a day in December 2007. We arrived as people were finishing breakfast and were invited to join them for a cup of tea. After breakfast people started to get ready for their day. It had been arranged that people were going Christmas shopping in 2 small groups with a members of staff. Others left at home were going to spend time wrapping presents and writing cards. Looking around the home with the manager showed that it continues to be maintained to a high standard throughout. People’s bedrooms were seen to be nicely decorated, there is a continuing programme of redecoration with a number of areas being decorated since the previous site visit. The morning was spent with a couple of people explaining their assessments, care plans and care files. This confirmed that they were involved in the process throughout, working with staff, and other professionals to identify their needs and develop guidelines to ensure that the care they receive is consistent. Everyone ate lunch together and people confirmed that they were able to choose what they wanted to eat. Snacks are available between meals. The afternoon was spent speaking with the management team and examining documentation including; finances, training and health and safety records. Observations throughout the day showed that people living at the home were treated with respect and dignity. Comments from people were positive about the relationships they have with the staff. This is a unique setting in that the majority of the people living at the home have lived there for over 15 years, some over 30 years. Throughout this time the manager has been involved with peoples care. What the service does well: Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 6 People’s needs are assessed and recorded in their personal files. In some cases these documents are written by the person themselves with staff support. People living in the home commented, “staff are nice”, and “they are always there if I need them” Activities are recorded in daily diary notes. Comments from people during the day included “we go out a lot”. People have choice about what they eat and commented about how nice the food is. People’s medication is managed by trained staff and minimises the risk of medication errors. The home is maintained to a high standard. Comments from relatives of people living in the home were very positive and included “Oak house is absolutely wonderful, a caring home”. 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 be made available in other formats on request. Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has an admissions procedure which is robust and would promote a consistent approach by staff when completing a potential admission to the home. Once the home’s Service User Guide has been updated it will provide people with an accurate description of the service being provided at the home. This will help people make an informed choice as part of the admission process. EVIDENCE: There have been no admissions to the home since the previous inspection was completed. The home has an admissions policy that would hopefully ensure a consistent approach by staff when a person has been referred for a potential admission. Examination of the policy showed it to be robust. It is impossible to judge how effective the admission process is as it has not been used. The Annual Quality Assurance Assessment (AQAA) completed by the home highlights that they wish to increase the number of people living at the home, and that this will test admission procedures. Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 9 The home has a Service User’s Guide. The deputy manager stated that he intends to review the document in January ‘08, as currently it does not accurately reflect the service provided in the home. Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 10 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): 6, 7, 9 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Each of the files examined contained care plans that were person centred and enabled staff to meet people’s needs consistently. People are supported to make decisions about their lives with the support of staff where it is required. Activities, menus and diaries provided evidence of people being involved in all aspects of life in the home. Risks are assessed by trained staff and minimise the risks to people whilst they are completing activities. EVIDENCE: Three people spent time with the inspector explaining their care packages. All of the care packages examined were developed from the management team completing needs assessments for each person. From speaking to each person it was clear that all three people were involved in completing their assessments and the subsequent care plans. The assessments and care plans cover the following topics: Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 11 • • • • • • • • • • • • Personal care and physical well-being Communication Mobility and dexterity Personal safety and risk assessment Medical history Medication Mental and cognitive ability Diet and weight Food and meal times Dental and foot care Religious observance Daily living and social activities Each of these areas had been looked at individually with the person supported by staff. Some areas had been completed by the person rather than the staff. The majority of the staff team have worked with the people living in the home for a number of years, and therefore know each person very well. Observations throughout the site visit supported this. The completed assessments and care plans provide the staff team with extensive written knowledge that enables them to provide a consistent service to each person that meets their individual needs. Each of the people spoken with felt that their needs were met by the staff. Examination of the review documents showed that the aim was to review people’s care plans 6 monthly, the management team stated this at the previous site visit. The plans examined had been reviewed once in the previous 12 months with the most recent review being missed. It becomes a good practice recommendation that the management team ensure that reviews are completed 6 monthly. To support people to learn new skills the staff complete teaching plans. This is good practice and provides clear steps that staff should follow to help the person achieve their goal. A recommendation of this inspection report is that when staff are developing the plans that objectives could be simpler and the steps to get there could be clearer. From speaking with 5 people during the day it is clear that people are supported to make decisions about their lives. People commented, “I am able to choose what I want to do”. The manager must ensure that where staff support people to make decisions this is recorded. This becomes a good practice recommendation of this inspection report. Appropriately trained members of staff assess risks. The risk assessments seen were detailed and enabled people to take risks while achieving their goals. A good practice recommendation of this inspection report would be for the staff to review the risk assessments presently in place and then look at the areas of people’s lives that have not been assessed as yet. Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 12 The deputy manager stated that in the New Year they are going to archive the information in people’s files. This is a good idea and will make the files easier to use. At present all of the files contain a large number of documents that stretch back a number of years. All documents are stored securely in the home’s office. Speaking to people they confirmed they could have access when they wished. The AQAA states that over the next 12 months the home will continue to develop all areas of reporting and record keeping within the care planning system. Oak House DS0000016516.V344814.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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home decide what activities and trips they would like to do and staff provide support enabling them to complete these activities. People’s religious needs are assessed and respected by the staff. People are supported by the staff to maintain their links with family and friends outside the home. People are able to choose what they want to eat and all commented about how nice it was. EVIDENCE: Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 14 One person attends a local day service. Everyone living in the home has been given the opportunity to attend day services/college. The main activity at the home is gardening and people take great pride in areas that they are responsible for. The manager explained that it has been a bad year for vegetables due to the weather. A wide range of plants are grown including vegetables and flowers. The home has spent the previous 12 months moving plants to allow a “poly tunnel” to be built, this has now been completed and in future people will be able to grow plants from seed. The AQAA states that over the next 12 months the home intends to revisit opportunities for people at local colleges and other centres. 5 people spoke about activities they had been involved in outside the home. On the day of the site visit staff took 2 small groups out to do their Christmas shopping. 1 person writes their own daily diary about the activities they are involved in, and places they have visited. Going through the diary with them it showed they go shopping locally regularly, going out for lunch, visiting garden centres, Cotswold Wildlife Park, Westonbirt Arboretum, ten pin bowling and the cinema. A number of these activities were 1 to 1 with a member of staff. The manager explained that in the New Year they will be converting 1 of the outbuildings to an art studio. The manager has arranged for an art tutor to visit regularly once the studio has been finished. At present some people make bird boxes in 1 of the workshops. These are then donated to the local falconry centre. The home has an activity room that has been re-decorated recently. This room has a stereo, TV, DVD player and games computer. In addition to this people can play darts and do some art work if they wish. 1 person explained to us that he and a few others have formed a “gentleman’s club” that meets in the activity room to listen to music and watch films. On the day of this site visit 1 person was making Christmas present tags. The notice board in the activity room showed a number of activities planned for December, these included a musician visiting for an evening, a skittle night at a local pub, a visit to the falconry centre, a train trip and an evening of ten pin bowling. Some people attend the local church regularly. Regular meetings are held between all of the people living in the home. In these meetings they discuss activities they would like to complete and any other important issues. The meeting is run by the people living in the home who also write up the minutes. All of the people spoken with agreed that their friends and family were free to visit when they wished. A couple of people explained that they had been on holiday to their families. Comments from relatives are all very positive about their visits to the home and the care provided to people living at the home. Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 15 The home makes good use of the vegetables grown in the garden. People living at the home choose the menus. Everyone spoken with about the menus agreed that they have choice and the “food is lovely”. The way in which menus are chosen have changed since the previous inspection. People are now asked each day what they would like for the next day. They are given 3 or 4 choices. The home has a dedicated cook that prepares all of the meals. On arrival at the home people were tucking into breakfasts. People take it in turns to complete chores such as laying the tables and clearing them. A concern of previous inspections has been people’s access to snacks in between meals. There is a snack cupboard by the laundry, when seen at this site visit it contained drinks, crisps, biscuits and other snacks. Observations throughout the day showed that people were using it. All of the people spoken with agreed that snacks were available when they wanted them. Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 16 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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s personal care needs are assessed and guidelines for staff to follow are available to minimise the risk of peoples needs not being met consistently. The home makes good use of other professionals to meet people’s needs where it is identified that they cannot. Risks to people living in the home are minimised through staff completing medication training and records being managed correctly. EVIDENCE: All of the files examined contained plans of how people wished to receive their personal care. The manager makes good use of other professionals to meet people’s needs. A lot of the assessments have been completed with the support of staff from the Forest of Dean Community Learning Disability Team. One health assessment Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 17 had been completed with the person, by staff from the home with the support of a physiotherapist and Community Nurse. The CSCI received a completed survey from a senior healthcare professional involved in the home who stated “the manager and deputy are keen to learn” and “people’s needs are met”. Medication administration is being managed correctly. The manager stated that they have just attended some pharmacy training around medication management. In addition to this training the manager and deputy have received training in administering buccal medazolam. It is a good practice recommendation that the manager obtains a copy of the 2008 BNF (British national Formulae). The AQAA states that the home intends to complete a review of assessments for people that self-medicate. This is a good practice. Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 18 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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Comments received during the day show that people feel able to talk to staff if they are unhappy and they feel that their comments are acted upon. The complaints procedure has been produced in a user-friendly format to enable all people with communication difficulties to follow the procedure if they need to. EVIDENCE: Comments from people throughout the day of this site visit confirmed that they felt that their comments were listened to and acted upon. A requirement of the previous inspection report was that the home should review the complaints procedure and produce it in an easy read format. At this inspection this had been completed. All the files seen contained a document confirming that the person had received a copy of the complaints procedure. A couple of people were asked about the complaints procedure. One person said if they were unhappy they would talk to the manager or deputy, they said when they had been unhappy in the past they have spoken to the manager and the problem was sorted out. Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 19 The home has not received any complaints since the previous inspection was completed. No complaints have been received by the CSCI since the previous inspection. The AQAA highlights the fact that the staff team must complete safeguarding adults training. This was discussed with the manager who stated that they are on a waiting list to attend the course. It becomes a requirement of this inspection report. The manager of the home manages all monies of people living there. Records of income and expenditure were detailed and receipts were available wherever possible. In addition to the records kept by the home an external auditor checks all financial records annually. Speaking to people in the home, they all agreed that they were happy with the manager holding their money. People stated “I can get my money whenever I need it”. Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 20 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, 25, 26, 27, 28, 29, 30 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is maintained to a high standard throughout which minimises potential risks to the people living there. The home provides people with substantial shared facilities as well as areas that they can use in privacy. People’s bedrooms reflected their interests and personalities whilst meeting their current needs. EVIDENCE: The building is maintained to a high standard throughout and provides people with ample communal space. On the ground floor there is a large lounge with a television, DVD player, stereo and games computer. The deputy manager has created a high quality home cinema system with a large projector screen in the Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 21 lounge. Groups of people in the home regularly sit down to watch films using this system. One person said that they had watched a film using the system and it was “really good”. There is a separate dining room sited near the kitchen. Everyone sits together for meals. As identified earlier the home has a games room that people were using to complete different activities during this site visit. People are able to play darts, computer games and listen to music. On the first floor there is another lounge with a television. The furniture provided in the communal areas is of good quality and in a good state of repair. The building and grounds were looked at with the registered manager. Since the previous site visit was completed the outside of the property has been completely repainted. The home is sited in extensive grounds and people living in the home have created different areas. One person has a raised flowerbed (as mentioned previously), and there is a wild garden at the front of the property maintained by another person. Around the rest of the property there are extensive vegetable patches and a chicken/duck run. The home grows a lot of vegetables and fruit and a lot of the soft fruit and currants are made into jams and drinks. All of the bedrooms were seen. All people now have locks on their bedroom doors. Bedrooms have continued to be personalised since the previous site visit was completed with a number of the rooms being painted in the colours chosen people living in them. People spoken with throughout the day confirmed that they were happy with their bedrooms. Some bedrooms are shared and where this is the case people there is evidence that people are asked whether this is their wish. A requirement from previous reports is for a bedroom without a window to be fitted with a skylight. The provider has purchased a skylight. The manager explained at this site visit that the person currently living in the room does not wish the window to be fitted at the moment. This requirement will be carried over in this report. There is an ongoing programme of internal decoration with a number of areas being painted since the previous site visit, whilst other areas will be painted in the New Year. The home has a dedicated cleaner who maintains the home’s cleanliness to a high standard. Oak House DS0000016516.V344814.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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff are receiving appropriate training to meet the current needs of the people living at the home. EVIDENCE: Staff complete mandatory training in subjects like health and safety, food hygiene, fire safety. Records showed that since the previous inspection was completed 2 of the management team have completed a course in medication management; all staff have completed a fire safety course while some staff have completed a course in manual handling. Speaking to the home’s cook they were unable to tell us when they had last completed a food hygiene course. Since the site visit was completed the deputy manager has contacted us and stated that food hygiene training is booked for January 2008. Currently two staff are completing National Vocational Qualifications (NVQ) at level two in care. One of these staff spoke to us about the course work they had completed so far. Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 23 No new staff have been recruited to the home since the previous inspection. People living at the home benefit from a stable staff team with many of the staff working at the home for a considerable period of time. Two staff were spoken to at length about their roles within the home, their training and practices. Both were very clear about their role within the home, with 1 member of staff working at the home for the past 30 years. Both confirmed that they received training to support their roles. Oak House DS0000016516.V344814.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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Feedback from relatives is very positive about the service that is provided by the home and this is supported by the comments from people during the day. Potential risks to people are minimised through the regular health and safety checks completed by the staff and qualified engineers. EVIDENCE: The registered manager has extensive knowledge about the needs of the people living at the home, as he has known a number of them for in excess of 20 to 30 years. The deputy manager of the home is the manager’s son. At this site visit he explained that he will be starting the Registered Manager’s Award (RMA) in the Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 25 next year once 1 of the other staff have completed their National Vocational Qualification (NVQ). It is planned that when the manager retires the deputy manager will apply to the CSCI for registration. As part of this inspection process the CSCI received completed surveys from a number of parents and family members. All of the feedback received was positive about the service. “Provides 1st class family home environment”. “All the staff have exceptional commitment to the people living there”. “Food and accommodation are 1st class”. “I think the care home runs perfectly alright, no improvements are necessary”. “People are always happy when they visit”. “They provide vulnerable adults with a safe environment”. “They are very well looked after”. “I feel the manager and staff are up to a high standard”. “My son has been at Oak house for 24 yrs and I would recommend it to anyone”. “Staff are very enthusiastic”. “My brother is extremely happy at Oak house”. “Oak house is absolutely wonderful, a caring home”. The only slightly negative comment implies that people do not do enough outside activities. 1 parent made a comment: “Involve the residents in more outdoor activities and recreation”. From the evidence gathered as part of this site visit it is clear that the number of activities off site have increased and are more person centred. In addition to surveys from relatives, 9 of the people living in the home completed surveys. These were all positive about the service they receive. The home has not completed another quality satisfaction survey for parents and relatives since the previous inspection was completed. The manager stated that they intend to do this in early 2008. We suggested that in addition to Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 26 sending the surveys to relatives and parents the home could also send them to other professionals involved with the people living in the home. The manager stated that they are currently working with 2 other care providers in developing a quality assurance document in plain English and pictures so that people living in the home can be involved. The AQAA states that the home are going to seek guidance on obtaining accreditation to demonstrate their commitment to high quality services. They state accreditation marks of interest include BS EN ISO 900, Investors in People and The Charter Mark Awards Scheme. All fire safety equipment had been tested by a qualified engineer and checked by staff weekly/monthly as required. The home has a fire risk assessment completed by an appropriately qualified person. Hot water outlets are tested and recorded weekly. Fridge and freezer temperatures are tested daily. It is recommended that the manager ensure that this is done twice daily. A food probe is used as and when required with cooked meat products. Portable appliance testing had been completed. The AQAA states that the home will employ a consultant to complete a Health & Safety audit. Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 27 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 3 25 2 26 3 27 3 28 3 29 3 30 3 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 2 3 X 2 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 X 3 X 2 X X 3 X Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA23 Regulation 13(6) Requirement The staff team must complete safeguarding adults training at the earliest opportunity. The registered person must ensure a skylight window is fitted in the bedroom, which has no external windows. A quality assurance system that places the views of the people living in the home as central must be implemented. Timescale for action 31/03/08 2. YA25 23(2) (p) 01/06/08 3. YA39 15 31/03/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations Care plans should be reviewed within the timescales defined by the home. Objectives in teaching plans should be SMART (specific, measurable, achievable, realistic and time-constrained). Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 29 2. YA9 The management team should look at each individual’s life and ensure that any risks that present themselves are minimised through an assessment being completed. The fridge and freezer temperatures should be monitored twice a day and records kept of these checks. 3. YA42 Oak House DS0000016516.V344814.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection 4th Floor 33 Colston 33 Colston Avenue Bristol BS1 4UA 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 DS0000016516.V344814.R01.S.doc Version 5.2 Page 31 - 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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