Care Home: Oakley Square Project

What the care home does well The home provides a very much needed service for women with complex mental health needs who are returning to live in the community after varying lengths of time in secure psychiatric units, special hospitals and prisons. The service works with each person as an individual to support them to develop the skills needed to become more independent whilst ensuring they receive the correct professional support. They also help them to participate in a wide range of activities and to develop or re-establish relationships. This is all achieved within a comprehensive risk management framework. The staff team is well managed and very skilled in supporting women with these complex needs. The home welcomes comment and constantly strives to improve, providing an environment where the women can express their wishes and make decisions for themselves. What has improved since the last inspection? Since the last inspection the home has worked to ensure staff receive regular individual supervision. In addition the home has managed its finances and is now fully staffed. The self assessment prepared by the home also identified that additional training has been provided for the staff to improve their skills in working with the people living in the service. What the care home could do better: The home is providing excellent outcomes for the people living in the service. There does however need to be an improvement in the record keeping around staff recruitment and training. This is to ensure all the staff have the current recruitment checks in place and that their mandatory training is completed as needed. This is to ensure the residents are protected and kept safe. It is also suggested that a shelter is provided in the garden to protect smokers from the rain. In addition the fire safety risk assessment needs to be found so it can be updates as needed. Key inspection report Care homes for adults (18-65 years) Name: Address: Oakley Square Project 69 Oakley Square London NW1 1NJ     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: Jane Ray     Date: 2 5 1 1 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 28 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 28 Information about the care home Name of care home: Address: Oakley Square Project 69 Oakley Square London NW1 1NJ 02073881112 02073881114 staff@oakley.equinoxcare.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Equinox care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 8 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Female whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home 69 Oakley Square is a care home providing accommodation and care for up to eight women, who have a history of mental health problems, resulting in admissions to special hospitals, secure units, and prisons. The home provides a community base following discharge and assists service users to readjust to their new life. Residents remain at the project for between three and five years during which time they are supported to learn positive coping, and practical daily living, skills. The staff team work closely with multi-disciplinary clinical teams to try and maximise the residents potential. The property is subject to management agreement with St Pancras and Humanist Housing Association who are responsible for the major repairs and most of the maintenance. The registered care service is managed by Equinox, which is a Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 8 Brief description of the care home voluntary organisation, which manages a range of similar projects. The house is a five storey Victorian building in a residential street in Camden, situated opposite a small park. There is a small, enclosed garden to the rear. The property is situated between Camden Town Underground and Euston Station, which are within a tenminute walk from the home. Mornington Crescent tube station is near by, and there are also several bus routes. Living accommodation for service users is over four floors. The house has eight single bedrooms, two lounges, a kitchen with a dining area, and activity rooms, two bathrooms and a shower room a single toilet plus two offices and a sleep in/meeting room for staff. As the home provides a mental health aftercare service there is no fee to the service users. The placing authority pays the full cost of 1928 pounds per week. Care Homes for Adults (18-65 years) Page 5 of 28 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: The site visit for this inspection was unannounced and took place over five hours. Prior to the inspection time was spent looking at information that had been sent to our office. This included a very comprehensive self assessment prepared by the manager of the home. We also looked at any notifications we had received. During the inspection we spent time speaking to four of the residents who were living in the home and three of the staff team. We also looked at a number of records held in the home. The inspector would like to thank the residents and staff for all their help with the inspection. Care Homes for Adults (18-65 years) Page 6 of 28 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 28 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 28 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. People thinking of moving to the home are given comprehensive information on which to base this decision. The home ensures that it feels confident it can meet the complex needs of the residents by undertaking a very thorough assessment process before offering them a place. Residents are also offered support to make their move to the home as smooth as possible. Evidence: Prospective service users are encouraged to visit the service before a referral is made and if accepted, structured pre-admission visits are organised to ensure that the service user gets to know the community, the staff team and the service user group (Extract from the AQAA prepared by the home) I had a really good understanding about the home and the support I was going to receive before I moved in (Quote from a resident) I was made very welcome when I arrived and I picked the colours for my bedroom walls (Quote from a resident) Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: We looked at the information given to prospective residents in the form of a brochure when they are considering if they wish to move into the home and the service user guide they receive once they move to the home. These documents were really clear and well organised giving all the necessary information. We looked at the information collected as part of the assessment process and spoke to the staff about how the decision is made about whether the home can meet the needs of the resident. It could be seen that this was a very detailed process that including obtaining detailed feedback from care professionals, carrying out an in depth assessment and discussing the needs of prospective residents at a multi-disciplinary panel. This ensured that there was very careful consideration about whether the service was appropriate to meet the specific and complex needs of the women who had been referred. The residents and staff both talked about the process of being introduced to the home and moving in. This includes a number of visits and the preparation of their room. There was also an induction programme for new residents to support them to get to know the area and be linked in with apropriate services. The residents said how well prepared they feel when they move to the home. We looked at the residents records and they all had a contract in place between themselves and the home. Whilst this did not state the details of the fees and what these cover, these details are provided in the service user guide. Care Homes for Adults (18-65 years) Page 10 of 28 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. The whole ethos of the home is to enable the residents to make decisions about their lives and through the effective use of care plans, risk assessments and the key working system to give the residents opportunities to make progress with the necessary support in place. Evidence: Care plans and risk assessments are created with the service users full participation and are reviewed every six months or immediately following a crisis or incident. Service users remove goals from their care plans when they are satisfied they have been accomplished (Extract from the AQAA prepared by the home) I do support plan and risk assessment with my key worker and we also prepare a weekly plan so we know what I am going to do each day (Quote from a resident) We looked at the support plans for four of the residents. They were all written very clearly and included very practical and achievable outcomes supporting the residents Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: with all aspects of their lives. From talking to the residents and staff it was very evident that the residents were fully involved in this process and used their key working sessions to discuss their progress and any changes they wanted to make. The support plans are reviewed every three months or more regularly if needed. The staff and residents were also able to describe the key working role and this was clearly intergral to the operation of the service and the support given to the women. Each resident has two key workers and they change every six months. Key worker sessions happen each week and the residents were able to describe how valuable they found this time to discuss issues and raise any concerns. The staff were also able to describe how they support the residents to access a wide range of services and activities as well as assisting with practical matters such as budgeting. All the residents whose records were inspected had attended a multi-disciplinary review meeting in the last six months. The home had kept a record of the decisions made at these meetings so that any action could be followed through whilst the official minutes were received. Where the assessment or support plan identified any areas of risk, there were comprehensive risk assessments in place covering a wide range of emotional, physical and practical issues. These again had been reviewed on a three monthly basis or following any serious incidents or a change in the persons individual needs. The staff explained that they have not had to use a deprivation of liberty safeguard as all the residents have got capacity and have managed to be involved in all their important decisions including whether they needed to be readmitted to hospital for further treatment. The residents said they felt involved in the running of the home. There is a residents meeting every three weeks chaired and recorded by the residents. This is attended by the manager and one other member of staff. Any ideas from this are discussed at the staff meeting so that they can be implemented. Residents have also been involved in preparing a magazine for the home. One resident represents the home on a service user panel that covers the whole organisation. Care Homes for Adults (18-65 years) Page 12 of 28 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 people living in the home are supported to have varied and fulfilling lives, participating in the wider community and enjoying their relationships with their families and friends. Evidence: The aim of the home is to empower service users towards a more positive, fulfilling life in the community. Service users are encouraged to develop a structured weekly programme which includes daily living skills like budgeting, shopping, cleaning, leisure and social activities as well as educational opportunities. (Extract from the AQAA prepared by the home) I go to the local Mind group and I meet people there and I have done a variety of college courses. (Quote from a resident) Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: I can budget my own money and I manage my own building society account. (Quote from a resident) We all keep to the cleaning rota. I like to eat the food prepared by another woman, but she does not eat mine - she is a better cook than I am. (Quote from a resident) From talking to the residents and staff and from reading the support plans it could be seen that all the residents were being supported to develop their independent living skills. One resident talked about the support she receives to use local public transport. The women all said how they helped with the cleaning in the home. The residents and staff explained that there are lots of opportunities for people to participate in a range of educational opportunities. One resident talked about how she is attending a course to learn bicycle maintenance and another explained she is doing a film production course. The support plans show that everyone is encouraged to access local community facilities and to develop interesting and meaningful lives. The residents and staff all explained that they each prepare their own meals. The residents explained that they buy their own food, with staff support as needed and then have their own storage space in the cupboard and fridge. The women were seen preparing meals and are all able eat what they individually want. The information provided by the home supports the women to access a place of worship if they wish to do so. The residents spoken to during the inspection all said they did not wish to practice a religion. They did however talk about how they enjoy their culture particularly through contact with their relatives and the food they liked to prepare. The residents were observed coming and going as they wished and using their own keys and collecting their post. The residents talked about how they are seeing relatives and friends. One person said she was meeting a friend later in the day and was planning to cook her some lunch. The home does have house rules in place about visitors to ensure that the women are protected and that they do not intrude in each others lives. The staff also explained that they are able to support the women to re-establish links with their children. Care Homes for Adults (18-65 years) Page 14 of 28 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. People living in the home will be supported to access the healthcare input they need to manage their mental health. They will also be supported to take their medication and encouraged to self medicate when they feel able to do so. Evidence: The service users mental health needs are subject to regular review through the Care Programme Approach and staff members are in touch with the care team to inform them about any changes. (Extract from the AQAA prepared by the home) I am now self-medicating and I have done this by working through a number of stages (Quote from a resident) I go regularly to the dentist and optician, see my psychiatrist and social worker every three months and attend a monthly clinic for my blood tests (Quote from a resident) From talking to the residents and reading their support plans it was evident that the support they receive is very much based on their individual needs that change over time. This support is given with the aim of enabling the residents to become more Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: independent. The residents in the home all have complex mental health needs and from looking at records it could be seen that their input from the mental health professionals is closely monitored and there is regular ongoing contact between the staff in the home and the care professionals. All the residents register with the GP, dentist and optician when they first move to the home and receive ongoing appointments. Two residents visited their GP during the inspection. The residents spoken to also confirmed that they attend their dental and eye checks. The staff explained that they also support the residents to seek other appropriate support such as attending alcoholics anonymous or other groups or services where appropriate. Staff were observed administering medication and this was done in a private and organised manner. The home uses the Boots medication administration system. The medication records are well organised and staff can easily tell if there has been any changes in the medication. The administration records were completed correctly and there was a clear audit trail. The staff confirmed that no control drugs were being administered at the time of the inspection. Residents can ask if they want medication that is given as required and there was a clear record of the maximum dose that could be given. Residents are supported when they feel able to move gradually towards self-medication. This is backed up by the appropriate support plan and risk assessments. Lockable drawers are available in their room to store their medication. The staff we spoke to and the training records showed that staff who administer medication have been trained to do so. Care Homes for Adults (18-65 years) Page 16 of 28 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. People living in the home know how to raise any concerns they might have and feel able to do so. The staff are appropriately trained to recognise and respond to safeguarding matters. Evidence: The staff team has been on various training courses including POVA and challenging behaviour and have had the opportunity to feedback to the staff team about this. Equinox has developed a dignity at work policy which addresses bullying behaviour. (Extract from the AQAA prepared by the home) If there are any complaints we just tell our key worker or the manager (Quote from a resident) From speaking to the residents it was clear that they all felt able to raise any concerns they might have. The AQAA explained that all residents have the complaints procedure explained to them when they move to the home as part of their induction. The complains record was seen and there had been four complaints this year which had all been addressed appropriately within a short timescale. The staff training records showed that all the staff had received training on safeguarding vulnerable adults. The staff spoken to had a good understanding of safeguarding, how they might recognise abuse and what steps they would need to Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: take. All the residents manage their own personal monies and have their own accounts. Staff can however support them to learn to budget and contact the DSS if there are queries about their benefits. In addition they also are given a weekly allowance by the home to purchase their food and other items such as toiletries. Care Homes for Adults (18-65 years) Page 18 of 28 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. People living in the home are offered a homely and comfortable environment. Evidence: Prospective service users and professionals visiting Oakley Square often comment that it has a very homely atmosphere. (Extract from the AQAA prepared by the home) My bedroom is very cosy and I enjoy watching the television there. (Quote from a resident) Oakley Square is located in a Victorian terrace house and is spread over four floors with five flights of stairs. The house is attractively decorated throughout with comfortable furnishings and interesting paintings and other decorations on display. There is a small enclosed rear garden and this is where residents may smoke in addition to their bedrooms. It was observed that there was no shelter available and it is recommended that this is provided. There is a spacious kitchen and two communal lounges. In addition there is an activity room with two computers offering internet access. Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: There are two shared bathrooms and it was observed that they had tiles missing from the wall. The staff explained that these repairs had been requested but take a long time. The house was observed to be very clean and tidy. Care Homes for Adults (18-65 years) Page 20 of 28 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 working in the home are very skilled and are able to offer a consistently high quality of support to the service users. Some records need to be kept up to date to ensure refresher training is provided as needed and to ensure current criminal record bureau checks are available. Some releif staff need to have their training updated to ensure they can continue to meet the needs of the residents. Evidence: Oakley Square has a full staff team with clarity of roles within the team. New staff undergo a service specific induction as well as attending the Equinox induction training. (Extract from the AQAA prepared by the home) The staff are very nice and helpful (Quote from a resident) At the time of the inspection there was a manager, assistant manager and eleven support workers in post. There are a minimum of two staff working during the day, although usually three and at night one waking and one sleeping member of staff. This was confirmed from speaking to the staff and looking at the rota. The staffing was adequate to meet the needs of the residents and staff explained that if needed, additional staff can be arranged. Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: One more recently recruited member of staff talked about the induction process which was extremely thorough and said that she felt very well prepared for the work. The induction programme and checklist was also seen which confirmed this view. In terms of ongoing training eight staff have completed the NVQ level 2 or above and two have started the training. The organisation provides an ongoing programme of mandatory training as well as training to support the staff to specifically meet the needs of the residents. This has included training on changes in the Mental Health Act and the Mental Capacity Act. The AQAA also talked about training arranged to help the staff understand about people who hear voices. The staff spoken to about this training said they had found it really valuable. The staff also have input at the three weekly team meeting from a forensic psychologist so they can be supported to develop their practice and meet the needs of the residents. The staff training records were inspected. Some of these records are recorded on a computer and others are kept in the form of paper certificates in the staff file. From talking to the assistant manager and staff it was clear that not all the training had been recorded which meant that it was not possible to tell whether staff had completed all the mandatory training or needed training updated. It is recommended that the staff training records are updated and outstanding training booked at needed including for releif staff. The recruitment checks were inspected for four staff. The original records are held at the head office and in each file there is a signed form confirming that the manager had seen the original documents. These forms were not available for the two most recently recruited staff. Information is also available on the computer to confirm staff CRB disclosures are in place and current permission to work in the UK. One member of night staff did not have a record of a current CRB, although the assistant manager stated that they had a completed CRB from when they came into post. It is recommended that an updated CRB is obtained. The record of staff supervision was inspected and this is taking place on a monthly basis and offers an opportunity for staff to discuss their key working role, team issues and training needs. Care Homes for Adults (18-65 years) Page 22 of 28 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. Oakley Square is a very well managed service. Residents are encouraged to give their views on how the service can be improved. It is not clear whether all the staff have the necessary health and safety training and this needs to be checked to keep everyone safe. Evidence: Service users fed back at the last service user survey that they felt the management and the staff team is approachable and listens to them (Extract from the AQAA prepared by the home) The managers style is very fair and you can always raise issues. (Quote from a member of staff) Whilst we did not meet the manager during the inspection it was very evident that the home was well run and that with the assitant manager she provides a stable and open leadership. The AQAA was completed by the manager to a very high standard and identified a number of ways in which the service could further improve. Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: The assistant manager explained that the residents are asked to complete a survey every six months giving their feedback on the service they received and their comments are used to identify further improvements. The latest set of surveys were seen. In addition there is a monthly monitoring visit carried out in the home and these records were also seen. The AQAA prepared by the home confirmed that all the maintenance checks for equipment in the home were up to date. The fire records in the home confirmed the fire alarm was being checked weekly and fire drills take place every four months at different times of the day. The assistant manager said a fire safety risk assessment had been completed but this could not be found. The training records were looked at for four staff and they appeared to have not had some mandatory training or this training was out of date. It was however evident from talking to staff that these records were not all accurate. At the last inspection there were concerns about the financial viability of the service as there were a couple of voids. At this inspection it was observed that the home had enough staff and from looking at records of staff team meetings it was clear that there were ongoing discussions about ensuring the service managed its budget appropriately. Care Homes for Adults (18-65 years) Page 24 of 28 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 25 of 28 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 1 42 13 The registered person must ensure all the staff have completed the essential health and safety training including fire safety, food hygiene and infection control. This is to ensure the residents are supported by staff who can keep them safe. 31/03/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 28 The registered person should provide a shelter in the garden for residents who wish to smoke to use when needed. The registered person should ensure that the records of recruitment checks are kept up to date to confirm the original documents have been seen and to ensure a current CRB disclosure is in place for all the team. The registered person should ensure that training records 2 34 3 35 Care Homes for Adults (18-65 years) Page 26 of 28 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 are kept up to date for the whole staff team so that training gaps can be identified and booked as needed for the permanent and releif staff. 4 42 The registered person should locate the fire safety risk assessment so it can be updated as needed. Care Homes for Adults (18-65 years) Page 27 of 28 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. 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. 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