Inspection on 30/11/06 for Woodberry Grove

This inspection was carried out on 30th November 2006.

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

Woodberry Grove 22/06/06

Woodberry Grove 25/10/05

Woodberry Grove 11/04/05

Woodberry Grove 01/09/04

Woodberry Grove 01/04/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Woodberry Grove 91 Wellington Road Bush Hill Park Enfield Middlesex EN1 2PW Lead Inspector Margaret Flaws Key Unannounced Inspection 30 November 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Woodberry Grove DS0000010638.V313280.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Woodberry Grove DS0000010638.V313280.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodberry Grove Address 91 Wellington Road Bush Hill Park Enfield Middlesex EN1 2PW 020 8360 2214 020 8886 9296 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) Hapee Care Ltd Mr Kathiresu Cumareshan Mrs Janet Carol McGuigan Care Home 26 Category(ies) of Dementia - over 65 years of age (26), Old age, registration, with number not falling within any other category (26) of places Woodberry Grove DS0000010638.V313280.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd June 2006 Brief Description of the Service: Woodberry Grove is a care home registered to provide a service for 26 older people. The service has recently been granted registration to provide dementia care services. A respite care service is also provided. The stated aim of the service is to provide a high standard of individual care, support and a pleasing environment for all the residents to enjoy a good quality life. Woodberry Grove is a private care home owned by Mr Cumaresham of Hapee Care Limited. Mr Cumaresham owns a number of other care homes in England. The service is provided in a large detached property with rear extension that has been converted for use as a care home. There are eighteen single bedrooms and four double bedrooms. Bedrooms are on the ground, first and second floor with a shaft lift serving all three floors. In addition, there is a chair lift linking the ground and first floors. There are bathrooms on all three floors. There are two lounge areas and a dining room on the ground floor and a room on the second floor which is used by the hairdresser and can also be used by staff and service users as a sitting area. There is a garden to the rear which includes a grassy area with trees and shrubs as well as a paved area with seating for residents. Woodberry Grove is in an quiet road in an attractive residential area of Bush Hill Park, Enfield. It is close to local shops, a railway station and bus routes. The provider must make information available about the service, including reports, to service users and other stakeholders. Fees for the home range between £345.00 - £485.00 per week. Woodberry Grove DS0000010638.V313280.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day. The Registered Manager Janet McGuigan assisted throughout with the inspection. Five service users, three relatives and five staff were spoken to. Care, home and staff records were inspected, along with health and safety documentation. A pre-inspection questionnaire and surveys from eleven service users, three relatives and two health care professionals were received. A tour of the premises completed the inspection. What the service does well: What has improved since the last inspection? What they could do better: Four requirements and one recommendation are made. Medication for service users with dementia should be reviewed. Staff files, while complete, need to be more systematic and should be put into order. The Electrical Safety Certificate must be renewed and a kitchen light bulb needs replacing. One recommendation is made – that staff continue to learn key words and phrases in Greek to communicate with one service user. Woodberry Grove DS0000010638.V313280.R01.S.doc Version 5.2 Page 6 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. Woodberry Grove DS0000010638.V313280.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Woodberry Grove DS0000010638.V313280.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Clear written information about the home and its services are available to prospective services users. Assessment and admission procedures are sound. EVIDENCE: The atmosphere at Woodberry Grove is homely and relaxed. On the day of the inspection, positive relationships were observed between service users and staff. Feedback from the service users and from three relatives spoken to was also very positive. Relatives of newly admitted service users said that their needs had been fully assessed. There were twenty four service users in the home. There have been three new admissions since the last inspection and one service user has died. Good information for prospective service users is contained in the statement of purpose and the service users’ guide. Trial visits are part of the process for checking mutual compatibility. Initial assessments give sufficient information for care planning. The Woodberry Grove DS0000010638.V313280.R01.S.doc Version 5.2 Page 9 Pre-assessment of prospective service users with dementia is also good, with assessed information taken forward into dementia care plans. The home does not provide intermediate care. Woodberry Grove DS0000010638.V313280.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8, 9 and 10 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users receive good care in the home. Care plans and risk assessments are sound. Medication policies and procedures are clear and adhered to protect the service users. However, the home should review the medications given to service users with dementia. EVIDENCE: There were twenty five service users in the home at the time of the inspection. Five care plans and service user’ files were inspected. These were clearly laid out and easy to understand. They included good profiles and information. The service users’ care needs were covered in depth, with detailed dementia care assessments and care plans in place. The care plans set out clear goals and actions to be taken to meet these goals and were regularly reviewed. Staff have received recent training on care planning, which the Registered Manager said will gradually enable them to produce the care plans for the service users whom they keywork (at present the manager completes these). Woodberry Grove DS0000010638.V313280.R01.S.doc Version 5.2 Page 11 Risk assessments in all areas of care are good and regularly reviewed. District nurses come in come in daily to give insulin injections to two diabetic service users and are available to check on the healthcare needs of others. Regular preventative health care visits take place regularly and are recorded appropriately. Feedback from health professionals (by survey and comments recorded were positive: one GP said “I have never seen (the service user) look so well, she’s always laughing and smiling now”. Interactions observed between service users were positive and they were clearly enjoying each other’s company. One service user was case tracked. The inspector spoke to this service user and observed her for a period of time; spoke to her daughter and read the service user’s file and discussed her care with the Registered Manager. This service user has dementia. The Manager described how the home risk managed her needs. For example, close to the time of her admission, she left the home on her own (climbing out of her ground floor window) and was later found near her old home. Subsequently, her bedroom window was secured to prevent it fully opening and the side entrance also made more secure. The home did a good job of engaging her family in the review of her care and supporting her safety. After discussing and establishing her long term life patterns with her daughter, staff are now taking this service user on more outings; encouraging her to engage in more activities and supporting the friendship she has developed with another service user. This service user is now fully settled and appeared very content. Staff were able to describe how they worked with service users with dementia and how their training helped them to assess their needs, especially in the days and weeks after admission. The service users are mobile and move freely around the home. While there is regularly serviced hoist available, there are no service users with significant manual handling needs. Medication arrangements were inspected and were satisfactory. MAR charts were examined and were in order. Medications were safely and appropriately stored. In particular, the medication fridge was kept locked, meeting a previous requirement. No service users self medicate. The Registered Manager said that the new medication contract with Boots was working very well. Staff have all received medication training. However, after reviewing the records of service user with dementia, it is required that their medication be reviewed to ensure that they are not receiving inappropriate medication. All the service users and relatives spoken to said that the staff treated them well and that their rights were respected. They were very positive about the quality of care given in the home. One service user, who chose to stay in bed on the morning of the inspection, indicated that was her choice and that she enjoyed being able to do so. Some serve users share rooms – one couple and Woodberry Grove DS0000010638.V313280.R01.S.doc Version 5.2 Page 12 two sisters. They were all happy with these arrangements and it was clear from observation that their privacy and dignity is respected. One new Greek speaking service user was happy with the way the home provides her care. Her relative said that she sometimes reverts to speaking Greek (which she did when speaking to the inspector), attends the Orthodox Church and listens to Greek radio stations in her room. She also enjoys cleaning, which the home enables her to participate in. Staff are also starting to learn some basic Greek and it is recommended that they continue with this process. Woodberry Grove DS0000010638.V313280.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Activities both in and outside of the home are varied and fun in the service users’ interests. Service users are supported to have family contact of their choice. The food is delicious, plentiful and nutritious. EVIDENCE: Service users mainly followed their own interests, which included watching TV and reading, during this inspection. There were no planned activities on that day. There have been several excursions since the last inspection. These have included trips to the theatre, pub lunches, several barbeques and Christmas shopping. In the home activities include exercises, singalongs with visiting musicians, and dances. The home is also starting a knitting club to make blankets to send overseas. One recently employed staff member used to teach home economics and is a qualified beautician. The home intends to use her skills in developing activities with the service users (once they have helped her improve her English language). The Registered Manager said that the service users, when consulted, said that they were bored with quizzes and so the home is trying to put new activities in place. Most service users participate as best they can in what is offered and this is documented in their daily notes. Woodberry Grove DS0000010638.V313280.R01.S.doc Version 5.2 Page 14 There is a general division between the two lounges in the home, with one lounge mainly occupied by service users who prefer to chat throughout the day and the other by people who prefer to watch television and do group activities. The garden is also well used in the summer. Some service users with dementia also participate in daily housework, cleaning and cooking activities in the home, to support their cognitive functioning and orientation. Visiting hours are not limited; families are always visiting and several service users go home regularly. Religious needs are well supported. For example, one service user who is an active Christian receives private communion in the home. Lunch was healthy and nutritious, with good choices available. Monthly menu cycles indicate that three substantial cooked meals are available daily. For example, porridge and eggs are available for breakfast; there is always a substantial three course lunch, then lighter evening meals like quiche and salad, pasta bakes and chilli con carne are offered. The cook has worked in the home for many years and is very familiar with the service users’ preferences. One service user used to be a cook and regularly gives suggestions and advice. Service users said that they loved the finger food buffets regularly offered and relatives spoken to said they thought the food was excellent. Service users’ cultural needs are considered. For example, three service users are Afro-Caribbean. Some food from the area is offered and there is supported contact with their churches. Woodberry Grove DS0000010638.V313280.R01.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The arrangements to protect service users are sound, with good training, policies and procedures to deal with incidents or allegations of abuse. EVIDENCE: The complaints file was checked. There have been no complaints received since the last inspection. The complaints procedure is robust. All staff have received adult protection training and the Registered Manager has completed a Trainer the Trainer course in this area of practice. The adult protection policy and procedure is appropriate. It includes actions to be taken in incidences of alleged abuse and is consistent with the local authority’s policies and procedures. Woodberry Grove DS0000010638.V313280.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home has been refurbished and brightened up to provide a more pleasant environment for the service users. EVIDENCE: The home has had considerable refurbishment since the last inspection. Most bedrooms have been repainted and fully refurbished with new beds, furniture and curtains; the hallways have been painted and new carpet laid. Three spare bedrooms are being redesigned to create a new ensuite bedroom. Minor repairs have been done to fix cracked windowpanes in rooms 11 and 12 and an electrical socket in room 16. The kitchen has had new flooring laid and the reception area opened out to create more space for the service users to move around. One kitchen light bulb needed replacing. Woodberry Grove DS0000010638.V313280.R01.S.doc Version 5.2 Page 17 Two cleaners cover weekdays and weekends. Hygiene and cleaning standards were good and the home was free from unpleasant odours. The small laundry is well maintained and ventilated. Woodberry Grove DS0000010638.V313280.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The established staff team works well to support the service users and there are sufficient staff on duty in the home. Improvements and considerable expansion of the staff training programme will help them support the service users with skill. EVIDENCE: Five staff members and the Registered Manager were interviewed. They had a good understanding of the service users’ needs. Service users were very positive about the staff: one said “they are very good to me. I like them a lot”. Many staff have worked at Woodberry Grove for a long time and staff turnover is low. Interactions observed between the staff team and the service users demonstrated that staff were kind and professional. The Registered Manager takes a ‘hand on’ approach with the staff and the service users. Staff said that their morale was very good and that they were well supported, formally and informally. Four staff files were inspected. All pre-employment checks had been completed for new staff but the files would benefit from being put into better order. New staff receive a thorough induction, a mix of formal and self-directed learning. Two new staff were spoken and said that their induction had equipped them well for working in the home. They said that they were well oriented to the needs of the service users. Woodberry Grove DS0000010638.V313280.R01.S.doc Version 5.2 Page 19 One student is on placement in the home. There were twenty five service users in the home on the day of the inspection and four staff on duty on each shift. Relatives and service users said that the staffing levels were good and that staff were always on hand if needed. Staff rotas demonstrated that this staffing level was consistent. Staff also said that they have time to sit and talk to the service users and spend individual time with them. This practice was observed throughout the day. Building on a Workforce Training Needs Assessment completed last year, staff training has taken a positive leap in quality, frequency and scope. Gaps in statutory training have been filled. Staff have received training in medication, moving and handling, food handling and adult protection, meeting a requirement from the last inspection. They have also had training in the following areas: health and safety, dementia care and advanced dementia care and infection control. The Registered Manager said staff are now progressing slowly with learning to do care planning after training provided. She has almost completed the Registered Managers’ Award and is getting ready to commence an NVQ4 in Care. She was recently chosen as one of nine finalists out of five thousand for a National Learner of the Year Award, after being put forward by Barnet College. NVQ achievement is good and all staff are progressing through either NVQ2 or NVQ3. The Registered Manager has been successful at securing free access to training programmes and works hard to ensure that staff are well trained to do their jobs. Woodberry Grove DS0000010638.V313280.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33,35, 36 and 38 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home continues to benefit from the leadership of the Registered Manager. Quality assurance processes are reasonable and service users are consulted regularly. The health and safety of service users is generally well protected. EVIDENCE: The Registered Manager has almost completed the Registered Managers’ Award. All the service users and staff spoken to were positive about her management style and the support she gives to the home. Woodberry Grove has good systems for supporting those service users who require help with their finances. Financial records inspected were accurate and systematic. Supervision records were very good. The demonstrated that staff receive bimonthly, comprehensive supervision. They all conformed this when Woodberry Grove DS0000010638.V313280.R01.S.doc Version 5.2 Page 21 interviewed. The Registered Manager received good support from the Registered Provider, who visits regularly. Accident and incident recording has improved, meeting a requirement from the last inspection. The CSCI is kept informed by Regulation 37 reports when necessary. Service users are surveyed annually. All health and safety certificates were checked and most were in order, as were fire safety records. A requirement is given for the Electrical Safety Certificate to be updated. Regular fire drills and checks take place and were documented. The Registered Manager has completed a Fire Risk Assessment (she has been trained to do this), which she is waiting for the Fire Service to inspect. The recording of food, fridge and freezer temperatures is now consistent, orderly and systematic. Woodberry Grove DS0000010638.V313280.R01.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X 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 2 Woodberry Grove DS0000010638.V313280.R01.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 OP9 Regulation 13(2) Requirement The Registered Person must ensure the medications given to service users with dementia are reviewed. The Registered Person must ensure that a kitchen light bulb is replaced. The Registered Person must ensure that staff files are put into good order. The Registered Person must ensure that electrical safety is checked and certified. Timescale for action 31/01/07 2. 3. 4. OP19 OP29 OP38 13(4) 18(1) 12(1) 31/12/06 31/01/07 31/01/07 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 OP7 Good Practice Recommendations The Registered Person should continue to provide opportunities to staff to continue learning Greek to communicate with a Greek speaking service user. Woodberry Grove DS0000010638.V313280.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA National Enquiry Line: 0845 015 0120 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 Woodberry Grove DS0000010638.V313280.R01.S.doc Version 5.2 Page 25 - 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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