Care Home: The Oaks

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What the care home does well The Oaks is providing people with a good level of care. The home has a friendly and relaxed atmosphere where residents were seen to be treated with care and understanding. Comprehensive care plans help staff to support and encourage residents to reach their full potential. The home has a stable staff team who receive a good level of training and over fifty per cent now hold a National Vocational Qualification (NVQ) in care. Feedback surveys from two relatives, a care manager and one staff member were very positive. What has improved since the last inspection? Since the last inspection a manager has been appointed, this person was previously the acting manager at The Oaks. She is currently undertaking the CSCI process of becoming the registered manager. She has also enrolled to study for the Registered Managers Award. Bedrooms have been redecorated and a new dining table and sofa have been purchased for the communal areas. It is hoped that a new sensory room for the residents will be completed in 2008. What the care home could do better: No requirements or recommendations were made during this visit. CARE HOME ADULTS 18-65 The Oaks 20 Normanhurst Close Three Bridges Crawley West Sussex RH10 1YL Lead Inspector Merle Blakeley Key Unannounced Inspection 20th December 2007 09:30 The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Oaks Address 20 Normanhurst Close Three Bridges Crawley West Sussex RH10 1YL 01293 543828 01293 543828 theoaks20@tiscali.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Alliance Home Care (Learning Disabilities) Limited New Manager currently undertaking CSCI registration Care Home 6 Category(ies) of Learning disability (6) registration, with number of places The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th July 2006 Brief Description of the Service: The Oaks is a care home registered to provide personal care and accommodation for up to six residents between the ages of 18 and 65 years of age who have a leaning disability. The property is detached and situated in a residential area of Three Bridges close to the outskirts of Crawley. Communal areas consist of a dining area, a lounge and a sensory room. Private accommodation consists of five bedrooms on the upper floor and one bedroom on the ground floor. Two bedrooms have en suite facilities. There are sufficient additional toilets and bathrooms throughout the home. The Oaks is currently occupied by five male residents who have lived together for many years. The current fees range from £1,104.84 to £1,739.43. The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was carried out on December 20th 2007. As well as this site visit information was also gained from a returned Annual Quality Assurance Assessment (AQAA), feedback surveys from two relatives, a care manager and one staff member. During the visit the inspector was able to spend some time observing the five people who live in the home and also talk to some of the staff and the manager who facilitated the inspection. Document reading was also carried out and a health and safety check was conducted. Staff were observed throughout the visit interacting with residents. What the service does well: What has improved since the last inspection? What they could do better: No requirements or recommendations were made during this visit. The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users guide has been updated. The home has a procedure for assessing a prospective resident. EVIDENCE: The home recently updated the service users guide in October 2007. All four people have lived in this home since it opened nine years ago, so there have been no new admissions. The manager was asked how the service would go about assessing a prospective resident should a vacancy occur in the future. She stated that there is a formal procedure for assessing someone’s needs, which involved looking at the admission criteria and carrying out an assessment with the person. The area manager and manager would normally carry out this role. Any new person moving into the home would have the opportunity to visit and have overnight stays to see if they would like to live in the home long-term. Reviews of people’s care plan packages are carried out six to twelve monthly to ensure that the home is continuing to meet their needs. The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Peoples care plans reflect their personal needs and goals. Where possible people are assisted in making choices and decisions. EVIDENCE: Each person has a person centred care plan, which includes detailed information about their needs, health, relationships, activities and short and long-term goals. Two of these plans were viewed and the information they contained was up to date and relevant. Care plan reviews are carried out regularly between 3-6 monthly. Each person has a key worker who provides them with 1:1 support in helping them to achieve their personal goals. All of the residents are non-verbal and the manager was asked as to how people are able to make choices and decisions in their daily lives. She stated that they are all able to make their preferences known by gestures and body language, which is encouraged by the staff. During this visit the inspector was able to view people making choices and showing staff what they wanted and The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 10 where they wanted to go. Although people make their own general day-to-day decisions family members and the care manager are involved with important decision making events. Risk assessments are carried out on all people and include areas such as safety for activities such as using the trampoline, carriage riding, bowling etc. Other risk areas are safety in the kitchen, home visits, the garden, out in the community, safeguarding adults and challenging behaviours. These comprehensive assessments are reviewed regularly to ensure that the risk still remains for the person. The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported to attend meaningful activities and they are out and about in the community on a daily basis. Visitors are made welcome in the home. A well-balanced varied menu is offered. EVIDENCE: Records revealed that people have access to a varied and interesting programme of activities throughout the week, which include local college classes that provide art, music and promoting independence skills, carriage riding, bowling, cinema, shopping, drives out and day trips and access to a sensory room. On the day four people were due to go carriage riding, however this was cancelled due to the very cold weather conditions so staff had organised to take people out for a drive instead. One relative expressed a wish for her son to go to church on Sunday and staff provide support for him so that he can continue to attend these services each week. All of the residents are out and about in the local community on a daily basis visiting various shops and other amenities. The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 12 All five residents have family members and most are all involved in their ongoing care and welfare. Some people’s relatives visit the home on a regular basis and some go and have short stays with their family. For the families who aren’t able to come and visit regularly the manager stated that she keeps in touch with them and keeps them informed. Two relative surveys were returned and they both stated that the very much appreciated the good level of care their son’s received. People are supported to be as independent as possible. The manager stated that as residents do not have comprehension about their rights and responsibilities the home has individual infringement rights written up for them. The home has produced a varied menu, which includes special diets. Some people require liquidised meals and staff were asked as to how these were prepared. They stated that foods are liquidised separately to maintain taste and texture. During the day lunchtime was observed and the atmosphere appeared relaxed and unhurried. The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal care is provided in the manner that people prefer. People’s healthcare needs are being met and medication is being appropriately administered. EVIDENCE: All five people require support with their personal care needs. The manager stated that all care is given in the privacy of bathrooms. Staff try to encourage people to help with their care. Residents will indicate as to whether they want a bath or a shower. People are able to get up when they want and have their personal care carried out at the time they wanted. The home is currently producing individual ‘health assessment books’ that will detail each persons particular healthcare needs. People also have a little book called ‘All About Me’, which contains details about each person’s likes and dislikes and how they might react in certain situations. It also includes useful information about their health, communication, medicines and routines. Records showed that people have access to a wide variety of healthcare The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 14 professionals such as epilepsy nurse, psychiatrist, occupational therapist, chiropodist, dentists, dietician, optician and annual ear examinations. Medication within the home is securely stored. All staff have received medication training. Medication records were checked and no discrepancies were found. The home has produced a good set of procedures, which guide staff in the administration of certain medicines. A pharmacy inspection was carried out in October 2007. The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. No complaints or safeguarding referrals have been made. The home ensures that people’s finances are safeguarded. EVIDENCE: The home has produced a complaints policy and procedure that is included in the service users guide and each family has a copy of this document. Also included in the guide is a complaints form, which would go to the manager if there were any concerns or complaints. People would rely on their friends and family to make a complaint on their behalf, as they lack the capacity to make judgements about the quality of care they receive. The manager stated that no complaints had been made to the home. The two relative surveys that were returned stated that family members knew how to make a complaint but they had never had to make one so far as they were happy with the care that was being provided. The home has produced policies and procedures regarding safeguarding adults. All staff receive annual adult protection training. All staff undergo a CRB check before they begin employment. No safeguarding referrals have been made. The home looks after people’s finances and two of these records were checked and were found to be in order. All receipts and monies had been accounted for. The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides people with a relaxed and comfortable environment. EVIDENCE: The Oaks is a comfortable and homely house located in a residential area close to the centre of Crawley. All the bedrooms that were viewed appeared individualised and contained people’s own possessions. Four of the bedrooms had been recently repainted. The home is still working on creating a new sensory room, which the manager stated should be ready next year. The spare bedroom has now been turned into a meeting room for training and review purposes. As it was close to Christmas the communal areas had been decorated and staff stated that some of the residents were getting quite excited about Christmas Day. The home was found to be clean and tidy on the day. The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a stable staff team who work well together. Suitable recruitment practises are carried out and staff receive a good level of training. EVIDENCE: The Oaks has a stable staff team who were seen to get on well together. There are normally three staff for the morning and afternoon shifts and one waking and one sleeping in person for the night shift. There are a total of eleven staff that includes four senior care staff and seven support workers. The staff team were observed during the day and they worked with people in a caring and sensitive manner. They were all knowledgeable about each person’s individual needs. Currently six of the staff team hold National Vocational Qualifications (NVQ) in Care and a further three staff are working towards gaining this qualification. Three staff recruitment files were viewed and they contained all the required information. Several of the staff have working visas and these were also checked. Two references, a CRB check and proof of ID were seen in the files. The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 18 Records show that staff have access to a good level of training such as infection control, fire training, food hygiene, first aid and safeguarding adults. Some of the staff have also been able to attend a local college course in English as a Second Language. Staff meetings are held once a month and supervision sessions six-weekly. Several staff were spoken to during the day and they all stated that they were happy working in the home. They felt they had reasonably good support and good access to training. They also felt that it was a good company to work for. The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A new manager has been appointed. The home carries out quality assurance monitoring. The health, safety and welfare of both residents and staff are protected by the home’s working practises and procedures. EVIDENCE: The new manager has been in post since August 2007; previous to this she was the deputy manager. The manager is currently undergoing the CSCI process to become the registered manager. In September 2007 she gained the NVQ Level 4 qualification and she will commence training for the Registered Managers Award (RMA) in January 2008. The home appears to be running well and all the required documentation is organised and up to date. Staff also said that they thought the home was being well managed and generally they felt well supported by her. The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 20 The home has a quality assurance programme, which includes seeking feedback from relatives, staff and stakeholders. Regulation 26 visits are carried out monthly and a sample of these reports were viewed. During this visit the area manager came into the home to briefly discuss staff training for January. The ongoing aims and objectives for the following year are to continually improve the level of care that people receive. A health and safety check was carried out and no immediate issues were identified. A fire risk assessment has been carried out with fire risk checks being carried out every two months. Fire drills are carried out three monthly and fire alarms and hot water temperatures monitored weekly. All staff have received fire safety training and all other required core skills training. Radiators are covered and some doors have automatic closures attached. Window restrictors have been fitted. The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Oaks DS0000014786.V354139.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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