Inspection on 05/09/08 for Woodlands House

This is the latest available inspection report for this service, carried out on 5th September 2008.

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 House 19/09/06

Woodlands House 14/12/05

Woodlands House 10/05/05

Woodlands House 12/10/04

Woodlands House 29/06/04

Woodlands House 20/01/04

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 13/03/2009.

CARE HOMES FOR OLDER PEOPLE Woodlands House 118 Cavendish Road London SW19 2HJ Lead Inspector Emma Dove Unannounced Inspection 5th and 12th September 2008 11:50 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 House DS0000034082.V371260.R02.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 House DS0000034082.V371260.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodlands House Address 118 Cavendish Road London SW19 2HJ 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 8408 8552 0208 543 9067 Central & Cecil Housing Trust Pauline Marcia King Care Home 64 Category(ies) of Dementia (64), Old age, not falling within any registration, with number other category (64) of places Woodlands House DS0000034082.V371260.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing (CRH - N) 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: 64 18th September 2007 Date of last inspection Brief Description of the Service: Woodlands House is a purpose built care home able to provide nursing care for twenty older people, residential care for twenty-four older people who may have dementia and twenty older people. There are twelve places for intermediate care. The home is owned and managed by Central and Cecil, a charitable organisation who have two other similar services in the local area. Accommodation is provided over three floors. A lounge, dining room, kitchenette, bathrooms and single bedrooms are available on each floor. People have access to enclosed gardens to the rear and side of the home. Each floor is served by a lift. Woodlands House is situated in a residential area of Colliers Wood, within a ten to fifteen minute walk of local shops, public transport and churches of a number of denominations. The home is staffed twenty-four hours a day by trained nursing staff, care assistants and domestic staff. Three meals are provided daily with drinks and snacks available between mealtimes. The weekly fees are from £438.60. Information regarding the CSCI is included in the Statement of Purpose and Service Users Guide. Woodlands House DS0000034082.V371260.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two star. This means people who use this service experience good quality outcomes. This unannounced inspection took place over four and a half hours on the 5th and five hours on the 12th September 2008. One regulation inspector visited, looked at records, spoke with people who use the service, visitors, staff and the manager. Questionnaires were sent to people who use the service and staff. We have received six completed questionnaires. The manager completed an Annual Quality Assurance Assessment (AQAA), which provided good information which has been included in this report. What the service does well: What has improved since the last inspection? We saw some progress with developing and improving care plans for some people, although further work is required. Items of old furniture, wheelchairs and zimmer frames have been disposed of, making the environment nicer for the people who live there. Some new staff have been appointed, this helps provide more consistent care and support to people who use the service. We saw most members of staff wearing a name badge, this helps people who use the service and visitors identify who they are talking with. Woodlands House DS0000034082.V371260.R02.S.doc Version 5.2 Page 6 Regular residents and relatives meetings have been held every other month for almost a year. These meetings have improved the way the service listens to people who use the service and their representatives. 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 House DS0000034082.V371260.R02.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 House DS0000034082.V371260.R02.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): 1, 3 and 6 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The home understands the importance of having sufficient information when choosing a care home. Admissions are not made until a full needs assessment has been completed and the manager or senior staff feel confident that they can meet the individuals needs. The intermediate care service supports people to return home as soon as possible. EVIDENCE: The Statement of Purpose and Service Users Guide include information about the services provided, facilities available and staffing. No progress has been made with developing the Service Users Guide to be easier to read and include photographs. Peoples comments about Woodlands included ‘lucky to get a place here’, ‘I asked for a permanent place following a short stay’, ‘it’s not like home but it’s Woodlands House DS0000034082.V371260.R02.S.doc Version 5.2 Page 9 ok’ and ‘I was happy to transfer from the intermediate care to the long stay’. We saw assessments completed before people moved into the home, sometimes at short notice. The manager said they are prepared for some assessments to be completed at short notice. People and their representatives are invited to visit the home, look around, meet staff and other people living there before making the decision to move in. The service has a separate twelve-bedded unit providing intermediate care. People using this service are supported by carers and nurses employed by the home and occupational therapists and nurses from the Primary Care Trust (PCT). A regular weekly meeting is held with professionals from the PCT and the GP to check on individual’s progress and raise issues if required. People using the intermediate care service made positive comments about the service, staff, the support they get and the meals. One person said they felt staff could do more for them, staff are aware of the balance between helping people and supporting them to manage by themselves. The service should consider the development of a small kitchen to enable people to carry on the tasks of daily living such as making their own drinks and snacks. This would also enable staff to do a more detailed assessment of individual’s abilities before they return home. Woodlands House DS0000034082.V371260.R02.S.doc Version 5.2 Page 10 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 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Care plans have been developed for people using the service, although some were seen to need reviewing and updating. They should include the care and support individuals need, how they want them to be met and be more person centred. People’s health needs are noted. Medication is generally well managed with records signed, however some medication was administered before it was due and had not been signed for. Medication is generally securely stored. EVIDENCE: Three people said they ‘always’ and two people said they ‘usually’ get care the care and support needed. We saw some care plans to need updating and reviewing to ensure they have all the information staff need to provide appropriate care to the individual. Staff must review care plans and update them when there are changes in Woodlands House DS0000034082.V371260.R02.S.doc Version 5.2 Page 11 need. One care plan had not been changed for two years when there had been changes in the support the individual required. Some care plans we saw had been updated and were being reviewed on a regular basis. We saw the care plan for one person recently admitted to the home, it included an assessment which was being used to develop the care plan. We saw another care plan detail the person’s religious needs and feel that this information could be expanded upon through discussion with the individual or representatives from the church. Daily records include the activities people have participated in, any visitors they have seen as well as any care and support given. These records could be more detailed with how the person experienced the care and support given. The daily records for one person said ‘aggressive and agitated’, the social work assessment, homes assessment and risk assessment made no mention of any issues with behaviour. It should be clear from a daily record indicating issues that may put other people living in the home and staff at risk that staff have either discussed the issues with the manager or senior staff or referred the person to the appropriate health professionals. The manager has completed an audit of care plans and is aware of the areas that need to be improved. The organisation is using a new computer system to write and review care plans and the home has prioritised one unit to be completed in October and November 2008. Three people said they ‘always’ while two people said they ‘usually’ get the medical support they need. People who use the service are registered with a GP and see other health professionals when required. We saw case files contain information about individuals health needs and any issues for staff to be aware of. We saw good records of health care appointments and actions staff need to take. Records of wounds include the size, description, clear guidance from the tissue viability nurse and a photograph. Records indicated that the treatment programme was being followed and the wound is being reviewed regular by nursing staff, the GP and tissue viability nurse. The manager said in the annual assessment that they could improve medication administration. We looked at medication storage and recording. Medication is appropriately stored with two exceptions. We found medication for one person who self medicates in a plastic box on a chest of drawers in a bedroom with the door open. The risk assessment for this person noted the medication is kept in a locked cupboard. This needs to be reviewed to ensure people who use the service are protected from harm. There was also a large unlocked box with some unused/unwanted medication in the office in one unit. Woodlands House DS0000034082.V371260.R02.S.doc Version 5.2 Page 12 Records of medication received and administered were found to be up to date, correct and signed by staff in four of the units. On one unit we found that two medications for two people were missing from the ‘blister pack’ prepared by the pharmacist. It was not clear why this medication was missing and it had not been signed as being administered by staff. The manager investigated the issue and has not been able to conclude the matter. Woodlands House DS0000034082.V371260.R02.S.doc Version 5.2 Page 13 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 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who use the service have the opportunity to maintain and develop important personal and family relationships. People are encouraged and supported to make decisions in their day-to-day life. The home offers a varied menu to suit people’s religious, cultural and medical dietary requirements. EVIDENCE: We saw people watching television, reading the paper and talking to staff, visitors or other people who use the service. The television was on in every unit, although we saw that it was not being watched for some time in two units. Staff should consider turning the television off for short periods of time each day to encourage different types of interaction. Three people said there are ‘sometimes’ and one person said ‘usually’ activities arranged that they can join in with. One person said they ‘find it difficult doing arts and craft and suggested more group activities that everyone could join in with. One person said ‘not always enough activities, but started to improve’. Woodlands House DS0000034082.V371260.R02.S.doc Version 5.2 Page 14 Notices are accessible to people who use the service about activities and outings. The manager said they use residents meetings to discuss suggestions for future activities and outings. They are hoping to use relatives who have volunteered to help with outings and events at the home. We saw a varied menu with alternatives provided which cater for individual’s medical and religious needs and preferences. Two people said they ‘always’ and three people ‘usually’ like the meals. Other comments included: ‘well presented’, ‘our relative looks forward to meals’, ‘the chips were good’, ‘food is lovely’, ‘I like the food’, ‘there are some off days’ and ‘cook is excellent and tries to please’. Woodlands House DS0000034082.V371260.R02.S.doc Version 5.2 Page 15 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 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure that allows people to express their views and concerns in a safe and understanding environment. People who use the service and their representatives say that they are happy with the service provided. Appropriate policies and procedures are in place for safeguarding adults. EVIDENCE: Six people who use the service were aware of how to make a complaint and who to speak with if they have concerns or worries. Two people said their relatives would report issues to staff. No issues or concerns were raised during our visits. The manager said they take all complaints seriously and investigate any concerns raised quickly to keep providing a good service. The complaints record includes actions taken and any areas to develop to prevent similar issues being raised in the future. Staff were aware of how to respond to concerns and complaints. The manager said all staff have completed training in protection or safeguarding, although some new staff are due to complete this training in the near future. Woodlands House DS0000034082.V371260.R02.S.doc Version 5.2 Page 16 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, 20, 21, 22, 23 and 26 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Woodlands House was purpose built and provides an environment that is appropriate to the needs of people who live there. The home is generally well maintained with a few areas needing attention. Specialist aids and adaptations are in place to meet individual’s needs. EVIDENCE: The home is separated into five units, two units on the first and second floors with one unit on the ground floor. Each unit has a lounge/dining area, single bedrooms, toilets, shower room, assisted bathrooms and a small kitchen for staff to prepare drinks, snacks, breakfast and serve meals. Two enclosed gardens are available to the rear of the home, with seating areas, flowerbeds and bird tables. Woodlands House DS0000034082.V371260.R02.S.doc Version 5.2 Page 17 Staff have separate toilet facilities and areas to take their breaks. The main kitchen and laundry are on the ground floor. Bedrooms are single, have an ensuite toilet and wash hand basin and are furnished with a bed, wardrobe and chest of drawers. The manager said they encourage people to personalise their rooms and bring belongings and small items of furniture when they move in. The manager said they are in the process of doing a deep clean including curtains, carpets, corridors and lampshades. Three people said the home is ‘always’ & two said it is ‘usually’ clean & fresh. One person made an additional comment that ‘sometimes it could be better’. We saw all areas of the home were clean and fresh. Appropriate policies are in place for infection control. Sufficient domestic staff are employed to keep the home to a good standard of cleanliness. Woodlands House DS0000034082.V371260.R02.S.doc Version 5.2 Page 18 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 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People have confidence in the staff who care for them. Good recruitment policies and procedures are in place with appropriate checks completed before staff start work. Staff have access to relevant training to help them carry out their job. EVIDENCE: People who use the service said there are ‘always and ‘usually’ staff available to help them. One person added that staff are often ‘dealing with others, so I may wait a while’. Four people said staff always listen and act on what they say. One person added that they ‘always wait due to lack of staff’. One person said ‘staff could respond quicker to the call bell’. Other comments about the staff included: ‘staff help’, ‘staff are supportive and caring’ and ‘the staff are good’. Staff said there are ‘always’ enough staff to meet peoples needs. We saw some good interactions between staff and people who use the service. Staff were seen to be responsive to peoples needs, give people time to walk at their pace and listen while people talked. Staff showed a detailed knowledge of peoples needs and how to meet them. Woodlands House DS0000034082.V371260.R02.S.doc Version 5.2 Page 19 The manager said they take up two written references, complete a Criminal Records Bureau (CRB) check and check staffs status regarding staying in the country before they start work at the home. Staff confirmed that they had filled in an application form, attended an interview and had a CRB check before they started work. New staff have a full induction to Woodlands House. This includes being given information about the service, the organisation, key policies and procedures. They also shadow existing staff to help them get to know the routines of the home and individuals needs. The organisation has a training and development programme available to all staff which includes sessions on health and safety, protection, dementia and moving and handling. The manager said they are looking at developing more training for staff working with people with visual and hearing impairments. Staff are also encouraged and supported to complete NVQ training. Woodlands House DS0000034082.V371260.R02.S.doc Version 5.2 Page 20 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 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The manager has the skills, knowledge and experience required to run the home and has a clear understanding of the key principles and focus of the service. The manager understands the importance of person centred care and good outcomes for people who use the service and is working to improve the services provided. Appropriate quality assurance systems are in place. Health and Safety policies and practices protect people who use the service, visitors and staff. EVIDENCE: The manager has been at the home for a year and is working through the areas to be improved. A deputy manager is in post with senior staff for four Woodlands House DS0000034082.V371260.R02.S.doc Version 5.2 Page 21 units in post and one new senior due to start work in the near future. This management structure has enabled the manager to delegate tasks and focus on the areas that need to improve. It has also provided support systems for staff. The regular residents meetings have been used to listen to what people want and guide some of the improvements at the home. A representative from the organisation visits every month and speaks with staff, people who use the service and looks at records. Any issues raised are addressed by the manager ensure policies and procedures are followed. They also send out annual surveys to seek the views of people who use the service and their representatives on the services provided. We saw Health and Safety records confirming that checks are carried out at the required intervals. Woodlands House DS0000034082.V371260.R02.S.doc Version 5.2 Page 22 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 3 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 X X 3 STAFFING Standard No Score 27 3 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 House DS0000034082.V371260.R02.S.doc Version 5.2 Page 23 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 OP7 Regulation 15 (2) b & 12 (1) Requirement More work is required to make sure all people who use the service have an up to date care plan that includes the support they need, how they want to be helped and what they can do for themselves to maintain their independence. Timescale for action 28/11/08 2. OP9 13 (2) A better system for reviewing care plans needs to be in place so staff complete this task every month and update care plans when changes in need are identified. Medication must only be 07/11/08 administered at the time it is due and must be signed for by staff administering it, to ensure peoples health needs are fully met. Medication must be securely stored to ensure people who use the service are protected from harm. Woodlands House DS0000034082.V371260.R02.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP1 Good Practice Recommendations The Service Users Guide should be made more accessible to people who use the service, photographs could be used to do this. This would help people make the decision to move in. More activities could be provided for individuals as well as groups to ensure peoples social and leisure needs are fully met. The service could look at having rummage boxes and bits for people who use the service to interact with around the units. Consideration should be given to providing a kitchen in the intermediate care unit to give people the opportunity to do daily living tasks. 2 OP12 3. OP19 Woodlands House DS0000034082.V371260.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 House DS0000034082.V371260.R02.S.doc Version 5.2 Page 26 - 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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