Care Home: Oakhouse Residential Care Services

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What the care home does well The needs of each resident are assessed and services are provided to meet them. People who live at the home have opportunities to learn and develop skills for independent living. There is good communication between the residents and the managers and the relatives. The home is clean, bright and safe to live in. Service users live a meaningful life with the evidence that they have friends who they can visit and spend time with on weekends. What has improved since the last inspection? The manager has worked hard to address the shortfalls identified at the last inspection. Accordingly, the worn out chair in a bedroom and the broken fire alarm have been replaced. The manager has also consulted an incontinence nurse who has carried out a needs assessment and provided appropriate care for a resident. The electrical installation and portable electrical checks have been undertaken to ensure the safety and wellbeing of the people who live at the home. What the care home could do better: The residents live in a safe and comfortable environment. This can further be improved by assisting the residents to live as independently as possible. The manager should work closely with social workers and obtain records of reviews within a short period of time after the meetings. The manager also needs to make arrangements for the benefits of a resident to be directly paid into the resident`s own account. CARE HOME ADULTS 18-65 Oakhouse Residential Care Services 69 Station Road Finchley London N3 2SH Lead Inspector Mr Teferi Degeneh Key Unannounced Inspection 28th July 2008 09:00 Oakhouse Residential Care Services DS0000010466.V362554.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 Oakhouse Residential Care Services DS0000010466.V362554.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. Oakhouse Residential Care Services DS0000010466.V362554.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakhouse Residential Care Services Address 69 Station Road Finchley London N3 2SH 020 8346 0666 F/P 020 8346 0666 oakhousecare@hotmail.co.uk 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) Mrs Bernadette Oyindamola Thomas Mrs Bernadette Oyindamola Thomas Care Home 2 Category(ies) of Learning disability (2), Mental disorder, registration, with number excluding learning disability or dementia (2) of places Oakhouse Residential Care Services DS0000010466.V362554.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Limited to 2 people of either gender who have a mental disorder, excluding learning disability or dementia (MD) or a learning disability (LD). 19th February 2007 Date of last inspection Brief Description of the Service: Oakhouse is a small private care home registered to provide care for two people with learning disabilities. The home is owned by Mrs Bernadette Thomas. The house is divided into two flats. The two service users have a large single bedroom each and share the communal lounge, kitchen and bathroom. There is a pleasant garden to the rear as well as a patio area with seating. Mrs Thomas lives in a flat on the first floor and has a small office within her flat for the purposes of running the home. Oakhouse is in an attractive residential area close to shops, services and a tube station. Fees for the home range from £582-£717. Inspection reports produced by the Commission for Social Care Inspection (CSCI) are available upon request from the manager or owner of the home or from the CSCI website at www.csci.org.uk. Oakhouse Residential Care Services DS0000010466.V362554.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. The inspection was undertaken over a period of five hours, starting at 9:00 am and concluding at approximately 2:00. The manager and owner, Mrs Bernadette Oyindamola Thomas, was present throughout the inspection. The inspection activity undertaken included a tour of the building, the examination of service users’ files including care records, the examination of health and safety records, and discussions with people who use the service and their relatives. The home’s annual quality assurance assessment (AQAA), which was completed and returned to the Commission for Social Care Inspection (CSCI) as part of this inspection, has also been considered. The inspection revealed that the people who live at the home are well cared for. Both residents said they are happy. One resident said: “I can travel on my own to see a fiend”. They added: “I like to be independent and I can cook my meals: I can clean my room”. Conversations with the manager and observations showed that the people who live at the home are relaxed, can manage their finances and are engaged with a variety of activities available to them in the community. The manager is committed to providing services that meet the cultural, dietary, and religious and all the individual needs of the people who use the service. . What the service does well: What has improved since the last inspection? The manager has worked hard to address the shortfalls identified at the last inspection. Accordingly, the worn out chair in a bedroom and the broken fire alarm have been replaced. The manager has also consulted an incontinence nurse who has carried out a needs assessment and provided appropriate care for a resident. The electrical installation and portable electrical checks have been undertaken to ensure the safety and wellbeing of the people who live at the home. Oakhouse Residential Care Services DS0000010466.V362554.R01.S.doc Version 5.2 Page 6 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. Oakhouse Residential Care Services DS0000010466.V362554.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 Oakhouse Residential Care Services DS0000010466.V362554.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): 2 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. New residents can be confident that their admission to the home is based on the outcome of their assessment and the ability of the home to meet their needs. EVIDENCE: Both residents have been living at the home since the late 1990’s. The manager described the process of admission when the people were admitted. She said she first visited each person at their home and completed their assessment before inviting them for a trial visit. The manager confirmed that the admission of the residents was based on the outcome of joint assessments carried out by the home, social workers, and health professionals. She said no new service users would be admitted if she and all the stakeholders believe that the home cannot meet their needs. The two people who live at the home said they are satisfied with the services. Oakhouse Residential Care Services DS0000010466.V362554.R01.S.doc Version 5.2 Page 9 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, and 9 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The residents’ needs are met by good risk assessment and care planning systems of the home. EVIDENCE: Both residents look have personal bank accounts. The owner receives a person’s benefits and pays them for personal allowance, shopping and savings for a holiday. Records of these payments are maintained. Following discussions the owner agreed to make arrangements for the benefits to be directly paid into the account of the resident. Another person have their money paid to their own account. Risk assessments are completed for all the people who live at the home. The manager said she sits down with the residents and reviews care plans. It was evident in a resident’s file that annual reviews have taken place and families, the resident, a social worker and a representative of health care professional have been involved. From discussions with the manager it was clear that a service review had taken place for the other resident as well even though recorded evidence was not available in the resident’s file. The manager said she has been asking for the minutes without success and she will continue Oakhouse Residential Care Services DS0000010466.V362554.R01.S.doc Version 5.2 Page 10 to chase it up. One of the residents spoken to said they have front and bedroom keys and they are able to go out and return to the home without a restriction. Oakhouse Residential Care Services DS0000010466.V362554.R01.S.doc Version 5.2 Page 11 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, and 17 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are good opportunities for the residents to be engaged in appropriate activities and to achieve skills for independent living. This is evidenced by their ability to travel independently, to visit and to be visited by friends and families and to choose and prepare their meals. EVIDENCE: A person spoken to explained how they go out to attend a day activity and to visit friends. They said that they use a public transport to go to central London to see a friend. They explained that they occasionally stay for a few days with their friend and that their friend can visit them in their bedroom in private. On the day of this inspection they were seen going out to a day centre. The manager also said she takes the residents to family occasions. She said the residents are part of their family; they go to shops, shows, swimming, restuarants and on dayout trips together. The manager said last year she went overseas on holiday with one resident. One of the residents likes going on a Oakhouse Residential Care Services DS0000010466.V362554.R01.S.doc Version 5.2 Page 12 holiday with their friend. Both residents have front and bedroom keys and they can go to bed or get up from bed at a time of their choice without restrictions. A relative spoken to said they can visit a resident in private. Each resident is consulted about the menus. Discussions with the manager and the residents revealed that the residents are able to choose what they want to eat. The manager said she believes in equality and meeting the individual needs of the residents. She said cultural and dietary preferences of the residents are respected at all times. It was stateted in the AQAA that the home does “encourage and support the service users to attend religious and cultural events”. A service user said they like the meals provided at the home. They said they like to prepare their own meals independently. The residents have access to all communal areas. They also spend time watching television or interacting with the manager in her lounge on the first floor. It was confirmed by the manager that the residents are registered on the electoral roll and they have been able to vote during local and national elections. Oakhouse Residential Care Services DS0000010466.V362554.R01.S.doc Version 5.2 Page 13 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, and 20 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The manager, who is also the main carer, is a committed and experienced person and the health and personal care needs of the people who use the service are met by good management and provision of services. EVIDENCE: A continence nurse has been consulted and an assessment completed for one person as required at the last inspection. The manager said the nurse provided necessary items which have been useful for the care of the person. The residents’ files showed that a psychiatrist, dentist, optician, and chiropodist have been involved. On the day of the inspection one resident was receiving treatment at a hospital. The manager is the main carer who provides personal care as needed. On some occasions when the manager goes on a holiday some relief workers assist the residents with personal care. The manager and the relief workers have known the residents for several years. They also have satisfactory Oakhouse Residential Care Services DS0000010466.V362554.R01.S.doc Version 5.2 Page 14 criminal record bureau certificates. One of the residents does not need assistance with personal care. From discussions with the manager and the residents it was evident that the residents self-administer their medication. The residents also keep their medication in their bedrooms. Medication is provided by Boots in blister packs. The manager said she occasionally reminds or prompts them to take their medication. Risk assessments have been completed to ensure that the residents can safely take their medications. Oakhouse Residential Care Services DS0000010466.V362554.R01.S.doc Version 5.2 Page 15 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, and 23 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The good safeguarding policies and the complaint management practices have enabled people who use the service to feel safe. EVIDENCE: The two residents and a relative spoken to said they know how to make a complaint if they have concerns. They stated that the manager is open and easy to talk to. From discussions with a relative of a resident and observations during the inspection process it was evident that the manager interacts very well both in person and by telephone with the people who use the service and their relatives. There have been no recorded complaints since January 2005. The home has a safeguarding policy and has obtained a copy of a similar policy from the local authority. Discussions and an examination of the files showed that the manager has attended training on adult safeguarding. She is also aware of the procedures to follow to deal with suspected or alleged cases of abuse. Oakhouse Residential Care Services DS0000010466.V362554.R01.S.doc Version 5.2 Page 16 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, and 30 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The size and facilities of the home are good. This means that the people who use the service live in a relaxed, homely environment where they can build on their confidence and achieve skills for independent living. EVIDENCE: Both of the residents said they like their bedrooms and are happy with the home. The residents have keys for the front door and their bedrooms. The communal areas and one of the bedrooms which were seen during a guided tour of the premises were clean, spacious, and comfortable. It was noted during conversations with the manager and a resident that people who use the service have access to the lounge in the manager’s flat on the first floor. One of the bedrooms has a patio which opens into a garden. The manager and the resident confirmed that the resident is able to lock and open the doors of the patio at night. A cleaner comes to the home once a week to clean the home. The residents are prompted to clean and tidy their rooms daily. From observations and a Oakhouse Residential Care Services DS0000010466.V362554.R01.S.doc Version 5.2 Page 17 discussion with the manager it was clear that a worn out chair and a broken fire alarm have been replaced as required at the last inspection. Oakhouse Residential Care Services DS0000010466.V362554.R01.S.doc Version 5.2 Page 18 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, and 35 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people who use the service have benefited from the experience, commitment and knowledge of the manager, who is also the main carer. EVIDENCE: The manager is the main carer and there are no other permanent or temporary staff. However, the manager occasionally uses relief workers whenever she goes on a holiday. The manager lives in the first floor flat and is available for service 24 hours a day. It was evident from discussions and records that the residents can independently travel using a public transport, make telephone calls, and prepare their own meals. The manager and the relief workers have long experience of supporting the residents. A relative of a resident and the two residents spoken to confirmed that they are satisfied with the care provided for them. The manager is a registered nurse with a current personal identification number. She also regularly updates her statutory training. Oakhouse Residential Care Services DS0000010466.V362554.R01.S.doc Version 5.2 Page 19 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, and 42 People using the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The people who use the service are confident that appropriate services that meet their individual needs are provided and managed by a committed and experienced manager. EVIDENCE: As mentioned above, the manager is a qualified nurse with current registration. She has been the manager of the home for ten years. She has also successfully completed the registered manager’s award (RMA). Verbal feedback from a relative and the residents indicated that the manager is a caring and approachable person. The manager has developed questionnaires for the residents, relatives and professionals. These questionnaires have been used as part of the home’s quality assurance system. From records, AQAA, and conversations with the Oakhouse Residential Care Services DS0000010466.V362554.R01.S.doc Version 5.2 Page 20 residents it was clear that monthly meetings take place to discuss common issues aimed at improving the service. It has been stated above that the manager does not keep the residents’ finance but she handles money for one person and passes the money to the resident. The records relating to financial transactions were checked and found to be in order. The electrical installation of the home and portable electrical appliances were checked and found to be working in good order on 13/02/07, as requested at the last inspection. Certificates of the gas boilers (21/12/07) were, which were seen, confirmed that they were safe to use. The home under takes fire alarm tests weekly and fire drills monthly. There is a fire evacuation plan and a fire risk assessment for the service user who smokes in their bedroom. There have been no recorded incidents or accidents since the last inspection. Oakhouse Residential Care Services DS0000010466.V362554.R01.S.doc Version 5.2 Page 21 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 X 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 X 26 X 3 3 X 3 X X X X 30 X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 3 X 3 X X 3 X Oakhouse Residential Care Services DS0000010466.V362554.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA7 Regulation 20 Requirement The registered person must consult a service user and their representative and arrange the service user’s money to be directly paid into the service user’s account. Timescale for action 30/09/08 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 The registered person should obtain the minutes of the review meetings within a possible short period of time. In this way she can refer to the contents and decisions of the meeting and meet the residents’ needs. Oakhouse Residential Care Services DS0000010466.V362554.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Oakhouse Residential Care Services DS0000010466.V362554.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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