Care Home: Oaklands

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What the care home does well Oaklands is a bungalow that is very well designed to provide a comfortable and safe home for the people who live there.There is a garden with different spaces for people.Everyone has their own bedroom, which they can have as they like.The staff are very good and have got to know the residents very well, so they know what they like and need.There are lots of interesting things for people to do. A staff member said, `There are new things all the time - the residents really enjoy living here!`There are lovely meals, and people can have healthy food that they enjoy eating.Menus have been made with pictures, to help people choose what they want.The Durnford Society supports the service very well, and provides good training for the staff. What has improved since the last inspection? Care plans are being improved, to include health, personal care, and residents` interests from the residents` point of view. Pictures and photos were being used, to help people understand.Page 12 of 33Care Homes for Adults (18-65 years)Staff levels at night have been improved, to meet peoples’ needs. Work had been done to the garden, to make it better for different people to enjoy. There was a new vegetable garden, too.A new medicine room was being provided, to help staff manage the medication safely and well. Sinks had been fitted in the laundries, so that staff could wash their hands, and reduce any risk of cross infection.One of the kitchens had been refitted, to provide a safe and pleasant place for residents` meals to be prepared. What the care home could do better: Two recommendations were made at this inspection.The Manager should continue with efforts to obtain an independent advocate to support any resident who no longer has family to support them, to ensure that their rights are upheld. The home`s procedure for dealing with any allegation of abuse must have accurate and up to date contact details, so that staff would know how to report any allegation. Key inspection report Care homes for adults (18-65 years) Name: Address: Oaklands 76/78 Church Road Plymstock Plymouth Devon PL9 9BD The quality rating for this care home is: three star excellent 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: Stella Lindsay Date: 3 0 0 9 2 0 0 9 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 judgment Care Homes for Adults (18-65 years) Page 2 of 33 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 33 Information about the care home Name of care home: Address: Oaklands 76/78 Church Road Plymstock Plymouth Devon PL9 9BD 01752481166 01752482790 oaklands@durnford.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Durnford Society Ltd care home 10 Number of places (if applicable): Under 65 Over 65 10 10 0 0 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is 10 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories Learning disability (Code LD) Physical disability (Code PD) Date of last inspection 0 5 1 0 2 0 0 6 A bit about the care home Oaklands is part of the Care Homes for Adults (18-65 years) Page 4 of 33 Durnford Society which is a voluntary organization. Oaklands care home provides care for up to ten service users who have learning disabilities and may or may not have physical disabilities Most of the service users who live at Oaklands require a high level of care and there are staffing levels to meet their needs. Oaklands is a purpose built bungalow with a garden all around. The home is separated into two units, each with its kitchen and lounge, and team of staff. All bedrooms are single rooms. The home is near to public transport routes, shops and local services. There are two minibuses for the use of the residents. The home is Care Homes for Adults (18-65 years) Page 5 of 33 equipped with various aids and adaptations to enhance service users independence. Current Fees: 1,233.98 to 2,198.90 Additional Charges: Hairdressing, chiropody, toiletries, transport, activities, personal effects. The most recent inspection report is made available to prospective service users on request. Care Homes for Adults (18-65 years) Page 6 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgment for each outcome: three star excellent 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 Care Homes for Adults (18-65 years) Page 7 of 33 How we did our inspection: This is what the inspector did when they were at the care home We visited Oaklands on Wednesday 30th September, from 10.30am till 5.15pm. We met the Acting Manager, who showed us round the house, and told us about how the home was being run. We met five of the people who were living at Oaklands, and six staff who were on duty that day. The Chief Executive of the Durnford Society came to meet us. Care Homes for Adults (18-65 years) Page 8 of 33 The Registered Manager had sent us information beforehand. Some staff had returned surveys to us, and so had some residents with help from their families. We looked at care plans and checked that the home had safe policies in place. We looked at how the home manages residents medicines and residents money. Care Homes for Adults (18-65 years) Page 9 of 33 What the care home does well Oaklands is a bungalow that is very well designed to provide a comfortable and safe home for the people who live there. There is a garden with different spaces for people. Everyone has their own bedroom, which they can have as they like. Care Homes for Adults (18-65 years) Page 10 of 33 The staff are very good and have got to know the residents very well, so they know what they like and need. There are lots of interesting things for people to do. A staff member said, There are new things all the time - the residents really enjoy living here! There are lovely meals, and people can have healthy food that they enjoy eating. Care Homes for Adults (18-65 years) Page 11 of 33 Menus have been made with pictures, to help people choose what they want. The Durnford Society supports the service very well, and provides good training for the staff. What has got better from the last inspection Care plans are being improved, to include health, personal care, and residents interests from the residents point of view. Pictures and photos were being used, to help people understand. Page 12 of 33 Care Homes for Adults (18-65 years) Staff levels at night have been improved, to meet peoples’ needs. Work had been done to the garden, to make it better for different people to enjoy. There was a new vegetable garden, too. A new medicine room was being provided, to help staff manage the medication safely and well. Sinks had been fitted in the laundries, so that staff could wash their hands, and reduce any risk of cross infection. Care Homes for Adults (18-65 years) Page 13 of 33 One of the kitchens had been refitted, to provide a safe and pleasant place for residents meals to be prepared. What the care home could do better Two recommendations were made at this inspection. The Manager should continue with efforts to obtain an independent advocate to support any resident who no longer has family to support them, to ensure that their rights are upheld. The homes procedure for dealing with any allegation of abuse must have accurate and up to date contact details, so that staff would know how to report any allegation. Care Homes for Adults (18-65 years) Page 14 of 33 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Stella Lindsay Care Quality Commission Citygate Gallowgate Newcastle upon Tyne NE1 4PA Telephone: 03000 616161 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. Care Homes for Adults (18-65 years) Page 15 of 33 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 16 of 33 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 excellent quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Good information about the service is available for prospective service users and their representatives. The care needs of individuals are assessed thoroughly before a service is offered, to make sure that when the person moves in, their needs can be well met at the home. Evidence: Information about the service had been produced in picture format using widget symbols, to help people understand. We looked at the information provided to staff when a new person was admitted to Oaklands. It was very comprehensive useful information. Staff told us that the persons previous placement had provided little information, and their Manager had gathered this good analysis by discussion with health and social care professionals. It covered what would constitute a good environment for this person, what would be meaningful education, what they needed for their physical and psychological health care, and what family contact was needed. A diary had been kept of the contact meetings and overnight stays that had been arranged before the person moved in. There was a record of the family contacts, which had developed further with monthly visits since the admission. Page 17 of 33 Care Homes for Adults (18-65 years) 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 excellent quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Care plans were detailed, comprehensive, and showed understanding of residents preferences and aspirations. Risks were assessed in order to enable people to have their choices. Evidence: The team were in the process of compiling person centred care plans combined with health action plans. One resident had given consent for this to be done, and we saw that the essentials of what was important to them were shown pictorially, with photos of important people. The plan included detailed information about specific health care issues, and details of the residents preferred bathing routine. The Acting Manager told us that they planned to include photos of preferred products, as scents were important to this person. Specific aspirations were also included, along with ways of making them practicable. Although many of the people who live at Oaklands have limited verbal communication, every effort was being made by staff to enable them to make choices about their lives. The Acting Manager told us they were introducing far more picture referencing throughout the care plans, to ensure open and more appropriate forms of communication and to make sure residents own views could be represented. Care Homes for Adults (18-65 years) Page 18 of 33 Evidence: We looked at the way the home supports people to manage their money. Each resident had been assisted to open a bank account, and monthly statements were kept in the home, so they or their representative could check. Cash was kept securely for each person, and checked daily by the shift leader. We saw that receipts were kept to account for all transactions. Residents paid for transport provided, with their use of the homes vehicle being calculated monthly, and this amount paid by cheque to leave an audit trail, for transparency. Not all residents had family members to support them. The Acting Manager said they had been unable to obtain the support of an advocate for regular activities such as a care plan review, but they would request such a service if a major decision became necessary for a resident with no family support. We saw risk assessments on individuals care plans, which gave detailed advice to staff, for instance, on how to assure a residents safety while they were swimming, or trampolining in the garden. Care Homes for Adults (18-65 years) Page 19 of 33 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 excellent quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Residents at Oaklands benefit from a good variety of activities, which meet their interests and needs. Personal development is encouraged. There is a nutritious and varied diet, which meets individual choice and health care requirements. Evidence: Oaklands is organised as two bungalows joined together, each with their own lounge and dining area, and their own staff group each day. Each side of the home had a weekly chart showing the activities that were planned, so that the staff could ensure that they had the time and resources to enable them all. Aspirations were recorded, including basket ball and speedway, which showed that staff kept working on new ideas. Staff and residents relatives both observed that residents could not always do what they want because they need individual support to go out, and even with high staffing levels people have to take their turn. With the resources available, the home provided a wide range of activities and ensured that everyone had some activity or other personal attention each Care Homes for Adults (18-65 years) Page 20 of 33 Evidence: day. The Acting Manager told us that referrals to the commissioning authorities were being made on behalf of some residents with the intention of further enhancing their activity programme. One resident attended college twice a week, for life skills training. Staff had supported this person to apply for horse riding one evening per week. One resident had been down to the shops that morning. Lots of people say hello, said a staff member who had accompanied them. Staff told us they had arranged for residents holidays in pairs. Individual holiday choices were considered by the staff and Acting Manager together, and arrangements made. The resident and the organisation both contributed financially. Staff told us that healthy eating is encouraged. Home grown potatoes, sweetcorn and courgettes had been enjoyed. Fruit was regularly grated into residents breakfast cereals, for added flavour and nutritional value. A record was kept of all meals eaten, so that peoples nutrition could be monitored. We saw that residents were given their lunches individually, with assistance as required. Staff were able to tell us exactly how residents liked their food. One person preferred to eat without interruption or other people being present, and arrangements were made to protect their mealtime. Menus in picture form had been produced, to encourage residents to make active choices, and let them know what was available. Care Homes for Adults (18-65 years) Page 21 of 33 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 excellent quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. Personal care was provided flexibly, according to peoples preferences. Residents good health was supported by staff training for specific conditions, and by careful adherence to procedures, with good records kept. Evidence: All care plans had been reviewed, to ensure that personal care was tailored according to residents choices and needs. The team was in the process of developing person centred plans and health action plans for all the residents, with input from family and friends with the agreement of the resident, and from health and social care professionals. These enhanced the staff knowledge, to meet residents physical and emotional needs, and to avoid illness or discomfort where possible. The staff at Oaklands are very good, said a relative on behalf of a resident. They look after me well and I am always kept very clean. We saw staff treating residents with respect at all times during our visit, taking care with their language and the way they spoke. There were records of medication reviews, and of visits by Occupational Therapists, Speech and Language Therapists. A record had been written following a residents visit to a dentist, and feedback was recorded after a visit from a chiropodist during this inspection, by the staff member who had been present to support the resident during their treatment. Care Homes for Adults (18-65 years) Page 22 of 33 Evidence: The Durnford Society keeps a set of scales suitable for wheel chair users, which is brought to Oaklands monthly. A suitable bed and mattress had been provided for a resident who A recent audit of medication management in the home had lead to a decision by senior management to provide a new medication room. This was being prepared at the time of this inspection, and represented a good improvement in facilities. The new medication room was central, and therefore easily accessible to both sides of the household. It was light, and there was sufficient storage space to arrange the medications in an orderly way, and good provision of worktops. We saw that records of medication administration were carefully kept, and that running totals of controlled drugs were checked daily by the shift leader. We saw that the importance of taking their medication, and the best way to deal with any refusal or noncompliance, was included in residents care plans. Care Homes for Adults (18-65 years) Page 23 of 33 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 judgment using a range of evidence, including a visit to this service. The home has sound policies and procedures in place, and residents are protected by the skills of the staff in observing and listening to them, to notice any change or dissatisfaction. Evidence: Residents were limited in their ability to make a complaint. The complaints procedure had been produced in pictorial form and was available to residents and their representatives. Two residents were helped by family members to complete and return surveys to the CQC. One said that they visit twice a week, and would speak up if they felt their relative was not happy. No formal complaints had been received by the home or the CQC. Two letters of appreciation had been received. The home had a policy and procedure on preventing and dealing with abuse of vulnerable adults, which included the locally agreed Alerters Guidance. It needed updating, as contact details had changed. Some staff had received training in the Protection of Vulnerable Adults, but not all. The Society was in the process of providing this training. All eight staff who completed our surveys said they knew what to do if anyone raised a concern about the home. Care Homes for Adults (18-65 years) Page 24 of 33 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 excellent quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to this service. The house is well designed and well maintained, to provide a convenient and pleasant home for the residents, meeting their complex needs. Evidence: Oaklands is a purpose built bungalow, with level access throughout and wide corridors. Although registered for ten residents, not more than nine are expected to be accommodated, as there are nine bedrooms (one of which would be large enough to accommodate two people who might choose to share). We visited some of the bedrooms with their occupants, and found them to be decorated according to their wishes. Door alarms had been provided where necessary, to alert staff when the occupant left their room by night. The bathrooms were well equipped, and efforts had been made to make them attractive places, with gentle colour schemes, and speakers to provide music to enhance peoples bath times. Each side of the house has its own lounge and dining area. We were told that the carpets were cleaned professionally. One was stained and had a burn mark from an iron. One of the kitchens had been refitted, with new stainless steel cooker and hood, and new flooring and units. The Acting Manager told us that there were plans to renew the other kitchen in the next financial year, along with redecorating two bedrooms. One lounge had been redecorated recently, and the other was due to be done. The layout of the garden had been arranged to meet the needs of individual residents. Care Homes for Adults (18-65 years) Page 25 of 33 Evidence: One had a patio area that they had free access to, without compromising their safety. Other parts of the garden had separate seating areas, with trellis used to provide privacy. A trampoline had been provided. A member of staff had developed a vegetable garden, and though residents were not actively engaged, they benefited from seeing the plants as they developed and in eating the produce. There is a laundry on each side of the home. Each contains laundry equipment of sufficient standard to meet the particular needs of the residents. Hand basins had been installed in each, to provide hand washing facilities in order to reduce any risk of cross infection. Care Homes for Adults (18-65 years) Page 26 of 33 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 judgment using a range of evidence, including a visit to this service. Residents benefit from staff who are well trained, knowledgeable, skilled, well supported and supervised. They are employed in sufficient numbers to meet residents complex needs. Staff development is encouraged and supported positively within the organisation. Evidence: We were given a printed staff rota. It showed that during the day there were normally four staff working on either side of the house, and two staff on duty on each side by night. This showed an increase in night staffing, following assessment of clients needs. The Acting Manager was normally additional to this. Cover for unplanned absences was not always possible, but the Durnford Society had a small bank of relief staff who knew the residents and could be called upon. One Residential Care Worker is appointed shift leader each day, to allocate tasks and make sure residents plans are realised. The shift leader carried the keys of the medication cupboard, and was responsible for audits, including daily checks of residents money and medication. The role of the key worker is being developed, to enhance their ability to speak with understanding on behalf of residents, for example at care plan reviews. Staff who spoke to us were keen to develop their skills and to progress in their careers. All who completed surveys were very positive about the training provided. Care Homes for Adults (18-65 years) Page 27 of 33 Evidence: One staff member told us that although it is busy, there is time to spend with the people who live here. It does not feel like an institution - it really is their home. Another said, I really enjoy working at Oaklands. The staff are all good team workers and we all look after the residents well. We saw that the home had a sound recruitment procedure, and that the checks necessary to protect residents from potential harm had been carried out. The recruitment procedure had been readdressed to highlight any gaps in the candidates employment history, to consider any implications for their inclusion in the team. A staff member confirmed that they had visited Oaklands before their formal interview, which would give management an opportunity to observe their initial ability to interact with people living in the home. We saw that new staff had worked supernumerary for two weeks, and had worked day shifts to get to know the residents and their care needs before moving on the night work. A thorough induction training was provided, including Learning Disability Award Framework units. The Training Officer for the Durnford Society had come to Oaklands to assess staff progress. Staff were provided with a Durnford Society Training and Continual Professional Development Folder which they could add to throughout their time with the company. In the AQAA, we were told that of the 30 permanent staff, 15 had already achieved at least level 2 in the National Vocational Qualification in Care, and five were working towards it. This is good achievement in working towards a qualified workforce. The Training Officer kept records of staffs mandatory training, and arranged for updates when these became necessary. Training had been provided in care planning processes, and person centred planning to support the on-going work in combining the Health Action plans, care plans and Person Centred Plans. The organisation was keen to maintain the level of staff supervision during the absence of the Registered Manager, and one of the Deputy Managers was supporting the Acting Manager with the task of carrying out Annual Reviews. Staff had been given Annual Review Preparation forms to complete before their meeting. Of the eight staff who completed our surveys, six said they meet with their manager regularly, and the other two said often, which was a positive response. The Acting Manager had programmed in dates for meetings. Care Homes for Adults (18-65 years) Page 28 of 33 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 judgment using a range of evidence, including a visit to this service. The home is well managed, run in the best interest of residents, with good arrangements in place to maintain their health and safety. Evidence: The Registered Manager for Oaklands was Mrs Jenna Worley. In her absence on maternity leave, Senior Management had appointed an Acting Manager and two Deputy Managers, understanding the support that would be needed to maintain the standard of care to people who live at Oaklands. Senior Managers had visited the home at least monthly and written a report each time. These showed that they had audited in turn the systems in the home, including medication management, care and support plans, moving and handling, health and safety and financial procedures. A record had been left in the home, with agreed actions and timescales. This home provides an excellent service, and the Registered Manager has said that she will keep as an on-going and continuing reflection on practice a process to allow service users and staff to become innovative and creative in their thinking in overcoming the barriers of provision due to financial constraints, through training and sharing ideas on best practice. This is a good ethos with which to maintain the services excellent rating. Care Homes for Adults (18-65 years) Page 29 of 33 Evidence: A staff member told us, the working environment is friendly and supportive. The management team are always available to help you with any problems you might have. Another said, I am lucky to be working in such a friendly environment. The staff and managers are very good at their jobs. Staff meetings had been held regularly to iron out problems, share information and make sure staff were kept well informed about details of residents care needs and plans. The health, safety and welfare of residents were fully promoted. The building and equipment were well maintained; risk had been assessed, understood, and well managed. Staff training included first aid, moving and handling, food hygiene, and health and safety. At a well attended staff meeting in September, Health and Safety took first place on the agenda, giving staff the opportunity to bring any issues to the attention of the management for action. Fire prevention equipment in the home had been upgraded, with respect to smoke detectors and the alarm panel. Fire training was provided at three monthly intervals to give all staff the opportunity to keep updated. An Environmental Health Officer had carried out an inspection of the kitchens and found them to be satisfactory. Care Homes for Adults (18-65 years) Page 30 of 33 Are there any outstanding requirements from the last inspection? Yes  No  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 31 of 33 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 Description 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 Description 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 7 The management should continue their efforts to engage independent advocates for people who live in the home. This is to ensure their rights are upheld. The written procedures relating to safeguarding vulnerable people should be checked periodically to update the contact details, and ensure the information is correct. This is so that staff would be clear about who to contact in the event of an allegation being made. 2 23 Care Homes for Adults (18-65 years) Page 32 of 33 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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