Care Home: Oakdene Care Home (Residential Unit)

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What the care home does well The statement of purpose and service user`s guide, meets the needs of the current group of people in the home. Care plans are very detailed, person centred, and support excellent health and personal care. The service has good links with other health and social care professionals, and uses these to support the needs of people living in the home. Medication is given out safely. The bedrooms reflect the personal preferences of the people who use them. Staff receive regular training and regular supervision to support them in the work they do. Staff were observed to have an excellent understanding with people who live in the home, and clearly knew how to respond to their needs. People living in the home have a varied life, being supported in undertaking a range of activities to suit their needs and preferences. The providers are very conscious of health and safety, and there are good recording systems in place to ensure that health and safety needs are met. The staff group are employed in numbers sufficient to assist people individually. What has improved since the last inspection? The window catches mentioned in the last report have now been put in place. What the care home could do better: The bulk medication could be audited more regularly. The signs to the new service user living area could be removed to improve the area. Key inspection report Care homes for adults (18-65 years) Name: Address: Oakdene Care Home (Residential Unit) 10 Woodborough Road St Anns Nottingham NG3 1AZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Keith Williamson     Date: 2 1 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 21 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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 21 Information about the care home Name of care home: Address: Oakdene Care Home (Residential Unit) 10 Woodborough Road St Anns Nottingham NG3 1AZ 01159580172 01159482700 linda.sadler@nottinghamcity.gov.uk www.nottinghamshire.gov.uk Nottingham City Council care home 25 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) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be aoommodated is 25. The registered person may provide the following category of service only: Care Home Only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home Oakdene is situated close to Nottingham city centre, near to local shops, pubs and restaurants. Oakdene provides care and support, including short-term care, for up to 25 people with a learning disability. The home was originally purpose built for people with physical difficulties so there is good access throughout the building, with two passenger lifts as well as stairs. Acommodation and communal areas are on three floors. There is a large communal dining room situated in the adjacent day centre. The fees range from £245 to £345 per week. Information about the home, including CSCI inspection reports, is available from the home. 1 9 0 3 2 0 0 9 25 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 21 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: The focus of inspections is on outcomes for people who use the service and their views of the services provided. The main method of inspection used was case tracking which involves selecting a sample number of people and tracking the care they received through talking with them where possible, looking at their records and accommodation, in this case three people were chosen. This visit took place over one day, commencing at 9.30pm and took six hours to complete. An opportunity was taken to observe the people, talk with the Manager and staff, look around the home, and view records, policies and care plans. Information was also obtained from the Annual Quality Assurance Assessment (AQAA), which gives information on the people, home and the staff group. Surveys were sent to Service Users and staff, however none were received back prior to the report being written so Care Homes for Adults (18-65 years) Page 5 of 21 none have been added to this report. Twelve of the Service Users were seen and two staff were spoken with, and their exchanges with the Service User group observed. The quality rating for this service is 2 star. This means the people who use this service experience Good quality outcomes. Care Homes for Adults (18-65 years) Page 6 of 21 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 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 21 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 21 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. Prospective service users, and their representatives, can be assured that the homes admission processes will enable them to make a decision as to whether the home could meet their needs and aspirations. Evidence: The staff have developed a comprehensive statement of purpose and service users guide, which meets the needs of the current group of people in the home. The information is available in a number of different formats which allows everyone in the home to understand it. The complaints procedure is also included in the guide. People have their needs assessed prior to moving into the home, though there has been no one admitted since the last key visit. Assessments seen on both peoples files. Care Homes for Adults (18-65 years) Page 9 of 21 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. Service Users have a plan of care, which details what care staff need to offer to ensure peoples needs are met. Evidence: We looked at the care records of people. We found them to be descriptive of the care and support offered to people. Care plans were adapted into a format more easily understood by people who live there. We saw that the plans are Person Centred with good levels of detail to inform staff how people like to be cared for. We saw that staff have a good understanding of the risks relating to each person who lives there, and have put risk assessments in place to reduce risks associated with each person. Care plans are agreed with the Service User or a representative, some being signed to agree the care and intervention offered. Records of what people do and what care is offered on a daily basis are kept securely. Care Homes for Adults (18-65 years) Page 10 of 21 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 home encourages service users to develop healthy and meaningful lifestyles Evidence: Some of the Service Users continue to have work placements at a nearby day centre, and all assist in keeping their bedrooms tidy. Care plans have yet to be amended to assist this process. Visiting continues to be unrestricted, as does the access for Service Users. Service Users have the choice of a bedroom door key; the manager stated these are offered following a risk assessment. Service Users indicated they felt safer having one. Meals are varied and flexible; Service Users participate in menu selection by means of a likes and dislikes list, and personal preference at each meal. The menu continues to be changed to offer people a healthier diet. Care Homes for Adults (18-65 years) Page 11 of 21 Evidence: Staff assist Service Users with activities. Service Users were getting ready to go on a Pre Christmas meal, there was lots of preparation work going on for the Christmas holiday break. Care Homes for Adults (18-65 years) Page 12 of 21 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. Service Users have their health and medication needs met appropriately. Evidence: We looked at the personal and healthcare records of people. We saw that they have good access to healthcare services to meet their personal and healthcare needs. On talking to staff as well as looking at the records, we found that staff act quickly on concerns they have about peoples needs, and these prompt actions have resulted in a good quality of life for those concerned. We looked at the way staff give out medication and found that staff are administering medication safely to people. The policy and procedures followed by the staff are very comprehensive. We saw staff records and these showed us that staff have undertaken training in the administration of medication. Care Homes for Adults (18-65 years) Page 13 of 21 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. Staff are aware of how to use safeguarding principles, which provides good protection to those living in the home. Evidence: We looked at the complaints procedure and saw that this was written in a way which is helpful for people living at the home to understand. We saw very good interaction between people who live in the home, and staff who support them. We saw by looking at staff training records and by talking to them that staff have a good understanding of safeguarding policies and procedures. Staff know what to do if they suspect that a person who lives in the home is being abused in any way. We also saw by looking at staff records, by talking to and observing staff that they understand how to work with people with challenging behaviour. Some of the Service Users have their own bank accounts, and some money is held by the staff. Staff support people living at the home in being responsible for their money. We checked the financial records at the home, and found accurate recording of money balances. Care Homes for Adults (18-65 years) Page 14 of 21 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. Service users live in a home that is homely and adapted to meet their individual needs Evidence: We looked at the public areas of the home and the bedrooms of people who live there. We found the communal areas to be very well decorated and homely, though some of the doors have been damaged with wheelchair footrests. The bedrooms were individually constructed to the needs and preferences of the people using them. This included many personal items such as family pictures and electrical goods. One Service User has recently moved to an area in the home used for staff. The signs on the doors need removing, to enable the person to identify with their new environment. The staff have a maintenance and renewal programme for furniture and fittings in the home. This is regularly updated, as part of the quality control in the home. Staff are aware of hygiene and how to control the spread of infection. This is important as it keeps people safe in the home. Care Homes for Adults (18-65 years) Page 15 of 21 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. Service Users are supported and protected by the homes recruitment practices Evidence: We saw excellent interaction between staff and Service Users in the home, and staff demonstrated a very good understanding of the needs of people living there. We talked to staff and saw them communicating with people in a manor suited to each individual. All staff said they were supported well to do their job, through their job description, induction training, on going training and regular supervision. We looked at a sample of staff recruitment records, and saw that all the necessary checks were made to safeguard people who live at the home. We looked at training records and this confirmed that staff have undertaken a wide range of training to help them in their roles. Training included health and safety, medication management and recognising challenging behavior. Care Homes for Adults (18-65 years) Page 16 of 21 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 service users live in a home that is well managed. Evidence: The registered manager has been in charge at the home for a number of years and has the experience and qualifications to provide a suitable and safe environment for people living there. There are many levels Quality Assurance(QA) and monitoring systems in place, and we noted a number of these. Staff are currently involved in sending out questionnaires for feedback on the service. Other forms of QA include feedback from relatives and professionals, regular staff checks on the building and visits from senior managers. Outcomes from the quality assurance monitoring is made available to people in the home, their representatives and those considering coming to stay at the home. This comes in a number of formats which people can understand. We viewed a number of the policies and procedures that are produced by the city council. We were satisfied that these provide good guidance for the staff to operate Care Homes for Adults (18-65 years) Page 17 of 21 Evidence: safe working practices. We looked at a number of tests the staff do to monitor areas such as the fire detection system, the hot water regulating system, and other areas such as electrical testing. These were up to date and showed us the staff monitoring helps keep people safe in the home. Care Homes for Adults (18-65 years) Page 18 of 21 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 19 of 21 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 1 18 Staff could check the bulk medication at a suitable time through the medication month. This would ensure Service Users had been given the correct medication, and a plentiful supply till the next medication delivery. The signs to the new service user living area could be removed to improve the area. 2 24 Care Homes for Adults (18-65 years) Page 20 of 21 Helpline: Telephone: 03000 616161 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 © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 21 of 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. 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