Care Home: Oakleigh House

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Oakleigh House 8 Barn Park Road Teignmouth Devon TQ14 8PN two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Judy Hill Date: 0 6 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. 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 judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Information about the care home Name of care home: Address: Oakleigh House 8 Barn Park Road Teignmouth Devon TQ14 8PN 01626870331 01626776715 oakleigh@carepartnerships.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Networking Care Partnerships (SW) Ltd Name of registered manager (if applicable) Mrs Allison Clara Whithead Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 6 0 care home 6 learning disability Additional conditions: 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 wtihin the following category: Learning disability (Code LD) The maximum number of service users who can be accommodated is 6 Date of last inspection A bit about the care home Oakleigh House is owned by Network Care Partnerships (SW) Limited. Up to six people can live at Oakleigh House. People who move into the home must be under 65 years of age. The people who live at Oakleigh House need help because they have learning disabilities. Oakleigh House is in Teignmouth, Devon. Teignmouth is by the sea. There are plenty of shops in the town. There is a train station and a bus service. The people who live at Oakleigh House will have their own bedroom and private bathroom or shower room. They will share a lounge/dining room, a sensory room, a kitchen and a laundry. There is a garden at the back of the house and a patio that is over the garage at the front of the house. There will always be friendly staff on duty to help people. 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 How we did our inspection: This is what the inspector did when they were at the care home This inspection was unannounced and included a site visit that was carried out by one inspector on 6th November 2008. The information contained in this report was gained in conversation with the people who use the service, the registered manager and the staff on duty. Additional information was gained from an Annual Quality Assurance Assessment that had been completed by the registered manager, the homes Statement of Purpose and Service Users Guide and the previous inspection report. Further information was gained from an inspection of records, including the residents needs assessments, risk assessments and care plans and staff recruitment and training records. During the site visit a physical inspection of the premises was carried out. What the care home does well Good individual needs assessments, care planning and reviews enable the staff to provide a service that meets the needs of the people who live at the home and encourage personal development. Detailed risk assessments and behavioural management plans enable the staff to understand and work with people whose behaviour can be challenging. Good support is provided to help the people who use the service to keep in touch with their families. Personal care is provided at a level that meets the individual needs of the people who use the service. Peoples mental and physical healthcare needs are monitored and timely referrals are made to professional health and social care services as and when necessary. Complaints are taken seriously and handled appropriately. Policies and procedures are in place and staff training has been provided to protect the residents from the threat of abuse. The people who use the service benefit from living in a spacious, comfortably furnished and well presented home. Safe practices are used to recruit staff and good provision is made to ensure that they receive training in health and safety related areas. What has got better from the last inspection The presentation of the information kept about the people who use the service is better organised and therefore more easily accessible to the staff. By gaining a better understanding of people who use the service, the number of incidents of challenging behaviour has fallen significantly. The manager who was registered at the time of the inspection, but has since left her post, has significantly improved the quality of care provided for the people who use the service and made this a much happier place to live and work in. What the care home could do better 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 Judy Hill 33 Greycoat Street London SW1P 2QF 02079792000 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 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 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 . Detailed assessments of the individual needs of the people who use the service are carried out. Evidence: A revised Statement of Purpose and Service Users Guide were seen at the Oakleigh House during the site visit. The registered manager said that each of the people who use the service had been given a copy of the Service Users Guide and a copy that had been produced in Widget format was seen in the entrance hall. No new people had moved into the home since the last inspection and no new admissions are planned as the service providers have told us that they are planning to move the three residents out as soon as suitable alternate accommodation can be found for them. The report of the previous inspection identified that the individual assessments of peoples needs were satisfactory, but difficult to access because of the way that the information was being stored. Considerable improvements have been made to the way in which information about people is stored and on this inspection the residents individual needs assessments were seen to be well documented and accessible. 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 . Good progress is being made to enable the residents to make more decision about the care and support they receive. Evidence: The residents individual care plans were seen to be well organised and accessible to the staff. Good use is being made of risk assessments and risk management plans to help the staff to minimise risk. The support staff complete daily records about the work they have done with each of the people using the service and these were seen to detailed and relevant. Regular reviews of the residents needs and care plans are being carried out and these were seen to be focussing on individual development. The registered manager said that although progress was slow benefits were being made which were rewarding for both the individual residents and the staff. Some developmental work is being carried out with the support of the Social Service and Health Authorities Specialist Support Team. An example of this joint working includes a programme of desensitisation that the staff and the Specialist Support Services are using to help one of the residents cope better with physical contact. A further example of good joint working has been in the prevention and management of incidents of challenging behaviour, which have greatly reduced Evidence: Care planning and reviews also focuses on improving communication between the staff and the residents to enable the residents to make more decisions about their own lives. The registered manager said that arrangements were being made to send the staff on training courses in Total Communications. It is recommended that staff also attend training courses on Maketon because it has been identified that at least one of the residents has been taught to use this method of communication in the past. 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 . Although their participation in outdoor activities is currently limited, sensitive development work is taking place to improve this situation. Evidence: The people who use the service have few opportunities to participate in activities outside their home environment. This is due to a large part by the shortage of day care services that are available that could meet their individual needs and preferences. The registered manager said that she and the staff had been working with the residents to try and find out what they would like to do outside their home and what they do not want to do. Short trips, either as a group or individually are popular. The people who use the service are encouraged to maintain close contact with their families and regular visits to and from families are facilitated. The residents are encouraged to get involved with the running of their home both on a practical level, by getting involved in domestic duties and by participating in meetings. The residents are encouraged to eat healthy meals and to contribute to menu planning and make choices about what they want to eat. The individual preferences about where people want to eat, either in a group or alone, are respected. 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 . The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: Good needs assessment and care planning has enabled the manager and staff to identify individual health care needs and work sensitively with people who have specific physical and mental health care needs and to monitor their general health and wellbeing. Personal care is provided in a way that suits the individual needs of the resident and sufficient one to one time is provided so that the residents are not rushed. A significant amount of work has been carried out to identify the causes of behaviour that challenges and the number of incidents of challenging behaviour has dropped. Medication is stored appropriately and administered by the staff. The medication records are kept up to date and the staff have access to information about the medicines they are giving to the residents, including possible side effects to look out for. 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 . Complaints are handled appropriately and policies, procedures and staff training are in place to safeguard the people who use the service from abuse. Evidence: A high number of complaints have been received from immediate neighbours about noise. The service providers, manager and staff have taken the complaints seriously and acted to try and resolve these issues. No other complaints have been received about this service. Policies are procedures are in place to safeguard the people who use the service from abuse. The deputy manager has been trained to provide training for staff on the Protection of Vulnerable Adults. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people who use the service benefit from living in a spacious and well presented home that is close to the town, railway station and beach. Evidence: Oakleigh House is a large terraced house in a quiet residential area of Teignmouth. It is close to the town centre, railway station and beach. The home has a large open plan lounge and dining room on the ground floor and a small room on the first floor that is available for the residents to use as a quiet lounge or sensory room. The kitchen and laundry room are on the ground floor and the residents have access to these areas. There are currently two vacant bedrooms that the residents are free to enter if they wish to do so. Each of the residents has their own single bedroom with an en-suite toilet and shower or bathroom. The bedrooms are presented in a style that suits the needs and wishes of the residents. There is an office and a staff sleeping in room on the second floor. Both have en-suite facilities. The parts of the house used by the residents were seen to be clean and comfortably furnished. Black mold was seen in a fitted cupboard in the laundry room and this needs to be dealt with. It was also noted that domestic chemicals had been left in the Evidence: laundry room and these need to be stored securely. 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 . The staff are well managed and work well with the people who use the service. Evidence: The home currently has a number of vacant posts that are not being advertised because alternative premises are being sought. The registered manager is relying heavily on agency staff to cover shifts but said that she was able to secure agency staff who knew the residents and worked well with them. A one to one staffing ratio is maintained throughout the day, which is appropriate because the people who use the service require a lot of individual staff time and attention. Two of the residents need two to one staff support when they go out so the staffing levels need to be monitored to ensure that people are not prevented from going out because there are not enough staff on duty to support them. An inspection of staff recruitment records showed that safe practices are being used to recruit staff. Staff are actively encouraged to gain National Vocational Qualifications at Levels 2, 3 and 4 in Care. The provision of health and safety related training is good and the deputy manager is qualified to provide some of the statutory training that the staff need. Some of the staff have attended training courses in specialized training to meet the individual needs of the people who use the service but the provision of more specialist training courses could be beneficial for the staff, service and residents. 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 management and administration of this service over the past year has been very good. Evidence: The registered manager, Allison Whitehead, took over the management of the home in November 2007. This followed a period of a little over a year when there was no registered manager in post and three temporary managers came and went. The frequent changes of manager had a negative impact on the quality of the service provided but Allison has managed to reverse this decline and the quality of care currently provided for the residents at Oakleigh House is very good. We were told during the site visit that Allison had handed in her notice two months ago and would be leaving the next day. Suitable arrangements were made to ensure that the service would be managed safely until the residents could be found a new home. Part of the manager job is to complete monthly audits to enable the registered service provider to keep a check on the quality of the service provided. Regular monthly visits are carried out by the operations manager on behalf of the Company and copies of reports of these visits were seen. Staff and House meetings are held and minutes taken. The house meeting include the people who use the service and minutes were seen to provide evidence of input from them. Relatives surveys are used to gain feedback from them about the service provided. Evidence: The Annual Quality Assurance Assessment completed for the commission identified that all of the required and recommended policies and procedures are kept at the home and are accessible to the staff. Regular servicing and maintenance is carried out to ensure that the heating, fire detection and safety appliances and electrical appliances are safe. Staff training is provided in health and safety related topics. 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 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 1 Refer to Standard 30 Good Practice Recommendations The registered persons must deal with the black mold in the fitted cupboard in the laundry and remind the staff to store domestic chemicals securely. The provision of more specialized training could benefit the staff, service and residents. 2 35 Helpline: 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 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) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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