Inspection on 15/06/07 for The Woodmill

This inspection was carried out on 15th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Woodmill 09/07/09

The Woodmill 15/02/06

The Woodmill 11/08/05

The Woodmill 31/12/04

The Woodmill 03/06/04

The Woodmill 09/03/04

Similar services:

The Vicarage

7 Hyde Road

5 Seafield Road

Trevaylor Manor

12 Orchard Mews

Stallcombe House

Stepping Stones

Cornerstones

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

CARE HOME ADULTS 18-65 The Woodmill Exeter Road Cullompton Devon EX15 1EA Lead Inspector Louise Delacroix Unannounced Inspection 15th June 2007 10:00 The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Woodmill Address Exeter Road Cullompton Devon EX15 1EA 01884 836220 01884 836229 chris@chitty6.fsnet.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Brain Injury Rehabilitation Trust Mrs Penny Jean Blackmore Care Home 19 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (19), Physical disability (19) of places The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th February 2006 Brief Description of the Service: The Woodmill is a single storey building, which was specially adapted in 1993, for the Brain Injury Rehabilitation Trust. It operates in conjunction with other residential services and community services, to provide a continuum of services operated by the Brain Injury Rehabilitation Trust. There are 19 single bedrooms all with en-suite facilities. There is a conservatory lounge and an activity /TV Lounge, with another activity area with pool table and seats. There is also an art room. A physiotherapy room is available. There is a training kitchen with a high/low sink and a work skills area. Outside there are two landscaped patios, BBQ area and a gardening section. The current weekly charge is between £1908 - £1362. Additional charges are made for clothing, toiletries, telephone calls, gifts for family members, chiropody, taxis and individual hobbies. The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and lasted seven hours and forty minutes. Nineteen people were living at the home, and time was spent talking to individuals and observing the care practice of staff in communal areas of the home and the way they interacted with the people using these rooms. Time was also spent talking with members of staff and the registered manager. Medication records, staff recruitment and training files, and plans of care were looked at. The Commission for Social Care Inspection (CSCI) asked for the home to send out a range of surveys published by the Commission to gain feedback from people in contact with the service. Relatives/visitors and health and social care professionals responded. Surveys were also sent to the staff team and the people living at the home. Everyone living at the home completed the surveys either independently or with the help of another. There was also a good number of responses from the staff team. All responses have been included in the report, as has details from the home’s pre-inspection report, which gives details about the service and is completed by the registered manager. What the service does well: The home provides a thorough and comprehensive assessment process, which helps ensure that the person moving to the home is fully involved, and that the service can meet their individual goals and care needs. People are encouraged to visit and provided with information that helps enable them to make a decision, where appropriate they are also taken to other services by the Trust to help them make a judgement about what type of support they require. Each person living at the home has a comprehensive plan of care, which recognises his or her individuality. The staff group are skilled in enabling people to make decisions and supporting them to maintain an independent lifestyle, which involves informed risk taking. There are strong links with the local community and people are supported to access social opportunities that enhance their own development and maintain interests. The service recognises the need for people to have contact with people that are important to them, and to be able to influence their daily routines. The home provides a varied diet in a flexible manner. People receive personal support in the way they prefer and require. There is a strong emphasis on meeting both the physical and emotional needs of people living at the home with excellent contacts with health services. Medication is well managed. The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 6 The complaint procedure is accessible. The service recognises its responsibility to safeguard vulnerable adults by training staff to a high standard, and is committed to working in a multi-disciplinary way when incidents occur. The home is maintained to a high standard with a rolling programme of maintenance. There is a focus on making the environment more accessible to the people living at the home, including those with complex disabilities. Staff are well trained in both mandatory and specialist areas of care. They are skilled in their approach and well supported with positive role models and regular observation and supervision of their work. The home is well managed with a strong commitment to improvement with good safety systems in place. What has improved since the last inspection? 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. The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 2,3,4 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Prospective service users are actively involved in the decision to move to the home and are involved in setting the goals in their care plans. Assessments are carried out to a high standard and are comprehensive and reflect the individuality of each person. EVIDENCE: The team at the brain injury unit carries out full assessments and then works with the person moving to the home to create a treatment and rehabilitation programme. The team consists of care staff, occupational therapists, physiotherapists and psychologists. Assessments from social care professionals, i.e. care managers also play an important role within the assessment. Several social care professionals commented that the home provides ‘good assessments followed by comprehensive packages of care focusing on individual needs’ and ‘they provide very detailed assessments’ and ‘they are clear about goals and expectations’. In their response thirteen staff members said they were not asked to care for people outside their area of experience, which shows that the assessment process works well, with the service ensuring they can meet the needs of new people moving to the home. The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 9 On the day of the inspection, a person considering moving to The Woodmill visited with their family and a social care professional to help inform their decision about the home’s suitability. The manager explained that they had also visited one of the smaller out reach homes to provide further choice and information about the service that the Trust provides. Staff were seen being proactive to make their visit comfortable and welcoming. Relatives responding to the CSCI survey commented that the service managed hospitality well and that staff were pleasant and helpful. A member of staff said one of the strengths of the service was ‘making clients feel at home’. The majority of the people living at the home said in their response to the CSCI survey that they felt they had been asked if they wanted to move to the home. Some people found it difficult to remember. The majority of people also felt that they had received enough information about the home before they moved in to help them decide if it was the right place for them. One person said ‘I received a lot of information’. The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7 and 9 were inspected. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Care needs are met to a high standard in an individual manner by caring and informed staff. The ethos of the home promotes the rights of people living there to make choices in their lives, and to be involved in setting the goals they wish to achieve. People are supported to take risks to enhance their independence. EVIDENCE: Plans of care are generated from detailed assessments and have a holistic approach to the lives of the people living at the home. They are well worded and sensitively portray how support should be provided in a way that recognises the person’s strengths and areas for development. The plans of care acknowledge that the success of support relies on the person living at the home being in agreement with the approach. This was further confirmed by discussions with staff, who were clear that their role was to maximise the potential of service users. One social care professional commented that ‘The Woodmill have supported a client’s wish to leave the unit despite the adverse The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 11 impact on the unit’s finances’. A staff member in their survey said ‘…we provide a safe environment for the service users to live in and we also promote independence as fully as possible’. A member of staff spoke about an incident that had occurred between two people living at the home, they recognised the frustrations of the individuals, the resulting tensions and were clear abut the action to be taken. This knowledge was reflected in the plan of care of one of the people involved. This shows that plans of care are working tools. Thirteen staff members said that they were always given clear instructions about how to support the people living at the home. A member of staff spoke with great enthusiasm about their role and showed a real recognition of service users’ individuality and progress, which was reflected in plans of care. All the social and health care professionals who responded felt that the service supports service users to live the life they choose and the service responds to the different needs of the people living at the home. Four relatives/visitors felt the latter was always the case and two said usually. During the inspection, one person living at the home said the staff ‘allow you to be who you want to be’ and the service ‘choose staff to suit you’. Staff were seen to involve people living at the home with making decisions about their daily routines, as well as reminding them of the consequences of their actions so that they could make an informed choice. The majority of people living at the home felt that generally they could either ‘always’ or ‘usually’ make decisions about what they did each day. Three said this sometimes happened and one said never. One person said ‘programmes are in place to improve my situation, I am given choices when appropriate’ and another person described how they followed ‘a timescale but can make alterations if I wish’. Another person said ‘I enjoy my programme of care that is making me better’. In the CSCI survey, people were asked if they could do what they wanted to do, with the majority saying yes, whether this was during the day, evening or weekend. Generally, people living at the home felt staff listened to them and acted on what they said, which was observed on the day of inspection, although four out of the nineteen respondents said this only happened sometimes. The manager plans to follow this issue up. Members of staff spoken to or observed showed an understanding of the people living at the home; this includes business support staff and catering staff. A relative recognised this in their commnet ‘I get all the support I could possibly expect…this includes all members of staff, including kitchen staff’. Care plans and discussion with staff evidence how people are supported to take part in an independent lifestyle, which includes risk taking. For example, decisions are made around risk by a multi-disciplinary team and with the person involved, and their representative if necessary. These decisions are The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 12 documented in care plans. Information is gathered from other sources to create a broader picture, and different approaches are tried until a successful one is found. There is also recognition for the need to review as people’s needs change over time. Plans of care include clear guidelines and risk assessments, which were up to date and reviewed. Records were also clear when guidelines had been revised or discontinued. In a staff handover, there was discussion around an earlier incident with staff showing insight into the behaviour of the service user and the possible triggers for their actions. Staff were clear about their role to prevent such situations arising by following guidelines to ensure a continuity in approach. Care plans encourage staff to share good techniques regarding approach and to feedback this back to be included in care plans, although one member of staff in their survey said this should be encouraged more often. The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,15,16, and 17 were inspected. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are strong links with the local community, which support and enrich peoples’ social opportunities and personal development. People are supported to maintain relationships important to them and make decisions over their lifestyle. Meals are varied and meet the individual needs of people living at the home. EVIDENCE: The staff group have worked hard to ensure that even people with complex needs have access to the same level of activities as more able people living at the home e.g. participation in a pottery group. Recognition was shown in care records of how to ensure people with challenging behaviour could be supported to be included in these events. A staff member commented that the service monitored ‘when/how often clients are taken on trips out and share access to trips out fairly among clients’. Records and discussions with staff confirmed this. A person living at the home talked about how they were supported to The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 14 maintain their hobby and praised the staff member who supported them and shared their interest. Minutes from service user group meetings evidence how trips are planned and who wishes to be involved. During the inspection, a quiz was taking place, and one to one activities were seen with a barbeque planed for the evening. Discussion with staff, an activities notice board and detailed care plans also evidence that service users have access to local community resources. This includes therapeutic work placements with local businesses. Up to date records are kept of each service users’ day, which detail their integration into community life by making use of the local services. There was evidence of access to college, trips to the pub, use of a local gym, visiting local shops, which included the local supermarket. There is also contact with people, who have moved on to independent living or a supported setting. At the end of each month, a chart indicates the percentage of trips or social events that each individual has participated in. Discussion with staff and care records show recognition of the need for people to express their sexuality. This includes ensuring this does not impact negatively on others living and working at the home. During the inspection, discussion took place regarding how a person living at the home could be supported to maintain contact with a previous partner balancing rights and risks. Relatives/visitors responding to the CSCI survey said they were able to maintain contact with people living at the home and felt they were kept up to date with important issues affecting them. A person with complex care needs talked about how they were being supported to visit a close family relative, which was confirmed by their records. Staff were also heard discussing the arrangements for the next visit. During the inspection, staff were seen listening to people living at the home and giving them time to express themselves, and asking their opinion how to manage situations, although on two occasions one member of staff did not maintain eye contact when a person was speaking to them leaving the service user looking anxious. However, this was not the case for other staff. When negotiations did need to take place, for example where a cigarette could be smoked, staff were consistent and reasonable in their approach. People living at the home were seen making decisions about where they spent their time and who with, although on one occasion a person was supported to spend time in their room because of the negative impact of their behaviour towards other service users. This was in line with clear guidelines in their care plan, and was explained to the person involved. A mealtime was observed, which showed that people chose where they sat and who they sat with. Staff also eat their meals at the same time, and there was a general buzz of conversation. One person commented that they liked the The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 15 company at the home. Some people chose to sit on their own, and this was respected. Staff were generally seen to tactfully support people with their meals, although one staff member was seen to stand whilst assisting a person with their meal, which is not good practice. On the day, of the inspection the evening team of staff had planned a barbeque, which people living at the home said they enjoyed. The food planned catered for a variety of tastes. The general menu is reviewed and contains fresh fruit and vegetables, and people were seen being offered a choice. Staff spoke about their recognition of the memory difficulties of the people living at the home and their need to be flexible if people change their mind about meals. Discussion with staff showed that the home caters for individual diets, including people who are diabetic and/or vegetarian. Staff showed a commitment to be flexible in times of meals, recognition of likes and dislikes, and responding to requests from the clients’ forum. The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19, and 20 were inspected. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service provides support and care, which reflects the individual needs of the people living at the home, and promotes good access to health care services. People are protected by good medication practice, and there is recognition in assessments and guidance for staff to work towards meeting both the physical and emotional needs of the people living at the home. EVIDENCE: Clear instructions are given in care plans about the level of support that people require for personal care. Daily records within plans of care showed flexible times for going to bed and getting up. Staff were heard discussing in a handover how a service user needs to be supported with personal care so that they do not become frightened showing an individualised approach. One person fell whilst in the corridor, and a staff member supported them in a caring manner, working at their pace and involving them in making a decision about how to get up. Discussion and observation of staff showed a consistent approach to recognising the individual needs of people living at the home. The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 17 The service has excellent contact with health services as shown through care plans and discussions with staff. All the health and social professionals said in their survey responses that individuals’ health care needs are always well met, and that the service is proactive in managing and improving people’s health, including meeting their specialist health care needs i.e. diabetes. This was confirmed by discussion with a senior member of staff who has shown a commitment to updating their own health training. One plan of care showed how the service had communicated well with a hospital as a result of a service user’s operation. Staff monitored pain relief during the inspection, and were quick to pick up on people’s changes of mood and well-being. One respondent commented that ‘staff at The Woodmill are very quick to act if they need more specialist input’. Relatives/visitors also commented that medical care is something that the home does well, including providing support from physiotherapists and occupational therapists. The home always reports incidents relating to serious health problems and records show that appropriate action has been taken. There is recognition by staff members of the psychological needs of people living at the home, and plans of care show clear guidance from the multidisciplinary team in how to meet these needs, although one staff member felt more training in the area of mental health should be provided for care staff. During the inspection, a person living at the home showed distress about their behaviour and how it had impacted on a member of staff. A senior member of staff showed their skill and experience by reminding the person about their brain injury and how this affected the way in which they reacted in certain situations. They provided reassurance but also involved the service user in talking through what happened and were clear in their explanations. A relative said in their CSCI survey ‘his health and mind has improved so much, tho’ slowly, since he has had such good care treatment, and helpful professional treatment’. Another relative said ‘all the professional help she has received has made her move forward …a success story’. A social care professional said in their survey that the service ‘ has been very supportive in developing my client’s social skills and help her overcome her physical difficulties’. A medication round was observed, which was carried out in a safe manner. The staff member confirmed that their training had been updated and that the management team observed their practice. Records are well maintained, and medication administered in an appropriate manner with safety mechanisms built into the process to help ensure that mistakes are not made. The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards inspected were 22 and 23. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People using the service are safeguarded by well-informed staff who work in a well managed and proactive service. EVIDENCE: In their pre-inspection questionnaire, the manager stated that no complaints had been received by the home. None have been received by CSCI. During the inspection, one person raised a concern, which they agreed to be shared with the manager. The manager, who arranged to meet with the person privately, immediately followed this up. The manager had carried out an audit of daily records and found that when concerns have been raised staff are always prompt and efficient in their response and have resolved the problem. However, the manager has decided that these should also be logged elsewhere so that if there are themes or patterns these could more easily be identified. Relatives/visitors to the home said that generally the service responded appropriately if they raised concerns. Comments included ‘the staff has always had a listening ear’ and ‘I know it would be sorted out for me’. One person who said they did not know how to make a complaint but felt that they would be able to go straight to the management. In their response to the CSCI survey, seven people living at the home said they did not now how to make a complaint but some of these said they had people who would act on their behalf, if needed. The majority of respondents The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 19 did know who to speak to if they were not happy. The home has produced a clear complaints policy that is accessible to people living at the home. The manager said this policy was available in each room but will also ensure that relatives/visitors are always given a copy. The majority of health and social care professionals stated that they always had confidence in the home to respond appropriately to concerns, with only one respondent saying usually. In their response to the CSCI survey, staff said they were clear about adult protection procedures, and a staff member in an interview demonstrated this as they were competent and confident about their role in safeguarding the people they cared for. Training records show that safeguarding training is in place for staff members, including in induction, and a senior member of staff spoke about how this was delivered in a practical manner using case scenarios. Staff have also signed to confirm that they have read and understood the policies relating to safeguarding vulnerable adults and their duty to alert authorities to poor practice. The home has an excellent record in the way that they have responded to serious incidents. They excel in multi-disciplinary working, respond promptly and recognise the need to request specialist advice when needed. Staff are clear about the on call system as demonstrated by a discussion during the inspection, and the manager showed a strong commitment to a consistent approach by ensuring that she has copies of key policies and care guidelines when she is on call. The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards inspected were 24,25 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The maintenance and décor of the home is maintained to a high standard, and provides a clean and homely atmosphere for people living there. EVIDENCE: The home is furnished and maintained to a high standard. There is a rolling programme of maintenance, and this was shown by a delivery of good quality bedroom furniture on the day of inspection. Some communal areas have been re-decorated, including the conservatory, which is now a brighter and more attractive area to sit in. There is a range of communal areas for people to use. The service constantly evaluates the environment and where possible it is changed to reduce barriers to people living at the home. For example, in two of the en-suite rooms walk-in showers have been installed, as this is more appropriate to the needs of the people using the rooms. The manager explained that new chairs have been bought in a style that enables people to be more independent. Recently an accessibility study has been carried out in The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 21 the home with the help of a service user who uses a wheelchair. This has highlighted that some minor changes need to be made, which the manager plans to follow up on. Some staff and people living in the home commented in their surveys that The Woodmill was ‘a very homely place’ and ‘I am very happy in this place’ and ‘I feel I am at home’. Four bedrooms have recently been re-decorated and one person living at the home explained how they had chosen the colours. Two other rooms were seen that had been recently decorated, and one of the occupants showed a strong sense of pride about their choice of colour and the artwork on the walls. Thirteen people living at the home said the home was always clean and fresh, with two people saying usually and two people saying sometimes. Two people said ‘ I am happy with standards’ and ‘very, very clean’. A relative said ‘I feel my son is lucky to be in a clean, safe and pleasant care home employing good care staff’. On the day of the inspection, the home was clean and staff were seen using infection control procedures and explained how this worked in the laundry area. They were clear that there were plentiful supplies of infection control equipment. The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards inspected were 32,34,35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a committed staff team, with a range of experience, whose training opportunities and skills benefit the people living at the home. However, a change to the recruitment process will provide a safer system. EVIDENCE: In response to the CSCI survey, care staff explained that they were clear about the policies of the organisations and there subsequent responsibilities. They said they knew what to do in an emergency and felt they received enough support to do the job well. The Brain Injury Trust provides a comprehensive training package, which starts at induction. This package covers mandatory training such as moving and handling, as well as specialist training on brain injuries. The majority of people living at the home said staff listened them to, and this was generally the case during the inspection with staff picking up on people’s verbal and non-verbal communication. Staff were caring, informative and sensitive to the individual needs of people. One member of staff was seen to be skilled in managing a potentially difficult situation. They showed patience The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 23 and focus when sitting with one person whose behaviour can be challenging to those around them. Surveys from health and social care professionals all stated that the staff group had the skills and experience to support people’s social and health care needs. One person said ‘I have been impressed by the skills of the staff and their commitment to improving my client’s quality of life – continuing to set and develop goals over several years and my client continues to progress because of small but significant improvements culminating in a very significant total outcome’. The two teams observed during the inspection contained strong and positive role models within them, providing clear direction and examples of good practice. Part of a staff handover showed a good rapport between teams with good quality information shared, which was reflected in surveys when staff members commented that the teams supported each other. Teams are made up of male and female staff to reflect the client group, and staff were clear about the boundaries relating to this. There were appropriate levels of staff on duty, which staff confirmed, although in their surveys both relatives/ visitors and people living at the home raised issues about more one to one care being available. The manager gave examples of how she is currently working with funders i.e. local authorities to highlight the benefits this would achieve for some of the people living at the home. However, this is a funding issue, which is not within the remit of CSCI. Three recruitment files were looked at for three members of staff who have been recruited since the last inspection. All three people had the appropriate police checks before starting work at the home and all people had suitable identification in place, which is good practice. However, files did not always indicate why referees had been chosen and why they were appropriate. On one occasion a reference had been sent to the home address of the referee rather than the care home where the person had worked. For another person, there was an unexplained gap in their employment history. Staff said in conversation and in their surveys that they felt well supported with their work through regular meetings with the manager, one to one supervision, observation of their work and through group meetings. A member of staff commented ‘The Woodmill does very well at supporting its staff and in providing a high level of care’. The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37,39 and 42 were inspected. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. This is a well-managed service that has excellent processes to ensure that the quality of the service is monitored. EVIDENCE: The manager of the home has demonstrated, through contact with CSCI previous to the inspection and during the inspection, a strong commitment to providing a high quality and well run service. She continues to work on her own personal professional development and recognises the importance in training to supplement her experience. There is strong evidence of good line management and staff are clear about their roles and level of responsibilities. A staff member said the atmosphere encouraged openness so that problems could be raised and resolved. The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 25 The manager is committed to self audit and this was shown by the quality of the systems in place on the day of inspection with a wealth of information to show how the service manages its quality assurance. These include surveys to people living at the home, and with people who have contact with the service resulting in the outcomes being published. The Trust has its own quarterly newsletter and this confirmed that the annual satisfaction rates for The Woodmill in 2006 were high. There is a regular client group forum, which enables people living at the home to influence the service, which was shown by the well-written minutes that were on display on the lounge, and a keyworker system so that each person has a member of staff who they have regular contact with, which provides an opportunity to discuss issues. There are also regular visits from someone outside of the service to monitor the quality. Staff confirmed that they have regular supervision and team meetings where they can discuss issues relating to the service. The home is also applying for accreditation from the Commission on Accreditation of Rehabilitation Facilities and is currently awaiting the outcome of a quality audit inspection. The home’s pre-inspection questionnaire states that safety checks are up to date and key policies are in place. The home has good systems in place to monitor health and safety issues. For example, records were seen for monitoring temperatures in fridges, staff in the kitchen showed how they worked to good food hygiene standards, and infection control measures are in place. Training records show that staff have fire training at regular intervals and have received mandatory training in areas such as moving and handling. Visits by someone outside of the service on a monthly basis also acts as a spot check for safety issues. The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 4 3 4 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 4 25 3 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 4 33 x 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 x 4 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 4 x 4 x x 3 x The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 27 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 YA34 Regulation 19 1 (b) Requirement Recruited staff must have a full employment history, together with a satisfactory written explanation of any gaps in employment. Timescale for action 13/08/07 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 YA34 Good Practice Recommendations When a referee has been chosen who is not a recent employer, staff files should contain a satisfactory written explanation as to why they have been chosen. References from care homes should be sent to the business address not the referee’s home address. The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 The Woodmill DS0000022068.V344985.R01.S.doc Version 5.2 Page 29 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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