Inspection on 14/08/09 for Woodlands Close, 1

This is the latest available inspection report for this service, carried out on 14th August 2009.

CQC found this care home to be providing an Good service.

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 Close, 1 05/09/06

Woodlands Close, 1 14/11/05

Woodlands Close, 1 21/06/05

Woodlands Close, 1 30/11/04

Woodlands Close, 1 23/06/04

Similar services:

22 Sandown Road

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Park View (15)

Craigmore House

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Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Woodlands Close, 1 1 Woodlands Close Preston Village North Shields Tyne And Wear NE29 9JS     The quality rating for this care home is:   two star good 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: Elizabeth Gaffney     Date: 1 4 0 8 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. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. 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 30 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Woodlands Close, 1 1 Woodlands Close Preston Village North Shields Tyne And Wear NE29 9JS 01912966953 F/P01912966953 ClareM@ubu.me.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Northern Life Care Limited T/A U.B.U. Name of registered manager (if applicable) Mrs Jayne Michelle Bowmer Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home 1 Woodlands Close is a large bungalow that has been adapted to provide residential care for three people with profound learning and physical disabilities. The home is in keeping with the local community and located close to local amenities. Each person has their own bedroom one of which has en-suite facilities. There is ample car parking and a small garden and patio are available at the rear of the premises. The current fees charged are 365 pounds per week. No extra charges. Information about charges is included in the homes statement of terms and conditions. The homes inspection 3 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home report, service user guide and statement of purpose are available on request. Care Homes for Adults (18-65 years) Page 5 of 30 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: two star good 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 quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out. Before the visit we looked at: Care Homes for Adults (18-65 years) Page 6 of 30 - Information we have received since the last visit on the 16 August 2007; - How the service dealt with any complaints and concerns since the last visit; - Any changes to how the home is run; - The managers view of how well they care for people; - The views of relatives, staff and other professionals. An unannounced visit was made on the 14 August 2009. During the visit we: - Talked with some of the staff and the manager; - Looked at information about the people who use the service and how well their needs are met; - Looked at other records which must be kept; - Checked that staff had the knowledge, skills and training to meet the needs of the people they care for; - Looked around the building to make sure it was clean, safe & comfortable; - Checked what improvements had been made since the last visit. What the care home does well: What has improved since the last inspection? Improvements have been made to the building. New dining room furniture has been purchased. A new fire place has been installed in the lounge. New carpets have been fitted throughout the home. Non-slip wood flooring has been fitted in the porch area. Additional improvements have been made to the rear garden. A new kitchen has been fitted. Staff have developed communication passports for each individual in consultation with the Speech and Language Therapy Team. This will help staff, and people who have contact with the service users living at Woodlands Close, to better understand their communication needs. Each service user has had a full medical review, including a review of their medication. This will help to promote and protect their health and well being. Rotas have been reviewed to ensure that staff are available at times when service users need support to access community based activities. Care Homes for Adults (18-65 years) Page 8 of 30 The service has devised a comprehensive flu plan to help keep people safe in the event of a Swine flu outbreak. An emergency flu pack has been put together in the event that service users need to placed elsewhere to ensure their safety and well-being. A Personal Emergency Evacuation Plan has been devised for each service user to help keep them safe in the event of a fire. The provider has appointed a dedicated training manager for the North East Region which is helping to improve the training opportunities available to Woodlands Close staff. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 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 10 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable arrangements for making sure that peoples needs are assessed before they move into the home. This will help ensure that staff are able to meet peoples needs on admission into Woodlands Close. Evidence: There have been no new admissions into Woodlands Close since 1999. As a consequence, compliance with Standard two of the National Minimum Standards has not been assessed during this visit. However, it has been confirmed during previous inspection visits that people received a multi-disciplinary needs assessment carried out by experienced staff before their admission. The Getting to Know You assessment was completed before each person moved into the home. There are policies and procedures setting out how people will be assessed for a place at the home. Of the relatives who completed surveys on behalf of three people who live at the home, one said that that they had been given a choice about whether they wanted to move into Woodlands Close. Two people did not reply. Care Homes for Adults (18-65 years) Page 11 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have good support plans that clearly set out how their assessed needs are to be met. This will help make sure that peoples individual needs and preferences are catered for. Staff will also be clear about how they should care for people. Evidence: Support plans have been devised for each person setting out what support they require and in what areas. Peoples support plans cover such areas as help needed with medication, managing personal finances, continence, and morning and evening routines. They are easy to understand, written in plain English and are reviewed on a regular basis. Where changes are made to the electronic copies of peoples support plans, paper copies are printed and staff are alerted to the changes that have taken place. However, none are available in an easy to read version. Electronic signatures confirm that staff have read and understood the contents of peoples support plans. Details of peoples preferences, wishes and future ambitions are included in their care records. Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: Each persons placement has been reviewed within the last six month. Staff who have worked at the home for a number of years rely on their experience, skills and knowledge to help them understand peoples needs and wishes. Staff support and encourage people to make simple everyday decisions and choices. The Speech and Language Team have supported staff to devise and implement communication programmes that encourage people to develop skills in expressing their own needs and wishes. Staff have learned to communicate with people in an effective manner. Staff on duty at the time of the inspection demonstrated a good understanding of peoples needs. A range of risk assessments have been completed for each individual covering such areas as transferring safely and accessing the kitchen. The completed risk assessments provide staff with guidance about how to promote independence whilst also keeping people safe. Risk assessments are reviewed on a regular basis. Of the relatives who completed surveys on behalf of three people who live at the home, two said that the care team at Woodlands Close treat them well and listen to and act upon what they say. One of the questionnaires was returned uncompleted. One relative also said the home works very well for all guests. Care Homes for Adults (18-65 years) Page 13 of 30 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 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 to engage in a range of appropriate activities both in the home and within the local community and to make simple choices about how they live their lives. This means that people are able to lead fulfilling lives and receive support which meets their needs. Evidence: In December 2008, the local authority contracts team expressed concerns about the lack of structured social activities within the home. The manager and her team have tried to address this concern by devising an activities timetable for each service user. In a recent report for North Tyneside Council, the home said that service users had accessed various activities ranging from trips out to Tynemouth beach, Whitley Bay, Light Water Valley and the Royal Quays. Service users have also been supported to access hydrotherapy sessions, cookery and music and drama classes. Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: The homes rota shows that an extra member of staff is provided on some shifts to help service users access community based activities. Staff reported that service users visit local shops, the library, pubs and cafes on a daily basis. On the day of the inspection, a member of staff prepared lunch with a service user. Staff have access to resources to help them carry activities within the home such as audio and video equipment, a foot spa, a relaxation bed, musical instruments and various games. Two service users have Snoozelam equipment in their bedrooms which can be operated independently by the occupants. The manager reported each service user has a timetable which sets out when service users will be supported to engage in purposeful activities, and participate in independent living skills, within Woodlands Close itself. Each service user receives 1 to 1 support to participate in the preparation of a lunch and tea time meal at least once a week. Staff reported that service users are supported to make everyday simple decisions and choices. Of the three service users and their relatives who returned surveys, one respondent said that they are usually able to make decisions about what they do each day. Two respondents did not reply. All staff have completed Mental Capacity Act and Deprivation of Liberty training. None of the care records looked at contain evidence that service users capacity to make decisions has been assessed using a recognised assessment tool. People are supported to retain relationships with family members and friends. For example, one service users activity timetable shows that staff support this person to meet with a friend once a week. Another service users timetable shows that they spend one afternoon a week with their family. Staff support people to attend local discos where they are able to meet up and socialise with friends. The home has a four week rotating menu which provides details of the meals served each day. Although the menus do not include a choice at each main meal time, staff reported that an alternative is always available. The inspector observed a tea-time meal as part of the inspection. The meal was unrushed and service users received one to one support to eat their meal. The buffet tea was nicely presented and looked nutritious. Staff confirmed that they have access to the specialist eating aids they need to meet peoples individual needs. The atmosphere at the meal was friendly and jovial. The kitchen is clean, hygienic, tidy and well equipped. Food cupboards,the fridge and freezers were well stocked. Staff have recently purchased a fridge to go in one service users bedroom and this has enabled the person to make independent choices about when they wish to have drink. Care Homes for Adults (18-65 years) Page 15 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements to meet peoples personal and healthcare support needs are satisfactory and promote their good health and well-being. Evidence: People are registered with a local GP practice, optician and dentist. The care records of two service users were looked at. This showed that each service user has received dental and optical care within the previous 12 months and at least two chiropody support sessions during the last six months. Access to specialised health care services is provided as and when needed. Support plans have been devised for each person to promote their health and well being. These cover such areas as support required when attending medical and healthcare appointments and taking medication. Checks of peoples weight are usually undertaken monthly although there were some gaps in the records kept by staff. None of the records looked at contain a Health Action Plan or a completed MUST nutritional risk assessment. Support plans setting out how staff should meet peoples personal care needs have Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: been devised. For example, in one persons care records, there is guidance describing the support they need with personal care, oral hygiene and bathing. Support plans covering assistance required with continence care and shaving have been put in place for another service user. Of the four staff that returned surveys, all said that they are always or usually given up to date information about the needs of the people they care for. They also said that the way information is shared within the home works well. There are records covering the administration and disposal of medication. Records are colour coded to help ensure that service users receive the correct medication. All medicines are kept safely locked away. The cabinet is kept clean and tidy. Staff administered medication in a safe and professional manner. The manager confirmed that staff have received accredited training. However, staff files do not contain evidence that staffs competency to administer medication is assessed on a regular basis. The Care Quality Commission has been notified of one mis-administration of medication in mid 2008. This involved a member of staff administering medication to the wrong service user. The provider and manager took appropriate action to prevent a further re-occurrence. A social services professional who recently returned a survey said that staff at the home manage peoples medication correctly. The home does not have an up to date medication reference manual. The last pharmacy inspection of the home took place in April 2009. Care Homes for Adults (18-65 years) Page 17 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can feel confident that their complaints or concerns will be listened to, taken seriously and acted upon. Satisfactory arrangements are in place to keep people safe from harm or abuse. Evidence: The provider has devised a complaints policy and procedure that all staff are expected to follow. Previous inspections have confirmed that each service user has been supplied with a copy of the homes service user guide which contains details of the complaints procedure. People have a support plan that sets out how staff will support them to make a complaint. The Commission has not received any complaints since the last inspection of the service. The home has received one complaint which was satisfactorily resolved. Of the four staff that returned surveys, all said that they have been told what to do if they receive a complaint. Of the relatives who completed surveys on behalf of three people who live at the home, one said that they would know who they should speak to if they were not happy with something. Two respondents did not reply. Although the provider has devised a safeguarding policy to help keep people safe, it has not been updated to take account of recent developments in adult safeguarding such as the implementation of the Deprivation of Liberty Regulations. The policy was however recently updated. Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: The home has obtained a copy of the local councils safeguarding policies and procedures. This helps them to be clear about how they are expected to work with the local council when safeguarding issues arise. All staff have completed local authority safeguarding training. Staff interviewed as part of the inspection were clear about the action they would take to keep people safe. There has been one safeguarding investigation since the last inspection. The manager handled the safeguarding concern in an appropriate manner and ensured that the relevant agencies were contacted and their advice followed. The investigation resulted in a member of staff being referred to the Vulnerable Adults Protection List for people considered unsuitable to work in care. Care Homes for Adults (18-65 years) Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is generally well maintained and has been satisfactorily adapted to meet the needs of the people using the service. Evidence: The home is clean, tidy, hygienic and there are no unpleasant odours. The Department of Health infection control self-assessment checklist has been completed following the last inspection. The layout and design of Woodlands Close enables people to live together in a homely domestic environment. There is a pleasant garden area to the rear of the building that can easily be accessed. There are plans to improve the front garden during the next 12 months to make it more accessible. Peoples bedrooms are attractively decorated and furnished. There are no shared bedrooms. Staff reported that the stained settee in one service users bedroom is due to be replaced shortly. Staff have supported people to personalise their bedrooms. The communal areas are well-maintained and attractively decorated. The kitchen is clean, tidy and hygienic. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: The home has been adapted to meet the needs of the people living there. A range of specialist aids and equipment have been provided. For example, both bathrooms have been fitted with a variable height bath, hoisting equipment and grab rails. In one of the bedrooms visited, a tracking hoist is available to help the service user transfer safely into the adjacent bathroom. A member of staff was asked to demonstrate how the hoist is used and did so in a safe and competent manner. The home has a mobile hoist, pressure relieving and visual sensory equipment. There are purpose built ramps to the front and rear doors which enable wheelchair users to safely enter and exit the building. Epilepsy monitoring equipment is used to ensure peoples safety overnight. Care Homes for Adults (18-65 years) Page 21 of 30 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 by qualified and well supported staff that have been subject to robust pre-employment checks. This means that people are able to benefit from being cared for by staff that are properly supported and supervised, and who are suitable to work with vulnerable adults. Evidence: Bureau disclosure and POVAFirst checks have been completed for each member of staff. Two written references have also been obtained. Each member of staff has completed an application form and provided a full employment history. Staffs identities have been verified. Each member of staff has a contract of employment and the provider obtained a health declaration for each person. Over 70 percent of the staff team have obtained a National Vocational Qualification (NVQ) at Level 2 or above. The remaining three staff are in the process of working towards this qualification. The manager has completed equality and diversity training. Staff who have obtained a NVQ covered equality and diversity issues as part of this course. The homes Annual Quality Assurance Assessment states that one member of staff has ended their employment during the last 12 months. Since the last inspection of the Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: service, the local authoritys contracts and care management teams have expressed concerns about staff sickness levels and the frequent use of agency staff. In the Annual Service Review report issued in 2008, the Care Quality Commission expressed concern that this potentially had a negative impact upon the quality and consistency of care provided. However, the stability of the staff team has improved during 2009. The manager reported that the impact of high staff sickness levels are minimised by always using the same bank worker to cover the required shifts. A system for monitoring and dealing with staff sickness has been introduced and the manager felt that this is working well. Six of the nine staff currently working at the home have been employed for over two years. On the day of the inspection, of the two staff on duty, one had worked at the home for over five years, and the other had been employed for over eight months. The home has one vacancy to which they have recently appointed. The local authority continues to require the provider to submit regular reports so that it can ensure that service users are receiving appropriate levels of care and support. A minimum of two staff are rostered on duty to support three service users over each 24 hour period. The night time period is covered by a member of staff who sleepsover in the building, as well as a waking night carer. A third member of staff is scheduled to work at those times of the day when service users have been identified as needing support to access and participate in community based activities. The manager confirmed that the hours currently funded by social services are sufficient to ensure that service users needs are met. Staff have completed moving and handling, first aid, health and safety, food hygiene and fire prevention training. Staff are also able to complete more specialised training, which enables them to meet the individual needs of people using the service. For example, one member of staff has completed training in communication skills, epilepsy, working with people who challenge the service as well as training about the Mental Capacity Act. Most longer serving staff have completed training in using sign language. Staff receive regular work based supervision. The National Minimum Standards state that staff should receive supervision at least six times a year. During the last 12 months one member of staff has received eight work based supervision sessions. A member of staff appointed in December 2008 has received four sessions. The manager has drawn up a supervision contract with each member of staff and keeps a written record of all sessions held. Staff related records are kept secure and confidential. Of the four staff who returned surveys, all said that: their employer had carried out Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: pre-employment checks; their induction training had generally covered everything they needed to know to do their job; the training they receive is relevant to their role, helps them to understand the needs of the service users they care for and keeps them up to date with new practices; there are generally enough staff on duty to meet peoples needs; they have the right experience and knowledge to meet the different needs of people living at the home. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good management systems are in place and staff follow safe working practices. This means that people can be confident that they will be kept safe and protected from harm. Evidence: The manager has obtained relevant qualifications, including the Registered Managers Award. Mrs Bowmer is a registered learning disability nurse and has worked at the home for approximately four years. She has also completed additional training such as Managing Your Work for Success. Staff spoken to as part of the inspection said they are clear about the standards of care to which they are expected to work. Arrangements are in place to ensure that peoples financial rights are protected and promoted. The manager acts as an appointee for each of the people living at Woodlands Close. The arrangements for controlling who has access to the homes safekeeping facilities are robust and known by staff. Good financial records are kept and there is evidence that regular audits take place. The provider requires staff to undertake twice daily checks of all money held on behalf of service users and to keep Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: a record of this. Two staff signatures are obtained for all financial transactions involving service users money. Receipts are obtained for all purchases. The homes policy and procedures for handling service users money and valuables was recently reviewed. The provider monitors the quality of care and services provided at the home. For example, monthly monitoring visits are carried out by the provider to ensure that Woodlands Close is operating in line with the providers policies and procedures and to confirm that a satisfactory standard of care is being provided. A detailed audit of the homes performance against the National Minimum Standards is carried out during these visits. Quality monitoring surveys are issued to peoples relatives and an analysis of the outcomes is produced. However, the report produced relates to the North East as a whole rather than to individual homes. The premises are safe and free from hazards. A selection of health and safety records was checked as part of the inspection. This showed that the homes electrical equipment was last tested in October 2008 and that it has a current gas safety certificate. The homes hoisting equipment received servicing visits in September 2008 and February 2009. Arrangements have been put in place to handle an outbreak of Swine flu within the home. An emergency flu outbreak plan has been devised for each person. Visitors to the home are encouraged to use the anti-bacterial hand wash available in the reception area. The home is clean and hygienic throughout. Fire prevention checks are generally well completed. However, it was identified that weekly fire alarm checks do not always take place. Staff received certificated fire training in March 2009. The home has a completed fire risk assessment which was last updated in March 2009. Each person has a Personal Emergency Evacuation Plan which will help to keep them safe in the event of a fire. Care Homes for Adults (18-65 years) Page 26 of 30 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 27 of 30 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 6 Ensure that peoples financial support plans address the good practice recommendations issued by the Care Quality Commission. Ensure that peoples support plans are available in a format that can be more easily understood by people using the service. Ensure that the MUST nutritional risk assessment recommended by the Care Quality Commission is completed for each service user. Obtain a copy of each persons Health Action Plan. Ensure that: - Staffs competency to administer medication is reviewed every 12 months and a written record kept of the outcome; - Staff have access to an up to date medication reference manual. 2 6 3 19 4 5 19 20 6 21 Ensure that: - Each person has an end of life care plan that has been Care Homes for Adults (18-65 years) Page 28 of 30 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 agreed with their family, GP and any other relevant healthcare professional; - End of life care plans are subject to review by the multidisciplinary team, the service user and their carers/family, as and when peoples condition, or wishes, change; -Where a person wishes to make an Advanced Decision about their end of life wishes and preferences, the home seeks advice from the persons care manager, GP and family; - End of life care plans are available to all people who have a legitimate reason to access it; - All staff receive training in end of life care; - The providers end of life policy covers Advance Decision-making. 7 23 Ensure that the homes safeguarding policy and procedures are updated to reflect current developments within the field of adult safeguarding. Produce an individual breakdown of the responses received to the quality satisfaction surveys issued for Woodlands Close. Ensure that the homes fire alarm system is checked weekly and a written record kept. 8 39 9 42 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) 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. 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