CARE HOME ADULTS 18-65
Woodpeckers (The) 10 Albion Way Verwood Dorset BH31 7LR Lead Inspector
Maxine Martin Unannounced Inspection 9th March 2006 16:00 Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 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 Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 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. Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Woodpeckers (The) Address 10 Albion Way Verwood Dorset BH31 7LR 01202 813708 01202 813708 allen.pat@virgin.net 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) Mrs Patricia Robinson Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection Brief Description of the Service: Woodpeckers is registered to provide accommodation to 3 adults who have a learning disability. The residents live in the home with Mr and Mrs Robinson, as part of their family. Each resident has a single bedroom, and shares a bathroom. They have access to the whole of the house and garden. The owners provide a high level of care, and employ other staff to support the residents during the day and at weekends. The home is a large 5-bedded house in a residential area of Verwood in Dorset. It is within walking distance to the village shops, and there are regular buses to the towns of Ringwood and Bournemouth. The home has been running since 1998, and 2 of the residents have lived in the home since it opened, and one resident has lived there now for 4 years. The residents can choose whether to go to another establishment for day activities, or remain in their home with staff to support them with leisure activities. Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 9th March 2006 and was continued on the 15th March 2006. On the initial visit the residents were getting ready to go out for a show and therefore a follow on inspection was necessary. The total time of the inspection was three hours and forty-five minutes. On the first visit a member of staff was present with the residents, Mr and Mrs Robinson joined us later. Discussions with the residents were undertaken and a tour of the house given by Mr. Robinson. The follow on inspection focused on care plans, pre-admission assessments, training, finances and medication and mainly involved Mrs Pat Robinson, although further discussions were held with the residents and interaction was observed. The purpose of the inspection was as part of the annual inspection required by the Commission. What the service does well:
Residents live in a homely environment and are involved alongside of the staff team and family to live as independently as possible. Their family and friends visit regularly and take part in social activities. All three residents said that they attend a range of activities and are looking forward to a planned holiday they have chosen. The building work and refurbishment ensures the residents live in a home where the quality of furnishing and environment is maintained to a high standard, which provides an appropriate setting to meet their needs. The atmosphere in the home is very relaxed and residents are actively involved in many of the daily life activities. They are involved in choosing and cooking their meals and take it in turns over other decisions. They are offered a varied and healthy diet and their health needs are monitored regularly. The residents live very active lives where their views and aspirations are responded to, which collectively enables the individual to feel safe, be supported appropriately with their rights respected and valued. There is a consistent care team who have the necessary skills, training and knowledge to support the residents and ensure their safety whilst encouraging the development of the individual’s skills, balancing risk and rights.
Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 Page 6 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. Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 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 Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Systems in place ensure that any prospective resident is properly assessed and full account is taken of their views. EVIDENCE: At the time of the inspection there was the possibility of one individual moving out and another person was in the early stages of pre-admission assessment. The home has an assessment document seen on the inspection that involves the person in all aspects of considering their care needs. They are liaising with the social worker and family. They have planned a provisional programme of trial visits for the individual. Mrs Robinson has taken into account the needs of the current residents and all trial arrangements include social events to support introduction. The Woodpeckers has had a consistent group of residents and staff, so this is a significant event for them from discussion and documentary evidence this is being carefully planned. Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 The staff team are committed to ensuring that residents are actively involved in the planning and review process to address their changing needs, so that their quality of life is maintained and improved. EVIDENCE: During the inspection individual files, care plans, risk assessments and review documents were seen which identified individual need and reflected changes. Outside agencies are actively involved, where necessary, in addressing the needs of the residents; letters and guidelines from other agencies were on the files. In relation to the one individual who may be moving out, there had been significant events but there was evidence of a multi-disciplinary approach to try and resolve the situation. Careful consideration and planning was also being undertaken to ensure this resident’s needs were priority in the planning for change. Whilst talking to residents they discussed things they liked to do, where they were going to, who had chosen the meals for tea. They were aware of the new
Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 Page 10 furnishings coming and seemed actively involved in many aspects of the functioning of the home. Staff were observed giving residents opportunities to make decisions about what they wanted to do. Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Residents are actively involved in the running of the home; their choices and preferences are taken into consideration. This creates an environment where they are seen to be working together with the staff to create a homely environment of their choice. EVIDENCE: Residents said they choose where they go to for a holiday. They talked about various activities that they do separately and as a group. They can choose to spend time together or have time alone when in the house. The garden area is well presented and they help Mr Robinson with the gardening; this is a particular interest of one individual. As this is the home of Mr and Mrs Robinson, they benefit and are involved in extended family events, which enhance their life experiences. On both visits the residents were actively involved in the preparation and planning of meals and negotiate a rota for this. Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 Page 12 They all have family contact and family members are encouraged to be part of their lives. As well as having shared space they have individual rooms, which are furnished to their choice and enable them to have their own privacy when they want this. There is an open culture of discussing things if anyone has a concern and where shared decisions need to be made. Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 20 Individual health care needs are fully met so that they can continue to have an active and integrated life in the community. EVIDENCE: Files were viewed and the medication system checked and discussions held with Mrs Robinson. The medication is kept in a locked cupboard appropriate to the needs of a small home. A large company dispenses each individual’s medication into a blister pack and there is a signing sheet completed by the staff member. This is then returned back to the dispensing agency to ensure medication is recorded. There were clear review dates for each individual by their GP to check their medication. The staff have all been trained in the dispensing of medication and certificates validated this. Each week residents willing take part in basic health checks; this involves a record of weight, nail care, checks on glasses, any minor injuries. Records were seen and the medication policy for the home. Currently there is no one in the home who would be able to self medicate. Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 Page 14 Where there are specific health issues there was documented evidence of meetings with consultants and medical staff had given training to the staff team. Annual checks such as opticians and dentist were also recorded. Through the range of activities, contact with family and friends, their emotional needs are supported. The residents are involved in all aspects of planning and evidence of being involved in everyday decisions were observed on the inspection. They talked confidently about their home and their lives. Staff have training in key areas to support residents. Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Residents have choice and are actively involved in the decision making process in the home. Rights and risk are balanced so that the individual’s quality of life is maintained. EVIDENCE: Residents said that they were able to choose things and be involved in decisions. The reviews indicated that they were involved in them. One problem that Mrs Robinson was having was getting outside agencies to always attend reviews; however, she still continues to invite them. The adult protection policy was seen and one member of staff has completed her unit for her NVQ on protection against abuse. Mrs Robinson is trying to arrange further training for the staff. The involvement of the residents in daily activities, the efforts to ensure their rights are respected all support their protection. The weekly checks help to identify if there are areas for concern. Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 Page 16 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Residents live in a clean, homely environment which is furnished to a high standard, which enables them to be supported in a way that supports their independence and respects their rights and choice. EVIDENCE: The house has been furnished to a high standard and is continually being updated to ensure a comfortable care environment. During both the unannounced and follow on inspection standards of hygiene were observed to be very high. Procedures are supported by good practices to ensure that these standards are maintained and all appropriate policies are adhered to in the safe storage of cleaning materials, food and the prevention of infection. The staff are trained as required. Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 Page 17 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 34 The staff team have remained consistent and continue to build on previous training, to enable them to support and develop the service in line with individuals’ needs. EVIDENCE: The staff team have known and supported the residents for several years and they have undertaken a range of training. One staff member has completed a City and Guilds level 2 qualification in working with people with a learning disability. Another staff member is to start her NVQ 2 in September. The manager is aiming to complete her NVQ 4 and Registered Managers award in June 2006. The manager advised that any delay in training has predominantly related to lack of availability of appropriate courses. She is currently seeking further training for the staff in Adult Protection and Fire safety. Staff are booked to attend a First Aid Course in April 2006. Where there have been specific areas of concern, medical staff have come and undertaken direct training and briefing with the staff. This was documented in the residents file from the Consultant. Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 The care environment supports the personal development of the residents in the home ensuring that their identified needs individually and corporately are addressed. EVIDENCE: The relationship between the management and the team is a very positive one, which reflects on the care of the residents. There is flexibility and an ethos of mutual support between staff, which enables consistent care provision. The development of a family home into this care service and the commitment of the manager means the values of an ordinary life within the community underpin the purpose of this service and lead to a well run home. The atmosphere within the home is very positive, residents appear confident and involved. The environment is maintained to a good standard and choice reflected in programmes of care that are full of varying activities and reflect individuality.
Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 Page 19 The reflection by Mrs Robinson of her own development whilst undertaking the training supports the overview of a well run home which is open to development and change. Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 3 x 3 x x x x x x Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Woodpeckers (The) DS0000026894.V286674.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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