Inspection on 25/06/09 for Woodbine Manor Care Home

This inspection was carried out on 25th June 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Woodbine Manor Care Home 25 Upper Bognor Road Bognor Regis West Sussex PO21 1JA     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Liz Palmer     Date: 2 5 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Woodbine Manor Care Home 25 Upper Bognor Road Bognor Regis West Sussex PO21 1JA 01243841136 01243841136 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Elderet Ltd Name of registered manager (if applicable) Mrs Angela Barton Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 29. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Woodbine Manor is a care home registered to accommodate up to twenty-nine persons in the category of OP. It is a large detached property with a purpose built extension to the rear located in a quiet residential area on the outskirts of Bognor. The home is arranged on two floors with main lounge, dining room, kitchen and laundry facilities included on the ground floor. A second lounge is situated on the first floor, which is accessed by a lift. Bedrooms are located on both floors. There is a small parking area to the front of the establishment and a secluded garden Care Homes for Older People Page 4 of 25 care home 29 Over 65 29 0 Brief description of the care home to the rear. The home has been owned by Eldernet Ltd since November 2007 Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection included a site visit to the home over a period of five hours, from 9.30am. The lead inspector was accompanied for part of the visit by a pharmacy inspector. During the inspection three staff were spoken to and the manager assisted with the inspection. The manager has been in post since January 2009 and is currently applying to be registered with the Commission. Three residents were spoken to privately as were two visiting relatives. Care plans, medication records, policies and staff records were sampled. Other information used to make judgements about the standard of care in the home included the homes Annual Quality Assurance Assessment (AQAA) that they completed and returned to us, records relating to safeguarding and complaints and the homes own quality assurance procedures. Care Homes for Older People Page 6 of 25 Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are assessed to ensure that only those whose needs can be met are admitted to the home. Evidence: The initial assessment of one new resident admitted to the home was sampled. It contained information about the persons care needs and any issues relating to mental well being, general health, mobility, religious needs and information relating to medication were also recorded. A care plan was drawn up from this assessment. Prospective residents are invited to visit the home or assessments can be done in their own home or in hospital if necessary. Care Homes for Older People Page 10 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have their health and personal care needs met in a way that respects their views and upholds their right to privacy. Medicine storage and handling is not managed safely. Evidence: Three care plans were looked at. The manager told us that all care plans had been reviewed and updated since her appointment. The care plans seen were generally up to date and clear. They contained information about health care needs, allergies, personal care needs, what the person can do independently and anything to avoid. Other details included what time a person likes to go to bed, some social history and any current hobbies and interests. There was evidence of regular review and changes being made as they arose. One care plan seen stated that a resident needed to be turned every two hours. No record of monitoring this was kept. When asked staff said they knew this happened as it was discussed during handover and the staff working in a pair is designated for each shift and this pair would know it was their responsibility. The manager said she was sure it happened as the resident had not developed any Care Homes for Older People Page 11 of 25 Evidence: bed sores. The manager agreed that a record to say it was occurring every two hours, signed by the staff who undertook it would be implemented. People spoken to confirmed that they are supported to pursue their hobbies and received, for example, the daily paper of their choice. They said they were treated with respect and that staff were kind and caring. They said staff knock before entering their rooms and speak to them in a respectful way. Daily records were seen and showed evidence of people being given choices and their independence being promoted. There was evidence that risks have been assessed and documentation was in place to support this. People who use the service are all registered with a local General Practitioner (GP). Evidence from the homes own quality assurance shows that the health care professionals who responded are satisfied with the care provided and the homes way of dealing with health matters. Records showed evidence of medical needs being followed up and referrals to other professionals when needed. Two residents spoken to during the inspection said they could ask staff to seek medical help when they needed it and said they felt safe and well cared for in the home. The storage, administering and recording of medication was assessed by a Commission specialist pharmacist inspector. We found that medicines were not being handled safely in this service. No one in the home was looking after or taking their medicines themselves. We observed approximately a third of the people living in the home being given their medicines. Medicines were being given to people by a carer who had been trained in the safe handling of medicines but not since in February 2004. They were seen to not follow safe practices. On two occasions the key was left in the lock of the trolley and it was left unattended whilst the carer went into peoples bedrooms to give them their medicines. On another occasion the medicine blister pack was left unattended on top of the medicine trolley. Leaving medicines unattended in this way could put people at risk of harm. The carer was also seen to sign the records to say that people had taken their medicines before they were actually given. Medicines were not stored securely for the protection of people who use this service. The spare medicine keys were not kept locked and the medicine fridge was not lockable. On the day of the inspection the medicine keys had been misplaced and the spares were in use. The main keys were found by the Commissions inspector on the sharps bin. Medicines liable to abuse, known as Controlled Drugs were not stored in a cupboard Care Homes for Older People Page 12 of 25 Evidence: that complies with the law. However a clear audit was kept of their use so as to readily detect any losses. The home have informed us that since our visit they have installed a Controlled Drugs cabinet that complies with the law. Receipt and disposal records of medicine are kept so that medicines can be accounted for. Several people had medicines prescribed to be given only when needed. We looked at the care plans for these people. None of them had a care plan that described to staff what the medicines were for, when they should be given nor how much medication to give when there was a choice of doses. There was additional information on MAR on post it notes giving guidance to staff. The post it notes did not always have the name of the resident and on one occasion a post it note for one person was seen attached to another persons chart. The use of post it notes is an unsafe practice as these can easily be transferred to another persons chart. Information relevant to peoples care should be recorded either on their medication record chart or in their care plans. One persons medicine supply was being used as stock for at least another two people prescribed this medicine. Medicines belong to the person they are prescribed and dispensed for and must not be used for other people, even when they are prescribed the same medicine. Two people were being given a laxative when there was no evidence that this had been prescribed for them. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have a range of activities on offer in the home and they are happy with the choices. Improvements to the kitchen and the food provided means people have a choice of fresh, nutritious food cooked in a hygienic environment. Evidence: A range of activities is available in the home. Residents birthdays are celebrated by the home and people are encouraged to join in if they wish. Residents and their families are consulted on the activities and they always have the choice whether to join in or not. A recent newsletter showed the home listens to comments made by residents and their relatives and acts on what they say about the activities and daily life in the home. Residents told us they are encouraged to pursue their own hobbies and remain independent as far as possible. Those who are able go out to the local shops. One relative commented to us that there were not many activities outside the home but were they were satisfied with the in-house arrangements. There are residents meetings, one resident said they discussed activities, food and other things which affect their lives. Residents said their visitors are welcome and are offered drinks when they visit the home. Some residents have their own telephones to enable them to keep in touch with friends and family. Residents spoken to said they felt they Care Homes for Older People Page 14 of 25 Evidence: had choice and control of their lives. Residents said they enjoyed the food and there was always a choice. Residents can choose where to eat and some prefer to eat in their rooms. Lunch time was observed to be calm and relaxed. Four staff were on duty in the dining room and people who needed support were seen to be getting it. Staff chatted to residents in a friendly and natural manner. Some people sat in the wheelchairs to eat, risk assessments were seen for this. Food preferences, dislikes, allergies and nutritional and dietary requirements are recorded in residents care plans. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to complain and are protected by the homes improvement to the policies and procedures for safeguarding them. Evidence: A complaints procedure is displayed in the home. Residents spoken to say they know how to make a complaint and feel that any concern they may have would be dealt with by the staff or the manager. Residents were observed making requests and expressing their views during the inspection. There was an open and relaxed atmosphere and staff dealt promptly with requests. The AQAA states that three complaints have been made in the last twelve months all of which have been resolved within the given timescale, one was upheld. One complaint made recently is being dealt with by the home. The home has a policy on safeguarding and staff spoken to were aware of their responsibilities to report any safeguarding issues. At the last inspection we made a requirement regarding the reporting of abuse which was seen to be met. There was documentary evidence that safeguarding issues are referred to Adult Services and all incidents are now appropriately reported to us under regulation 37. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service benefit from a clean and homely environment, which is well maintained. Evidence: The inside and outside of the home are maintained to a high standard. Residents say their rooms are cleaned regularly and staff were seen to be wearing suitable gloves and aprons. A resident commented on the high standard of hygiene promoted in the home. Residents rooms were individually decorated and evidence of people bringing in their own belongings was seen. Suitable laundry facilities are available and a home maintenance programme is in place to ensure continuous update and improvement. Care Homes for Older People Page 17 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for recruiting staff protect people living in the home. People who use the service have their needs met by staff that are caring and sufficient in numbers however, gaps in training could place them at risk Evidence: The home employs a mixture of staff skills and experience. Staff have clear designated roles, for example, there is a manager, deputy, senior care staff, care staff, cook, domestic staff and a maintenance person. During the inspection there were suitable numbers of staff on duty to attend to the needs of service users. Residents spoken to said there were usually enough staff on duty during the day and night to meet their needs. They said call bells were answered promptly. Staff were observed interacting in a positive and respectful manner with residents. The three staff spoken to during the inspection were confident and competent at their jobs. They spoke confidently about the needs and preferences of individual service users. There is on going training provided including mandatory courses such as, first aid, food hygiene, infection control, health and safety and fire training. Staff are supported to undertake National Vocational Qualifications (NVQs). The AQAA states that the home currently has over 50 of its staff having or working towards NVQ level 2, or above. The files of two new staff were sampled at this inspection and both had evidence of a CRB and POVA check being done before they started work. Other evidence of their Care Homes for Older People Page 18 of 25 Evidence: recruitment procedures included an application form and a request for references. Care Homes for Older People Page 19 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements have been made to the running of the home. Further improvements and a period of sustained improvement, with a registered manager, will consloidate this. Evidence: A new manager has been appointed to the home and since our visit her application to be registered with the Commission has been successful. She is qualified to NVQ level 4 and has completed the Registered Managers Award. Since her appointment in January this year she has made many improvements to the home. The new manager has dealt with complaints made and set backs encountered by the home. The improvements in safeguarding training and procedures for example, ensure people are better protected and action is taken swiftly on their behalf. Staff say moral has improved under the new manager and she is approachable and supportive. Records relating to fire safety, electrical and water temperature checks were sampled. Water temperature checks were seen to be taken although the manager agreed that Care Homes for Older People Page 20 of 25 Evidence: more random checking of different outlets would offer greater protection. Tests had been carried out on all portable electrical items and the manager was aware when this was due to be done again. There were some gaps noted in the testing of the emergency lighting, the manager agreed to action this immediately. Monthly regulation 26, monitoring visits are completed. The reports from these were sampled and were seen to highlight the same issues that have been raised by the Commission. There is a pattern of deficits being highlighted and action being taken to rectify them. The home is proactive in this way. Care Homes for Older People Page 21 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Care plans must include 24/07/2009 detailed information and instructions for staff in respect of the administration and management of medicines prescribed to be given on an as and when required basis. To enable people to be given their medicines in a clear and consistent way that meet their needs. 2 9 13 All medication must be stored securely at all times. So as to protect the people who use the service from harm. 28/08/2009 3 9 13 Only trained staff who can demonstrate that they are competent are to administer medicines. To ensure safe practices are followed as per the guidelines given by the 30/09/2009 Care Homes for Older People Page 23 of 25 Royal Pharmaceutical Society. 4 9 13 All controlled drugs must be stored in a cabinet the meets the requirements of the Misuse of Drugs (Safe Custody) Regulations 1973. To comply with the law. 30/10/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!