Care Home: Oakley Care Home

What the care home does well We received completed surveys from both of the people who live at the home. They told us that they were happy with all aspects of the service. When asked what they liked best about the home one resident wrote ‘I go out a lot and the food is really good.’ During our visit we were able to meet one resident who appeared very happy and relaxed in his surroundings. He told us about his recent holiday which had been arranged by the manager. He said that he had really enjoyed himself and was looking forward to the next one. Oakley is a very small home and care is provided in a family like environment. There are no staff employed there so all the care is provided by the manager. This close daily contact means that the manager has a very good understanding of the residents and an in-depth knowledge of their needs. It also enables the manager to quickly identify and act on any concerns in relation to a resident. As Oakley is such a small home, daily routines such as meal times and activities can be very flexible. As such, residents have increased opportunities to make everyday choices. Residents at this home are provided with a good standard of accommodation which is well maintained and nicely furnished. During the visit we found that all areas of the home were clean, warm and comfortable.Oakley Care HomeDS0000069017.V376493.R01.S.docVersion 5.2 What has improved since the last inspection? Since our last inspection the manager has improved the way that medication is stored. We were able to confirm during this visit that all medication is now stored safely and securely. A number of improvements have been made to the environment including refurbishment of the kitchen. Residents at the home were involved in this project helping to choose designs and colour schemes. The manager continues to develop the service and listens to the views and opinions of people who live at the home. For example, the range of activities provided has been increased in line with residents’ requests and both residents recently enjoyed a holiday.Oakley Care HomeDS0000069017.V376493.R01.S.docVersion 5.2 What the care home could do better: No requirements were made as a result of this inspection. Some recommendations were made to support further development of the service. We made a recommendation that the manager continues to attend regular refresher training in the key health and safety areas such as moving and handling, to ensure that she remains updated on safe working practices. We made a recommendation that the manager attends training in relation to the Mental Capacity act to ensure that she is aware of the implications the legislation has when caring for a person who may need decisions making on their behalf and in their best interests. Key inspection report CARE HOME ADULTS 18-65 Oakley Care Home 21 Norton Road Heysham Lancashire LA3 1HA Lead Inspector Marie Cordingley Key Unannounced Inspection 10th August 2009 13:00 Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 1 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. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 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. Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 2 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 Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakley Care Home Address 21 Norton Road Heysham Lancashire LA3 1HA 01524 831554 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 Jane Gilmour Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only. Care home only - code PC, to service users of the following gender:Either. Whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 3 Date of last inspection 10th August 2007 Brief Description of the Service: Oakley Care Home is a small home registered with the Care Quality Commission to provide care and accommodation for up to three younger adults with mental health needs. However, at the time of the visit there were only two residents at the home and there were no plans to admit a third person. The home is situated in the Sandylands area of Morecambe close to a number of facilities and amenities. Whilst care is provided on a 24 hour basis, the home is managed in a very informal manner and has a family like environment. Residents health care needs are met by community professionals such as district nurses and doctors. At the time of the inspection fees at this home were £283 weekly. Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating of this service is two star. This means that people using the service experience good quality outcomes. The inspection of the home included an unannounced site visit. As the visit was unannounced the manager and residents did not know it would be taking place until we arrived. During the visit we held discussions with the manager and one of the residents. We also looked at a selection of paperwork and carried out a tour of the home. Prior to the visit we asked the manager of the home to complete a comprehensive self assessment which covers all aspects of the service. The assessment required the manager to identify particular strengths of the home as well as identify areas for development. The manager retuned the assessment to us within agreed timescales and completed it to a good standard. We also wrote to people who live at the home and asked them to take part in a written survey. All the residents returned completed questionnaires and expressed satisfaction with all aspects of the service. Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 6 What the service does well: We received completed surveys from both of the people who live at the home. They told us that they were happy with all aspects of the service. When asked what they liked best about the home one resident wrote ‘I go out a lot and the food is really good.’ During our visit we were able to meet one resident who appeared very happy and relaxed in his surroundings. He told us about his recent holiday which had been arranged by the manager. He said that he had really enjoyed himself and was looking forward to the next one. Oakley is a very small home and care is provided in a family like environment. There are no staff employed there so all the care is provided by the manager. This close daily contact means that the manager has a very good understanding of the residents and an in-depth knowledge of their needs. It also enables the manager to quickly identify and act on any concerns in relation to a resident. As Oakley is such a small home, daily routines such as meal times and activities can be very flexible. As such, residents have increased opportunities to make everyday choices. Residents at this home are provided with a good standard of accommodation which is well maintained and nicely furnished. During the visit we found that all areas of the home were clean, warm and comfortable. Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? Since our last inspection the manager has improved the way that medication is stored. We were able to confirm during this visit that all medication is now stored safely and securely. A number of improvements have been made to the environment including refurbishment of the kitchen. Residents at the home were involved in this project helping to choose designs and colour schemes. The manager continues to develop the service and listens to the views and opinions of people who live at the home. For example, the range of activities provided has been increased in line with residents’ requests and both residents recently enjoyed a holiday. Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 8 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 9 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 Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 2 People using the 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 manager will ensure that she can meet the needs of any prospective resident before offering them a place at the home. EVIDENCE: Both of the people who live at the home have done so for many years and there are no plans to admit a third person for the foreseeable future. In discussion, the manager told us that she would be very careful to ensure that any new person who came to live at the home would be suitable and compatible with the existing residents. The process of assessment was discussed. The manager was aware of the importance of obtaining thorough information about a prospective resident’s needs, so as to ensure that their needs could be met at the home. In addition, obtaining this level of information would enable her to put a detailed plan of care in place before they arrived. Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 11 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care is planned in line with people’s individual needs and wishes. People are encouraged to make decisions and express their opinions. EVIDENCE: Each resident has an individual plan in place that outlines their care needs and how these needs are to be met. Both of the people who live at the home confirmed in their surveys that they knew about their plans and the information they contained. Since the last inspection, the manager has continued to improve processes for individual care planning and ensures that they are regularly reviewed to reflect people’s changing needs. Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 12 In discussion, the manager advised us that she constantly encouraged residents to make their own decisions and have a say about things that are important to them. We recommended that the manager research local advocacy groups and make their details available to the people living at the home to further support them in expressing their views. The manager demonstrated a good understanding of risk taking and recognised that well planned and managed risk taking can be an aid to a person’s growth and development. The manager had systems in place to assess individual risks associated with new activities for instance, and where appropriate, measures were in place to reduce such risks without removing a person’s opportunity for personal development. We saw a number of examples of how residents have gained confidence in new activities which have enhanced their lifestyle. Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: 12, 13, 15, 16 & 17 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are supported to choose how to spend their time and take part in activities that they enjoy. EVIDENCE: We found that both residents of the home lead a varied lifestyle and have regular opportunities to engage in activities they enjoy. Activities enjoyed by the residents include hobbies such as swimming and regular trips out. Both residents also play active roles in their local community and are regularly supported to access local facilities and amenities. Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 14 We were able to confirm that residents are supported to maintain important relationships and visitors are welcomed at the home at any reasonable time. At the time of our visit the residents had just returned from a holiday. We spoke to one resident who told us he had really enjoyed the experience and couldn’t wait for the next one! People who live at the home were very complimentary about the food provided and in their written surveys both said they felt the food was one of the things they liked most about the home. The manager advised us that because the home is small, she found it quite easy to meet residents’ individual preferences and knew all their likes and dislikes. We were also able to confirm that residents are involved in deciding what meals they have increasing their opportunity to make choices in their daily lives. Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 People using the 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 manager monitors the health and wellbeing of people who live at the home closely and ensures that they are enabled to access medical advice when needed. EVIDENCE: Oakley is a small home and presently there are only two residents living there. There are no staff employed at the home and all the care is provided by the manager. As such, the manager has a very good knowledge of the residents and their individual needs. Each resident has an individual plan in place which includes information about their health care needs. Records are also kept to demonstrate that people living at the home are regularly visited by health care professionals such as community psychiatric nurses. Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 16 The manager advised us that she constantly monitored people’s health and wellbeing and records showed that she was quick to take action (such as making contact with a GP) if any concerns were identified. There are basic procedures in place which cover the receipt, storage, administration and disposal of medication. We viewed a selection of medication administration records which were in good order with no errors or omissions. One person who lives at the home chooses to manage her own medication and she has been supported in this decision by the manager. Appropriate risk assessments and a written agreement are in place in relation to this. We viewed the home’s medication store and were able to confirm that all residents’ medication is now kept in a locked cupboard to help ensure people’s safety and wellbeing. Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to raise any concerns and the manager would deal with any concerns raised appropriately. EVIDENCE: People who live at this home have close daily contact with the manager and as such, regular opportunity to express views and discuss concerns. However, there is a danger that this close contact may make it more difficult for residents to complain. The manager advised us that to try and address this issue she met with residents on a regular basis and asked them to let her know if there was anything at all they are not happy with so as to gather their views about all aspects of the service. In their completed surveys both residents told us that they knew how to make a complaint. The home has a complaints book in place. We viewed this and found that there had been no complaints made since the last inspection. In addition, the Care Quality Commission have not received any complaints about this home since its registration. Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 18 The manager of the home has undertaken training in Safeguarding Adults and is fully aware of the procedures to be followed in the event that an incident of abuse is alleged or suspected. . Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at this home are provided with comfortable, homely accommodation which is decorated and furnished to a high standard. EVIDENCE: This home is conveniently located in the Heysham area of Morecambe. It is within walking distance of the beach and close to a number of facilities and amenities. At the time of our visit we found the home was clean, warm and comfortable and all areas were nicely decorated and furnished. Both residents have their own lockable bedrooms which are nicely decorated and filled with personal items such as pictures and ornaments. Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 20 There are a variety of communal areas to use including several lounges and safe outdoor space. The manager advised us that she had recently purchased additional outdoor furniture for the enjoyment of people who live at the home. Since the last inspection a number of improvements had been made within the home as part of the rolling programme of improvement. A new kitchen had been fitted and we were advised that both residents had helped to choose the kitchen and colour schemes. There are basic infection control procedures in place which outline the manager’s approach to ensuring that any infection is not spread within the home. Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience excellent/good/adequate/poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. None of the above standards were assessed because there are no staff employed at this home. EVIDENCE: Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 22 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Oakley is a well managed home which is run in the best interests of people who live there. EVIDENCE: The owner/manager of Oakley took over the home approximately two years ago. During this time she has continued to develop the service and has made some positive changes as a result of listening to people who live at the home. Both residents completed surveys and expressed satisfaction with all aspects of their care. We were able to talk with one of the residents during our visit and he appeared comfortable and relaxed in his surroundings. Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 23 The manager has measures in place to ensure that residents have the opportunity to express their views and opinions about the running of the home. As well as consulting people on a daily basis, the manager invites the residents, their relatives and other people such as community health care professionals to take part in regular satisfaction surveys. There are a number of measures in place to help ensure the health and safety of residents including fire safety and infection control procedures. In addition, information completed by the manager confirmed that all safety checks are regularly carried out within the home including gas and electric appliances. The manager of this home has completed training in the key health and safety areas including moving and handling and food hygiene. We made a recommendation that she attend regular refresher training to ensure that she remains fully updated in these areas. Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 24 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 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 x 33 x 34 x 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Version 5.2 Page 25 Oakley Care Home DS0000069017.V376493.R01.S.doc NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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. 2. Refer to Standard YA7 YA34 Good Practice Recommendations The manager should research local advocacy services and make their contact details available to residents. A recruitment policy and procedures that include the gathering of information as specified in Schedule 2 of The Care Homes Regulations 2001, should be developed and followed for any person who works in the home on a voluntary basis. The manager should complete training in relation to The Mental Capacity act. The manager should complete the registered manager’s award. An audit should be carried out against Appendix 3 of the National Minimum Standards to determine which policies and procedures are still outstanding. Those still outstanding should be developed and implemented. DS0000069017.V376493.R01.S.doc Version 5.2 Page 26 3. 4. 5. YA35 YA37 YA40 Oakley Care Home 6. YA41 An audit should be carried out of all the records in the home to ensure that all records required by the Care Homes Regulations 2001 are in place. The manager should ensure that she completes regular refresher training on the key health and safety areas such as moving and handling. 7. YA42 Oakley Care Home DS0000069017.V376493.R01.S.doc Version 5.2 Page 27 Care Quality Commission North West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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