Inspection on 02/11/07 for Woodlands

This is the latest available inspection report for this service, carried out on 2nd November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Woodlands 08/06/05

Woodlands 01/04/05

Woodlands 25/10/04

Woodlands 17/05/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Woodlands 33 - 35 Fox Lane London N13 4AB Lead Inspector Mr Teferi Degeneh Key Unannounced Inspection 2nd November 2007 08:00 X10015.doc Version 1.40 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 Woodlands DS0000032662.V348853.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 Older People. 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. Woodlands DS0000032662.V348853.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodlands Address 33 - 35 Fox Lane London N13 4AB 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) 020 8886 8725 F/P 020 8886 8725 Mr Hemunjit Ramparsad Mr Hemunjit Ramparsad Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Woodlands DS0000032662.V348853.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP 2. Dementia - Code DE The maximum number of service users who can be accommodated is: 20 16th May 2006 Date of last inspection Brief Description of the Service: Woodlands is a care home registered to provide care to twenty older people. The home is located in the residential areas of Palmers Green and is a short walk from local shops, public transport links and is close to a park. The home has fourteen single bedrooms and three double rooms located on the ground and first floors. The main lounge and sitting area is on the ground floor however there is a smaller additional lounge on the first floor. There is a passenger lift to enable service users with mobility difficulties to get to the first floor and there is a garden at the rear of the property. The stated aim of the home is to provide a caring home that offers choice and independence, encourages residents to exercise fully their rights and enables them to lead a fulfilling and comfortable life. Information about the home including inspection reports can be available by contacting the manager. The current weekly fees range from £360 - £425. Woodlands DS0000032662.V348853.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home had not been informed beforehand that this inspection was taking place. It was therefore a surprise early morning visit to see how the people who live at the home are looked after. A deputy manager and two care staff were on shift and two other waking night staff were ready to leave when I arrived. There were nine residents sitting in the living areas and one person in their bedroom. A domestic assistant and the manager Mr Hemunjit Ramparsad, who is also the owner of the home, came in at approximately nine O’clock. As part of the inspection a number of the people who live at the home were observed and spoken to. An opportunity was also available to talk to all the care staff and the manager. Four residents’ files and all staff files were seen. Other documents such as the home’s policies, procedures, staff rotas, menus and health and safety records were examined. The premises and facilities of the home were checked during a guided tour of the building just before the end of the visit. Finally, verbal feedback about the outcome of the inspection was given to the manager, who agreed to make further improvements to the service. What the service does well: What has improved since the last inspection? Good progress has been made since the last inspection. The loft has been cleared and is being converted to an office and a training room. Incidents, accidents and contacts with the people who use service are daily recorded by the staff. The kitchen has been refurbished and the stairs have been fitted with new carpets. It was evident from discussions with the staff and the manager that care staff have attended training in medication administration and the manager has contacted an organisation to provide more training for the staff. Woodlands DS0000032662.V348853.R01.S.doc Version 5.2 Page 6 What they could do better: 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. Woodlands DS0000032662.V348853.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Woodlands DS0000032662.V348853.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at the home are confident that their admission to the home is based on the ability of the home to meet their needs. EVIDENCE: Four service user files including that of a person who has been recently admitted were seen. All these files have contained evidence of assessments and reviews of needs of the people who use service. The manager said new residents are admitted on the basis that the assessed needs can be met by the home. Discussions with the staff and the manager indicated that some residents whose needs could no longer be met have previously moved to more appropriate accommodation. It was stated in the last inspection report that the service user guide contains sufficient information and the statement of purpose has been revised to include clear information on the criteria for admission and the arrangements in place regarding therapeutic activities for service users. The home does not provide intermediate care. Woodlands DS0000032662.V348853.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good care planning and risk assessment systems, which enable residents and their relatives to be involved. People who use the service feel confident that health needs are met by having access to health care professionals. However, the medication administration system is below people’s expectation, as medicines are not given out on time. This puts people’s health at risk. EVIDENCE: All the four files assessed have up to date care plans and risk assessments. It was evident that people who use service, relatives and care managers are involved in the review of care plans. Daily contact with the residents are recorded and kept in the files. The care staff have worked at the home for a long time. The people spoken to described the staff as caring and understanding. All residents are registered with their own general practitioner. Records and discussions with the manager and residents showed that health professionals such as dentists, opticians and chiropodists visit the home to Woodlands DS0000032662.V348853.R01.S.doc Version 5.2 Page 10 treat the residents. There are recorded documents to show that the home supports people to access hospitals for emergencies when required. A district nurse visits the home to treat a person with pressure sores. Screening is provided wherever a bedroom is shared. Some people have telephone in their rooms while some others have mobile telephones. Medication is kept in a locked cabinet. The medication administration records (MAR) sheets and the medicines were checked and found to be in order. However, medicines were not administered on or nearer the recommended time. The staff spoken to explained that they had to prepare and serve breakfast before they could administer medication. There was a feeling that the staff on duty were stretched to do a variety of things such as cooking, looking after people, administering medication and providing personal care. Woodlands DS0000032662.V348853.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some people who live at the home have benefited little from the good efforts of the home and the commitment of staff to provide service that meets the diverse cultural and social needs of the people. The timing and manner in which meals are served do not meet some people’s needs. EVIDENCE: As stated above the residents have assessments and care plans in their files. Cultural and social needs of the residents are identified and recorded in their care plans. It was noted from the reports and discussions with the manager and the people who use the service that support is provided by the staff to enable the residents practice their spiritual activities at the home or to attend places of worship. The visitors’ book showed that relatives and friends regularly visit the home. Some people who live at the home have either a landline in their room or a mobile telephone. A programme of activities is Woodlands DS0000032662.V348853.R01.S.doc Version 5.2 Page 12 displayed on the wall and it was observed that staff do some activities with the residents. The registered person confirmed that the home does not manage people’s money. Where people bring with them their personal belongings, these are recorded and kept in their files. There is a weekly menu, which appeared to be varied and nutritious. The manager and the staff confirmed that the menu has been developed in consultation with the people who use serve. It has been mentioned above that the care staff are also responsible for cooking and this has resulted in the residents being left in the lounge on their own without supervision or not being given their medication on time. For example, when breakfast was served some people who could not feed themselves had to wait until the staff had served the others and found time to help them with feeding. Even the feeding itself looked hurried and interrupted as the care staff were also busy with other tasks. Woodlands DS0000032662.V348853.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are confident that they are protected by the home’s complaints and adult safeguarding policies and by their knowledge that they can be listened to if they have a concern. EVIDENCE: There is a complaints book and an up to date complaints procedure. No complaints have been recorded since the last inspection. One of the people spoken to said they know that they can talk to staff or the manager if they have concerns. The staff spoken to know about complaints and safeguarding of adults. Through observation it was evident that the staff are committed to providing good care to the people. Staff records contained evidence of their training in relation to adult safeguarding. They have a long experience of working at the home. The people who use service said the staff are good. The manager confirmed that the home does not look aftter peoples money. An assessment of a file of a recently admitted person revealed that the home keeps lists of peoples personal items. It was confirmed by the manager that people who use the service are able to exercise their right to vote during local and national elections. Woodlands DS0000032662.V348853.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The facilities, lay out and the size of this home make people feel that they live in a safe and homely environment. Close supervision and good management programme of the smell on the ground floor can make the home even a better place to live in. EVIDENCE: The home was generally clean and tidy except a corridor on the ground floor where there was a bad smell. The manager said the home was aware of the smell and has put a plan in place to manage the problem. There is a cleaner who comes and cleans communal areas. The plan includes shampooing the carpets and providing support to a person who lives in a room where the smell comes from. The manager has now cleared the loft, which he intends to use as Woodlands DS0000032662.V348853.R01.S.doc Version 5.2 Page 15 an office and staff training room. He has also changed the stair carpets. The kitchen has been refurbished following an environmental health officer’s visit to the home on 8/02/07. The home is located in a quite residential area. The people spoken to said they like the home. There are two interconnected lounges with television sets. Records relating to health and safety and fire safety (see below) are up to date. Woodlands DS0000032662.V348853.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The experience, attitude and skills of the staff are good to ensure not only people are safe but also are supported with respect and dignity. This can further improve when a new cook is recruited. EVIDENCE: Improvements have been made in terms of staff training as a number of them have attended basic food hygiene, medication administration, health and safety, first aid and adult safeguarding. Some staff have completed training in the national vocational qualification in care at level 2 while others have embarked on a similar training. The manager confirmed that he has contacted an organisation which provides training to come to the home and give staff refreshment courses in mandatory as well as non-mandatory training areas. Three care staff cover the day shifts while two staff are on the night shifts. As mentioned earlier the staff can be stretched with a number of tasks such as cooking and laundry to undertake besides providing direct care and regular monitoring to the people. The staff on shift were experienced and looked committed to their duties. They observed having good interactions with the people who use service. Verbal feedback from the residents was that the staff are good and they treat people with respect and dignity. There is a recruitment procedure which involves an advertisement of a job and selection of people Woodlands DS0000032662.V348853.R01.S.doc Version 5.2 Page 17 through an interview process. New employees start work only after a receipt by the home of their satisfactory enhanced criminal record bureau (CRB) check certificates and two written references. Currently, the manager is waiting for a CRB certificate for a new person to start work. He also said he will recruit a cook so that the care staff will spend their time with residents rather than in the kitchen. Woodlands DS0000032662.V348853.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and safety, and wellbeing of people who use the service are ensured by up to date policies, procedures and good management of the home. EVIDENCE: The registered manager is also the registered owner of the home. He said he was qualified as a registered nurse and has a long work experience at different hospitals. He has also owned and managed a similar care home before. The manager stated that he did economics and accounting at a university and is qualified as an accountant. He has attended care related training from time to time and has successfully completed the registered managers’ award (RMA). The manager is supported by a deputy manager, who is also experienced and Woodlands DS0000032662.V348853.R01.S.doc Version 5.2 Page 19 currently undertaking training to achieve the RMA. Both managers supervise care staff on a regular basis. He home has a quality assurance system. Questionnaires have been developed and distributed to people who use the service and their relatives to ask them how they judge the quality of services and facilities of the home. The feedback obtained through this process was seen and found to be positive. The manager said he also consults the residents at their meetings. The manager has also a plan to keep the summary of the outcome of the quality review process and to make it available to all stakeholders including the Commission for Social Care Inspection. The manager seemed to be open to new ideas and co-operative with the inspection process. It has already been mentioned that the home does not manage people’s money. A list of personal belongings is kept in each person’s files. The home has up to date policies and procedures on communicable diseases and infection control, control of substances hazardous to health and clinical disposals. The manager was pleased to confirm that the number of accidents and incidents has fallen due to staff training and good management of falls. As mentioned above the environmental health officer visited the home in February 2007 and advised the home to refurbish the kitchen. This has now been done. The manager presented documents and certificates to confirm that regular test and maintenance are carried out on portable electrical appliances, fire extinguishers, smoke detectors, the lift and emergency lights. It was evident from discussions with the manager and an assessment of staff files that the staff have attended training which includes health and safety and first aid. Woodlands DS0000032662.V348853.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Woodlands DS0000032662.V348853.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NO 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. 1 Standard OP9 Regulation 13(2) Requirement The registered person must ensure that medication is administered and recorded as prescribed and recommended by health professionals. This will make medication as effective as it is intended to be by the prescribing health professionals. The registered person must ensure that meals are provided to people who use the service in a manner that meets their needs. People must not be hurried with eating their meals and there must always be sufficient staff to help people who need support with feeding. The registered person must ensure that all parts of the home are free from bad smells. This will eliminate a chance of infection and make the home a more comfortable place to live in. The registered person must ensure that there are appropriate numbers of staff on shift to meet the needs of the people who use service. This will DS0000032662.V348853.R01.S.doc Timescale for action 21/11/07 2 OP15 16(i) 30/11/07 3 OP26 16(k) 30/11/07 4 OP27 18(1)(a) 31/12/07 Woodlands Version 5.2 Page 22 ensure that there is regular supervision and appropriate support, for example with feeding, for the residents. 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 Woodlands DS0000032662.V348853.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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. Extracts may not be used or reproduced without the express permission of CSCI Woodlands DS0000032662.V348853.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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