Care Home: Oakley House

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What the care home does well Oakley House provides a supportive environment, which allows the residents to develop their potential as individuals. There is more communal space than required and the residents freely access all areas of the home. The happy atmosphere there ensures that there are few disagreements and that it is a pleasant experience to visit the home. The residents are very welcoming and considerate towards each other. The comments from the residents when they spoke with the inspector were very positive. They felt that Oakley House was their home and they lived as a family. None of them identified any problems with living there and no one complained about any of the other residents. They also expressed their appreciation of the manager and staff and the supportive care they receive from them. What has improved since the last inspection? Parts of the house have been redecorated. What the care home could do better: There were no areas identified that the service needs to improve. Key inspection report Care homes for adults (18-65 years) Name: Address: Oakley House 23 Gerard Road Weston Super Mare North Somerset BS23 2RE     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: Jacqueline Sullivan     Date: 0 7 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Oakley House 23 Gerard Road Weston Super Mare North Somerset BS23 2RE 01934627481 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Valerie Murray care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Oakley House is a small community home for younger adults with learning is situated close to local amenities that allow the residents the opportunity independently pursue specialist interests. Currently the home is registered people all of whom have been there for a considerable time. Oakley House converted Victorian property, which provides ample space and facilities for residents. The fees for the home are negotiated on an individual basis. disability. It to for three is a its 3 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 26 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: 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 peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection of Oakley House took place over parts of two days to ensure that all the residents were at home and therefore could take part in the inspection process. The inspector spoke with the staff member on duty as the manager was on holiday. We viewed the essential documentation held at the home. The residents and Inspector then reviewed their personal files and discussed their daily life at Oakley House. The quality of life for the residents at Oakley House was perceived by the inspector to be of a very high standard, with the staff providing guidance and supervision to support the residents to be independent. All of the comments received from the residents were favourable and as they have lived there a long time, they regard Oakley House as their home. Care Homes for Adults (18-65 years) Page 5 of 26 Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 26 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 judgement using a range of evidence, including a visit to this service. Residents can be assured that they will have the opportunity to visit the home prior to making a decision to live there. Residents have the information necessary to make informed choices. Evidence: The statement of purpose and the service user guide contained the correct information. The current residents have lived at the home for several years.We spoke with three residents who confirmed that they had a copy of the service user guide and had seen the statement of purpose.Each confirmed that it was written in a format they understood. We looked at the resident files and saw that they contained detail assessments which informed their care plans.We saw that each person had a folder which contained information about their needs and aspirations and the staff member and residents confirmed that their needs are met by the staff team. Care Homes for Adults (18-65 years) Page 9 of 26 Evidence: Care Homes for Adults (18-65 years) Page 10 of 26 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 judgement using a range of evidence, including a visit to this service. Residents benefit from knowing and understanding their care plans. Residents are assisted to take risks and are able to make choices about the care they want to receive from the staff team. Evidence: The people who were visited expressed no concerns over the way the care staff treated them and said that the staff respected their privacy and dignity. Staff spoken with were able to give examples about how they ensure people have choice about their personal care. We spoke with three residents who confirmed that they are aware and used to participating in the reviews of their care plans and planning for the future. They were able to describe the plans. One person said that they were really happy at the home and felt that It is like living in a family. He said I want to stay here and I said that at the meeting. He was referring to his most recent review. He said he felt anxious Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: that he may have may have live in supportive living in the future. He felt strongly that he wanted to remain living in the home as this was where he was happy. As noted at the last inspection the residents have individual care files which contain current care plans linked to the assessment of support needed which in turn is based on the activities of daily living. All the documentation had been reviewed including the risk assessments. These were seen on the care files. Daily events are recorded in different ways in several ways which include events recorded on daily record sheets and events being recorded in individual books. These confirmed that appointments with GPS , special events, and visits to families and visitors to the home took place regularly. On the evening of inspection we saw one person reading their life book. The book was very detailed and showed this persons choices about for example food choices and how she wished to be cared for. This showed us that the staff regularly speak to residents and understand their needs and preferences. Residents are involved with the day-to--ay running of the house. They make choices about the food they eat, the colours of their bedrooms, events they attend and equipment for their rooms. The residents are supported to make informed decisions about their lives, and identified other people who they liked to be involved in these decisions, such as parents or friends. A daily log is used to record visits and events in the clients life and to report on any changes. All changes are communicated to the manager.The client and the carer sign the home records. Care Homes for Adults (18-65 years) Page 12 of 26 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 judgement using a range of evidence, including a visit to this service. The home enables younger adults to follow their interests and be integrated into community life and leisure activities. The residents choose the food that they would like to eat. Evidence: One the first day of inspection all the residents were out all day as they are involved in a wide variety of activities and return home in the evening. The activities include college courses, Day Centre activities or employment. The residents choose which of these they would like to attend or take part in. One person works in a supermarket and may soon be taking additional training so he can serve food. He said , They want me to work another day. I really like it there. Another person said ,He is the best worker there. This showed us the strong relationship between the people who lived Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: there. It was clear they got on well and supported each other. One person told us about the allotment they work on. Again they enjoyed this and supplied the home with the produce that they grew. Another resident particularly enjoys attending a pottery group, and visiting the local shops and community . The residents have lived at Oakley House for some considerable time, and enjoy attending leisure activities with each other. They attend social groups in the community and have string links with the residents of the sister house who they spend a lot of time with particularly at weekends. As noted at the last inspection all of the residents at Oakley House are able to self advocate, and participate in the day-to-day planning of their lives. They are supported with decisions by both the homeowner and staff at the home, and by involving relatives. Residents are free to invite friends and relatives to visit, and often will spend time away from the home visiting relatives. The menus are decided by the residents and on one day a week they have takeaways. This is recorded in the care documentation. In order for the home to fully evidence that residents are eating a healthy diet consideration should be given to recording menus and food eaten by the residents. Care Homes for Adults (18-65 years) Page 14 of 26 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 judgement using a range of evidence, including a visit to this service. Residents can be assured that personal support is flexible, consistent and responsive to their changing needs. Residents can be confident that their health needs will be met by the staff team. Evidence: The level at which the residents require support with personal care is individual to them. They are able to express a choice of the gender of the person they want to support them and this is noted in their care files and actioned by the staff. The residents continued good health is promoted by the owner of the home, who ensures that the residents are referred were necessary for healthcare services. The inspector confirmed this with one resident who spoke of his recent visits to the Doctor and the support from the home to attend the appointments. If residents are unwell, the home is able to provide staff to support them to stay at home. It remains the case that the medication at the home is minimal. The prescribed medication is reviewed on a regular basis by either the GP or consultant psychiatrist. Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: The medication administration and records were checked and found to be correct. As noted at the last inspection the home does not have any controlled drugs, and keeps a minimal stock of homely remedies. We spoke to the three people who live at the home and they confirmed that their health needs were met. Care Homes for Adults (18-65 years) Page 16 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are in place to minimize risk so that the safety and welfare of individuals are protected. The policies and practices of the agency ensure that individuals are safeguarded from abuse or harm. Evidence: The residents at Oakley House are able to self advocate and raise any concerns or complaints directly with the homeowner. We asked one person what they would do if they were unhappy about something. They said I Would tell x (A staff member )if I am worried. Three residents confirmed that they were confident in the staff team to resolve any issues they had. We observed that there is an open culture at the home between the residents and staff. The complaints procedure is available to the residents. A copy is on the notice board. We saw that it is in an accessible format, it is also available in the statement of purpose. There have been no complaints or adult protection issues at this home. Care Homes for Adults (18-65 years) Page 17 of 26 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 judgement using a range of evidence, including a visit to this service. Residents are encouraged to see Oakley House as their own home. It is well maintained and an attractive home, which is accessible to community facilities and services. Evidence: Oakley House is a well maintained property which provides family type accommodation for its three residents. The residents confirmed with the that they had been involved with the redecoration and refurbishment of the home including their bedrooms. Two people showed us their rooms and we saw they were homely and well furnished. One person had their own computer and music centre in their rooms. The bathroom upstairs has been replaced since the last inspection. The residents stated that they were happy with the home and their rooms, which they furnished to their individual taste. Residents access all areas of the home and are aware that before entering each others rooms they are supposed to knock. The manager employs a friend to clean the home who we met on the first day of Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: inspection. The residents are never at home when the domestic staff are on the premises. The home is clean and free from unpleasant odours and provides a comfortable and safe environment for the residents. All the residents stated that they felt like this was their home and that they were happy there. A staff member said, It is like one big family. I dont see it as work. Care Homes for Adults (18-65 years) Page 19 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents can be confident that there are sufficient staff to meet their needs. Staff have the skills to communicate effectively with the residents Evidence: No new staff have been recruited to Oakley House since the last inspection. The manager and one staff member provide the majority of the support to the residents at Oakley House. This is supplemented by support from staff that are employed at Harewood House (the partner home). By working this way the residents have continuity of staff support. The manager has undertaken sufficient training and attends regular meetings in order to update her knowledge and skills when providing support for the residents. The residents confirmed to the inspectors that if they wish to attend activities then they have sufficient staff available. The residents also stated that the staff who came to the home when the manager was absent with people they knew and who knew them therefore a continuity of care is provided. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: Staff training is in place to ensure the residents needs are met. Staff files are kept at the sister house and these were brought to us on the second day of inspection. These were seen to include the necessary information. Consideration should be given to keeping these at the home. Care Homes for Adults (18-65 years) Page 21 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents can be confident that the home is well run and that they have the opportunity to be involved in the decision making. The residents can be confident that the environment is safe and that their health and welfare are protected. Evidence: As noted at the last inspection there is a stable staff team with the proprietor providing 24 hour support on a regular basis. The owner also ensures that the established routine and known preferences of the residents influence the day to day running of the home. The outcome of this approach is that the home runs for the benefit of the residents. The outcomes for the residents were stated to be very positive. Residents are encouraged to be independent and become part of the community. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: As previously stated some of the residents were aware that there are other housing options available to them but they feel that they are in the best place for them as it suits their own interests and lifestyle. The residents were very satisfied with their service. We saw positive service questionnaires to this effect and information in the care documentation. There were no health and safety concerns at the home at the time of the inspection; fire safety checks had been completed and the fire risk assessment had been carried out was available for the inspector to read. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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