Care Home: Oakwood

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What the care home does well The manager has developed a "residents guide" and a statement of purpose which are available to anyone including any prospective person moving in. The guide includes good levels of information on the purpose of the home and the facilities on offer and includes visual pictures which may help some people understand the information given. She has also included pictures of all the staff so that people can get to know who works at the home. Regular checks are made on the safety of the building and equipment to make sure the home is a safe place to live. The service continues to employ longstanding members of staff who offer great stability to the home. Members of the staff team appeared to know the residents well and have formed good relationships. Staff showed good knowledge and understanding of the needs of each person. Detailed individual support plans were available for each person. The plans were detailed and regularly reviewed and gave enough information to show how their personal, medical and social needs would be met and covered a diverse range of needs e including ,eg, optical check ups and hospital checks on any medical condition. The system for recording health checks also makes sure that each person is offered regular health checks. The home is effectively managed and any development are in the best interests of people living there, ensuring a good quality of service is provided. What has improved since the last inspection? The service had procedures for responding to concerns and complaints and for making sure that people have a pictorial complaints procedure which is clear to read and understand. The commission have not received any complaint about the service following the last inspection. There has been no cause for any visits to the service since its last routine inspection. People are able to enjoy a varied lifestyle and take part in the activities of their choice, including local visits to the community, day trips out, an annual holiday, music sessions, discos, lunch out etc. The maintenance and decoration of the home has been continual and has helped to keep the decor of the home to a high standard offering a good standard to the living conditions at Oakwood. The manager had developed a visual training plan. These records showed that staff undertake a variety of training to help them support people. This included diverse needs and areas such as, eg, health and safety, food hygiene, health action planning, epilepsy, abuse awareness, moving and handling, first aid, communication and challenging behaviour.The home currently has 75 per cent of staff with a care qualification called an "nvq." This is an example of how they have exceeded the basic standards which advises that at least half of the workforce should have a care qualification. We received 5 staff surveys all very positive with comments stating, "We have a very knowledgeable staff team who are supportive of each other." " We always strive to do our best for the people we support regarding all aspects of their lives." "We provide a service that is tailored to individuals needs, through use of "PCP`s, (person centred plans)" which are regularly updated." "people who have visited our service have commented what a good atmosphere our house has, like a family." "Team meetings are regular and informative..." "I was given an excellent induction at our house and also I was given the opportunity to complete a personal development portfolio...." ""I have been provided with excellent training since starting at Oakwood." "I have regular support and supervisions to discuss any problems I have or training I need." " We always strive to do our best for the people we support regarding all aspects of their lives." "....had statutory training before being able to administer medications." As an example of good practice, the organisation had developed records called, " Me and my money." They contained a section with a financial capability assessment and risk assessment workbook. They were very detailed, clear, open and transparent in how they support and manage each persons finances in their best interest. The company have also introduced a "disability distress assessment tool." This helped give a summary of the signs, symptoms and behaviours of each person so that they could be supported and helped with any discomfort. eg, Staff helped to build a profile of certain behaviours individual to each person which helped translate into what was wrong. They use signs and symptoms of distress with a description of the eyes and their facial appearance. We received 4 comment cards from people at the service. Staff had helped each person to fill them in and they very positive in indicating they were happy living at Oakwood. Staff had developed a clear visual menu plan were everyone had the opportunity to pick a picture of what food they would like for their meals. People were supported every day with this menu plan and staff took the time in supporting people in making their own choices. The service continues to provide an excellent standard of care and continues to meet the standards as identified at the last inspection. What the care home could do better: The service is meeting the vast majority of the national minimum standards and has met all of those assessed on this occasion. In a number of respects these standards are being exceeded. The manager continues to look at ways in which the service can be exceeded. The service would benefit from developing an in house policy and procedure describing how people are supported in coming to live at Oakwood.To publish and share the findings of recent questionnaires used as part of quality assurance to find out peoples opinions of Oakwood. To include the opinions of everyone at Oakwood while carrying out monthly checks, (regulations 26 visits) so that their views can be considered regarding the home. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Oakwood 16 The Wiend Bebington Wirral CH42 6RZ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Diane Sharrock     Date: 2 0 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Oakwood 16 The Wiend Bebington Wirral CH42 6RZ 01516439421 Telephone number: Fax number: Email address: Provider web address: Joan.Arnold@Macintyrecharity.org Name of registered provider(s): Name of registered manager (if applicable) Mrs Joan Arnold Type of registration: Number of places registered: MacIntyre Care care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The registered person may provide the following category/ies 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: Learning disability - Code LD The maximum number of service users who can be accommodated is: 5 Date of last inspection Brief description of the care home Oakwood is registered to accommodate 5 adults with a learning disability. Oakwood is a two-storey property located in a residential area. On the ground floor there is a lounge, dining room, kitchen, laundry, shower room, toilet and a single bedroom with en-suite. On the first floor there are 4 single bedrooms, a bathroom, toilet and an office. Bathing aids are provided. The home has a large garden, which has a seating area. There is wheelchair access via a ramp from the lounge. Parking is available on the main road. Oakwood is located in a central position close to Birkenhead and Prenton. There are local shops within walking distance and the bus stops nearby. The Care Homes for Adults (18-65 years) Page 4 of 32 Over 65 0 5 Brief description of the care home service receives a grant from the local authorities which the manager advises comes to aproximately 36,594.87 pounds per year for each person. Care Homes for Adults (18-65 years) Page 5 of 32 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 overall quality rating for this service is 3 star. This means that people who use the service experience excellent quality outcomes. This unannounced visit took place on the 20th January 2009 over a period of 5.5 hours. This was carried out with the help of the registered manager and the staff on duty. We gathered information for this inspection in a number of ways. We looked at various records and comments and observations made during our visit have also been used as evidence for this report. Care Homes for Adults (18-65 years) Page 6 of 32 Case tracking was used as part of the visit to the service. This involves looking at the support and care a person gets from the staff including their care plans, medication, money and their living conditions. We also spent time meeting both staff and residents. Inspections involve measuring a number of standards considered as important by the commission. A selection of comment cards were also sent before the inspection to offer people further opportunity to give their opinions. The manager completed a questionnaire we sent before our visit. The information from this was used by us to plan this visit and in writing this report. The document was completed and was returned to the commission before this visit took place. What the care home does well: What has improved since the last inspection? The service had procedures for responding to concerns and complaints and for making sure that people have a pictorial complaints procedure which is clear to read and understand. The commission have not received any complaint about the service following the last inspection. There has been no cause for any visits to the service since its last routine inspection. People are able to enjoy a varied lifestyle and take part in the activities of their choice, including local visits to the community, day trips out, an annual holiday, music sessions, discos, lunch out etc. The maintenance and decoration of the home has been continual and has helped to keep the decor of the home to a high standard offering a good standard to the living conditions at Oakwood. The manager had developed a visual training plan. These records showed that staff undertake a variety of training to help them support people. This included diverse needs and areas such as, eg, health and safety, food hygiene, health action planning, epilepsy, abuse awareness, moving and handling, first aid, communication and challenging behaviour. Care Homes for Adults (18-65 years) Page 8 of 32 The home currently has 75 per cent of staff with a care qualification called an nvq. This is an example of how they have exceeded the basic standards which advises that at least half of the workforce should have a care qualification. We received 5 staff surveys all very positive with comments stating, We have a very knowledgeable staff team who are supportive of each other. We always strive to do our best for the people we support regarding all aspects of their lives. We provide a service that is tailored to individuals needs, through use of PCPs, (person centred plans) which are regularly updated. people who have visited our service have commented what a good atmosphere our house has, like a family. Team meetings are regular and informative... I was given an excellent induction at our house and also I was given the opportunity to complete a personal development portfolio.... I have been provided with excellent training since starting at Oakwood. I have regular support and supervisions to discuss any problems I have or training I need. We always strive to do our best for the people we support regarding all aspects of their lives. ....had statutory training before being able to administer medications. As an example of good practice, the organisation had developed records called, Me and my money. They contained a section with a financial capability assessment and risk assessment workbook. They were very detailed, clear, open and transparent in how they support and manage each persons finances in their best interest. The company have also introduced a disability distress assessment tool. This helped give a summary of the signs, symptoms and behaviours of each person so that they could be supported and helped with any discomfort. eg, Staff helped to build a profile of certain behaviours individual to each person which helped translate into what was wrong. They use signs and symptoms of distress with a description of the eyes and their facial appearance. We received 4 comment cards from people at the service. Staff had helped each person to fill them in and they very positive in indicating they were happy living at Oakwood. Staff had developed a clear visual menu plan were everyone had the opportunity to pick a picture of what food they would like for their meals. People were supported every day with this menu plan and staff took the time in supporting people in making their own choices. The service continues to provide an excellent standard of care and continues to meet the standards as identified at the last inspection. What they could do better: The service is meeting the vast majority of the national minimum standards and has met all of those assessed on this occasion. In a number of respects these standards are being exceeded. The manager continues to look at ways in which the service can be exceeded. The service would benefit from developing an in house policy and procedure describing how people are supported in coming to live at Oakwood. Care Homes for Adults (18-65 years) Page 9 of 32 To publish and share the findings of recent questionnaires used as part of quality assurance to find out peoples opinions of Oakwood. To include the opinions of everyone at Oakwood while carrying out monthly checks, (regulations 26 visits) so that their views can be considered regarding the home. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 10 of 32 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 11 of 32 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. Good information is given to anyone thinking about moving into the home. This makes sure that the home is the right place for the person to live and that their needs can and be met. Evidence: The manager has developed a residents guide and a statement of purpose which are available to anyone including any prospective person. The guide includes good levels of information on the purpose of the home and the facilities on offer and includes visual pictures which may help some people understand the information given. She has also included pictures of all the staff so that people can get to know who works at the home. Good information is given to any prospective person including the option of having a trial visit to the home. This makes sure the home is the right place for the person to live in and and that their needs can be met. Care Homes for Adults (18-65 years) Page 12 of 32 Evidence: The staff have also developed documents called getting to know you. These documents are very detailed and give information about the person including their likes and dislikes. The packs help the staff to, eg, (extracts from the pack say), find out how you need us to help you when you move into a new house, so that we can give you the right support. The document also says,eg, when weve been helping you for 6 months so that we can help you see what things you can do better now and what things we dont need to help you with any more. We usually go though the pack every 12 months. This document was very clear and in an easy read format so that people knew staff offer to help support them with a wide variety of needs such as, the pack covers physical health, eyesight, emotional health, personal support, medication, communication, likes and dislikes including food and drink, work and training, social and leisure interests,, religion and culture and areas of risks. We looked at one assessment which showed how much work staff had done to help one person be comfortable and safe at the home. This guide gives clear details of catering costs, were all meals are provided including 1 takeaway each week. The meals on trips out for each person and staff are also provided to value of 7 pounds each. This was a good example of clear open and transparent information given to everyone about what they can expect when they come to live at the home. Care Homes for Adults (18-65 years) Page 13 of 32 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 individual needs and choices of the people living at Oakwood are identified so that staff can support them to meet those choices and all aspects of daily living. Evidence: Detailed individual support plans were available for each person, we looked at 2 of them. Each person has a person centred plan in place. These plans have lots of pictures to help each persons understanding and help keep everyone updated about the person. This includes things such as what they like and dont like including different food and menus. The home has a house budget for food shopping and uses local shops and supermarkets. Each person is supported in choosing their meals and staff support people in going out to do the shopping. Staff had developed a clear visual menu plan were everyone had the opportunity to pick a picture of what food they would like for their meals. People were supported every day with this menu plan and staff took the time in supporting people in making their own choices. Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: They also include how each person likes to communicate and how they like to be supported. It was obvious that everyone had worked hard with these plans and that each person was included in making their plan as detailed and informative as possible. Some included a personal wish list and some contained lots of information and pictures about each persons family and background. They gave enough information to show how their personal, medical and social needs would be met. They covered a diverse range of needs for each person living at the home including going out and social needs and communication tools. These plans provided everyone with clear guidance and were appropriate instructions as to the support people require in a range of environments and situations to enhance their life. In discussions with staff they were able to explain the way in which people living there make decisions and how they are able to decide for themselves. For example, staff support people in going out almost daily. Staff were knowledgeable about the needs of each person and knew how to meet their needs. Staff were observed to be respectful and seemed to have a good rapport with each person. We received 5 staff surveys all very positive with comments stating, We have a very knowledgable staff team who are supportive of each other. We always strive to do our best for the people we support regarding all aspects of their lives. We provide a service that is tailored to individuals needs, through use of PCPs which are regularly updated. We received 4 comment cards from people at the service. Staff had helped each person to fill them in and they very positive in indicating they were happy living at Oakwood. We looked at financial records which were well kept, accurate and in good order. Each person has been supported in opening their own bank account. As an example of good practice, the organisation had developed records called, Me and my money. They contained a section with a financial capability assessment and risk assessment workbook. They were very detailed, clear, open and transparent in how they support and manage each persons finances in their best interest. We looked at various policies including one for mismanagement and discrepancies of finances. We also looked at a finance policy, which was very detailed in explaining about the financial risk planning documents used for each person. This helped give clear open information explaining every aspect of how each person is supported with their Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: finances. Care Homes for Adults (18-65 years) Page 16 of 32 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 at Oakwood are supported so they can live a lifestyle of their choice. Evidence: Discussions with staff and in looking at records, it showed that the people staying at Oakwood always receive the support they need to get out and about regularly in their local community. For example one person fancied some fresh air and staff arranged to go out during our visit so the person was supported with their choice of activity. We saw some people seeking out the company of staff, and they were comfortable in their presence and confident that their requests for support with drinks, medication or leisure activities were acted upon. Each persons file showed that staff do try to plan social events and activities and also Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: carry out risk assessments to help make activities as safe as possible. These records and the weekly visual plan in the office showed that this is continual and that there had been trips out locally to the shops, chiropodist, disco, softball and a trip to New Brighton. The plans also contained as a matter of good practice individual pictures of the staff who support them. The plans also had various pieces of good practice including details of, essential things in my life. Each person is supported in identiyfing whats important to them and what they would like support with. We saw some requests and support offered with, eg, regular contact with my family. how to support me when going on the bus. how to support me when i go shopping. Throughout our visit it was obvious that there was a great commitment to support people with their social needs and requests. The organisation offered alot of support and priority in making this happen. eg Oakwood has a recreational budget of 2,162 pounds divided between the five people who live there. Each person has a, service user agreement, which openly gives a list of what activities they can support financially throughout the year based on what each person chooses. eg weekly music sessions, weekly softball, 7 day trips a year, costs toward an annual holiday. They also have clear, open details of any contribution costs to wards the services vehicle. The pre inspection questionnaire explained that they are continually planning to develop support with activities and plan to do various things including, encouraging the involvement of advocates and volunteers to develop circles of support, They also plan to, introduce a Great interaction policy with positive interactions training for staff, and explore alternative recreational activities. The manager organises regular house meetings to discuss the running of the home. We looked at recent minutes and they showed good discussions on everything at the home keeping everyone informed and included in the developments of their home. Care Homes for Adults (18-65 years) Page 18 of 32 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. The individual needs and choices of the people living at Oakwood are identified so that staff can support them to meet those needs, choices and all aspects of daily living. Evidence: Detailed individual support plans were available for each person we looked at two of them. The plans were detailed and regularly reviewed and gave enough information to show how their personal, medical and social needs would be met and covered a diverse range of needs, including , eg, optical check ups and hospital checks on any medical condition. The system for recording health checks also makes sure that each person is offered regular health checks. These sections were called, My personal health profile. They were all regularly updated and gave details of any health concerns or conditions the doctor or hospital were treating. The plans had various sections including a section called, I want to tell you something.... it offered pictorial support to each person to support them in getting information across to people. This included making a complaint or voicing concerns. The plans also contained as a matter of good practice individual pictures of the staff Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: who support them. The company have also introduced a disability distress assessment tool. This helped give a summary of the signs, symptoms and behaviours of each person so that they could be supported and helped with any discomfort. eg, Staff helped to build a profile of certain behaviours individual to each person which helped translate into what was wrong. They use signs and symptoms of distress with a description of the eyes and their facial appearance. The company and staff have also managed to deal sensitively with one subject that is often difficult to discuss. They have produced a sensitive document called, last wishes. The questionnaire helps identify personal wishes such as, are there any instructions from the family arising from the individuals ethnicity, culture or religion that effect how the individual should be treated after death. We looked at the storage and procedures of managing medications at the home and they were found to be well maintained and safely managed. Staff who support people with their medication have received training in dealing with medication. The manager advised that each staff member also has an assessments on their competence before they are given the responsibility of administering medication. The medications records were very detailed and everyone had worked hard to offer accurate and up to date medication records. They including details of any side effects and any known allergies. The clear systems in place for dealing with medications, along with a good commitment and investment into staff training, help to reduce the risk of mistakes occurring. It also provides a clear audit trail to check people receive their medication correctly. In discussions with staff they were able to explain the way in which people living there make decisions and how they are able to decide for themselves, for example staff support people, eg, when they choose to go out to an appointment or to the doctors, were to sit and be comfortable. Members of the staff team have supported people for a considerable length of time and therefore have a good understanding of their personal support needs. Staff training records showed that they had received specialist training in a number of topics including, epilepsy, challenging behaviour and communication. Staff explained that this helped them to understand and deal with these conditions and helped update their practices especially communication tools. One staff member explained how they had developed the use of pictures throughout Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: the home which has helped people with choices and independence. People at the service were seen to be supported in their own individual routine for the day by each of the staff . General observations showed that staff are respectful towards the people who use the service and promote the persons dignity at all times. Staff were aware of the support each person needed and had a good rapport and knowledge base of each person. Each persons support file had a company commitment of what they can expect while living at Oakwood. Extracts taken from the commitment which had been developed in pictorial format stating, You will be treated with respect at all times. We will support you to communicate with us in a way of your personal choosing. we will think about our work and continuously check with you that you are satisfied. During our visit this commitment was clearly in practice at Oakwood, both in the records seen and during our discussions, observations and comment cards received which were all very positive. Care Homes for Adults (18-65 years) Page 21 of 32 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. People are protected by the homes procedure for responding to concerns and complaints. Evidence: The organisation has policies in place for dealing with complaints and safeguarding issues and these provide guidance for staff. There is a book in the home for recording complaints received about the service, although none have been received since our last visit. Information about how to raise a concern or complaint is made available to the people living at Oakwood. Staff have developed this policy using pictures to help everyone understand how they can be supported in making their views and concerns known. The individual support plans for each person at the home had various sections including a section called, I want to tell you something.... These documents offered pictorial support to each person to support them in getting information across to people. This included making a complaint or voicing concerns. This is good practice as it helps to increase the opportunities for people using the service now and in the future to have a better understanding of the ways in which they can raise concerns. Following our previous visit the manager explained she had contacted a local advocacy Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: team to request they support people who did not have any next of kin. She explained that due to their restrictions of staffing levels and workloads they were unable to offer assistance with advocacy. We looked at various policies including one for mismanagement and discrepancies of finances. We also looked at a finance policy, which was very detailed in explaining about the financial risk planning documents used for each person. This helped give clear open information explaining every aspect of how each person is supported with their finances. We looked at financial records which were well kept, accurate and in good order. Each person has their own bank account. As an example of good practice, the organsiation had developed records called, Me and my money. They contained a section with a financial capability assessment and risk assessment workbook. They were very detailed, clear, open and transparent in how they support and manage each persons finances in their best interest. Staff told us that they are trained in abuse awareness and are trained to support and protect people. The manager had a visual training plan displayed in her office. It gave details of the training already identified for staff. This helped keep all staff up to date in all necessary policies and procedures including abuse awareness. Care Homes for Adults (18-65 years) Page 23 of 32 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. People live in a safe, comfortable and highly maintained home. Evidence: We were shown around the home and looked at a sample of areas. Each person has their own bedroom were they are encouraged to have personal belongings and to individualize the room they way they want. The manager has provided double beds for every person. We received 4 comments cards from people who live at the home and they were all positive in the facilities they are provided with. The home was decorated to a high standard offering a homely and well presented living space. The lounge is furnished with colour co ordinating furnishings and has large patio windows overlooking the gardens. We received 5 staff comment cards which were all very positive and included various comments such as, people who have visited our service have commented what a good atmosphere our house has, like a family. We always strive to do our best for the people we support regarding all aspects of their lives. Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: The kitchen and dining room offer a domestic style facility accessible to everyone. The attention to detail was obvious in how staff had worked hard in making the facilities suitable to the needs of everyone living at Oakwood. eg, Staff had displayed pictures in the kitchen on different draws and cupboards to help people find what they are looking for. Staff had also done this in peoples bedrooms so they could find what clothes they were looking for in their wardrobe and cupboards. The manager explained how they assess each persons needs especially if their needs change. She advised that they would always change the environment with the right equipment and adaptions to make the home a better place for people to live in. The manager had arranged an away day, for staff and from this developed an, annual development plan. This plan helped identify what people thought they needed within the home, including the environment and showed good details as to the commitment the organization have in offering a high standard of living thats suitable to everyones needs. We looked at a sample of maintenance certificates. They showed up to date checks as listed in the homes pre inspection questionnaire which helped show what actions were taken to keep the home safe and well maintained. We also met the health and safety officer for the home. They were able to show alot of health and safety records and checks that take place to constantly show what actions are taken to make sure the home is always safe. The health and safety officer does detailed monthly safety checks which is in addition to the usual contractual checks. Risk assessments were detailed and regularly reviewed showing what actions are taken to always maintain peoples safety. Care Homes for Adults (18-65 years) Page 25 of 32 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. People are supported and protected by the services recruitment and selection procedures with well trained staff. Evidence: Observation of staff and discussions with them indicate that the staff know the needs of people well and know their likes and dislikes. It was evident they had a good understanding of how to support people and how to make sure their needs are met and their individuality respected and catered for. The manager had developed a visual training plan and had various training records showing what each person had already achieved. These records showed that staff undertake a variety of training to help them support people. This included diverse needs and areas such as, eg, health and safety, food hygiene, health action planning, epilepsy, abuse awareness, moving and handling, first aid, communication and challenging behaviour. The home currently has 75 per cent of staff with a care qualification called an nvq but the manager is hoping they eventually have 100 per cent of staff with this qualification. This is an example of how they have exceeded the basic standards which Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: advises that at least half of the workforce should have a care qualification. We received 5 staff surveys all very positive with comments stating, We have a very knowledgeable staff team who are supportive of each other. people who have visited our service have commented what a good atmosphere our house has, like a family. Team meetings are regular and informative... I was given an excellent induction at our house and also I was given the opportunity to complete a personal development portfolio.... I have been provided with excellent training since starting at Oakwood. I have regular support and supervisions to discuss any problems I have or training I need. We always strive to do our best for the people we support regarding all aspects of their lives. ....had statutory training before being able to administer medications. We provide a service that is tailored to individuals needs, through use of PCPs which are regularly updated. We have a complaints procedure in place.... Some staff gave some personal suggestions on how to improve the service, eg, ...it would be nice to be able to share out the hours better having more 1 to 1. More staffing on a regular basis so everyone can benefit from 1 to 1 interaction. We looked at a sample of staff files and one show good records describing how they were supported in coming to work in the home. Each person has a personal development plan. We looked at one that had very good detail to the training and support given over 12 months to help make sure they were well trained and able to support people in the best ways possible. Records showed that before anyone is appointed to work at Oakwood they have a series of checks which are carried out. These include obtaining written references and checking with the criminal records bureau (CRB). These checks help to make sure the people living there are safe and that staff are suitable to support them. Care Homes for Adults (18-65 years) Page 27 of 32 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 home is well managed and the health and safety of everyone at the home is is promoted and protected. Evidence: Oakwood continues to benefit from an experienced and appropriately qualified manager who is able to demonstrate that she effectively manages the service in the best interest of everyone living there. The manager has been at Oakwood for many years and offers a great stability and rapport to everyone at the home. The manager has an open and positive management approach and regularly works as part of the team. The home is effectively managed and any development is in the best interests of people living there to ensuring a good quality of service is provided. eg The manager described and explained the companies, The big respect report. We looked at an old report for 06. A senior manager from another service visits the home to observe the standards at the home and will produce a report. The manager felt they do this every Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: year but couldnt find the most recent reports. The 2006 report was very positive and covered the environment, people they met, person centred working, communication and choice. The report gave a very positive overview. Oakwood has a maintenance/refurnishing action plan 2008/2009, which covers any work needed and identified. The manager had already identified what work was needed to maintain the high standard of decor already achieved, eg the lounge carpet had recently been replaced. The manager described the recent staff away day which she had arranged which helped to develop this document for the home. The development plan also covers everything at the home including services and the environment. The manager advised us that head office send out surveys to relatives and carers each year but she didnt have the recent results for 2008. If they had been published they could be of use for people to look at in the statement of purpose. The focus of the service is very much on providing the best support to people living at Oakwood and reponding to their needs. The manager meets with everyone on a regular basis and the minutes of these meetings shows good communication keeping everyone up to date and included with the developments of their home. The home is visited on a regular basis by a representative of the organization. These visits form part of the quality assurance process and form an opinion on the standard of care provided. These visits are also a requirement of the care home regulations and a report has to be produced to show evidence of these checks. The manager acknowledged that the reports had been done recently but they were not always fully completed to included views from everyone at the home. Records and certificates showed that regular checks are carried out on the building and equipment. This includes checking electrical appliances, the gas supply and regular fire checks. These checks help to make sure that the home is well managed and is a safe place to live and work in. Care Homes for Adults (18-65 years) Page 29 of 32 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 30 of 32 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 1 2 To develop an inhouse policy and procedure describing how staff support and arrange for people to come and live at the service. To publish and share the findings of recent questionnaires used as part of quality assurance to find out peoples opinions of Oakwood. To include the opinions of everyone at Oakwood while carrying out monthly checks, (regulations 26 visits) so that their views can be considered regarding the home. 2 39 3 39 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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