Inspection on 30/01/09 for Woodbridge House

This inspection was carried out on 30th January 2009.

CSCI found this care home to be providing an Good service.

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

Woodbridge House 06/02/08

Woodbridge House 07/09/07

Woodbridge House 28/02/07

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Woodbridge House 151 Sturdee Avenue Gillingham Kent ME7 2HH     The quality rating for this care home is:   two star good 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: Joseph Harris     Date: 3 0 0 1 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 Adults (18-65 years) 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 Adults (18-65 years) Page 2 of 27 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Woodbridge House 151 Sturdee Avenue Gillingham Kent ME7 2HH 02085024466 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Aitch Care Homes (London) Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 10 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 10 The maximum number of service users to be accommodated is 10. 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: Learning Disabilities (LD) Date of last inspection Brief description of the care home Woodbridge House is a large detached corner property situated on the outskirts of Gillingham town centre. The home can accommodate up to 10 service users aged between 18 and 65 with a learning disability and complex needs. The home is on a main bus route and the Gillingham town centre main line railway station is approximately 1 mile away and has easy access to the local library, shops and other facilities. The house is a modern building that has been recently refurbished throughout. All bedrooms are single occupancy with en-suite facilities. Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home The fees range from 1,300 to 1,550 pounds per week Care Homes for Adults (18-65 years) Page 5 of 27 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection process culminated in a site visit to the service on the 30th January 2009. The visit commenced at 09:30 hours and lasted for approximately 7 hours. Prior to the site visit information relating to the service was examined including the Annual Quality Assurance Assessment (AQAA), information received from other sources, concerns, complaints and safeguarding issues and notifications by the home. At the site visit discussions were held with the Manager, the Regional Operation Manager, the Deputy Manager, staff and service users. A range of documentation was examined including individual support plans, staff records, training information, medication records and health and safety documentation amongst other things. Care Homes for Adults (18-65 years) Page 6 of 27 A tour of the premises was conducted viewing a number of bedrooms and all communal areas of the home. Staff were observed in their interactions with service users. 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. Care Homes for Adults (18-65 years) Page 8 of 27 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 27 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. The needs of prospective service users are assessed prior to admission. Evidence: No new service users have been admitted to the home since the last inspection. However, there is a well established referral process in place within the organisation. Initial referrals are screened by a central referral team and a suitable placement is identified. The manager stated that once a referral is received by the home supporting documentation is reviewed and a visit arranged to meet the individual. Staff in the home, it was reported, now have a greater level of involvement in the referral process and in the decision-making processes. Prospective service users are invited to the home on a flexible basis depending on individual needs and wishes. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 individual needs, risks and choices of each service user are promoted and planned for. Evidence: The individual support plans for two service users were examined. In both circumstances these had been developed providing clear guidance for staff to be able to meet individual needs consistently. The manager acknowledged that the process of developing these plans is on-going and they are being updated in conjunction with care management reviews. Refer to recommendation 1. The plans are person-centred and detail support needs, behaviour management issues and guidance in a narrative format. The plans show evidence of regular review and the involvement of service users. The organisation does not take on a financial appointee role for any service users and this responsibility is carried out by someone independent of the service such as the next of kin. Residents are encouraged and supported to choose how they spend their Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: time and in their day to day decision making. The manager is also updating and reviewing the risk management and assessments for each service user using a similar framework to the service user plans focusing on promoting independence and a person centred approach to responsible risk taking. These assessments are also kept under review. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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. Service users have a lifestyle that suits their needs. Evidence: The people who use the service have access to a range of occupational and recreational activities. The manager stated that she intends to introduce more structure into the activities programme for service users. Some residents currently attend college courses and visit local resources and drop-in centres. One person has been enabled to continue participating in Hydrotherapy with friends from another service. Residents are supported to go out of the home as frequently as possible and records showed that recent trips have been arranged to ten-pin bowling, karaoke, trampolining, shopping and for walks in the park amongst other things. There is also available space and facilities in the home to enable people to watch TV, listen to music and play games in groups or alone. The home has a Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: sensory room that is currently used mainly for meetings. It would be beneficial for residents if this room reverted back to its original purpose with refurbishment where required. Refer to recommendation 2. It was reported that visitors are welcome into the home at all reasonable times. The manager stated that most of the service users have active and positive family support. People are also encouraged to maintain friendships outside of the home. There is sufficient space within the home to ensure visitors can meet in private. The home did receive two complaints regarding this issue and has addressed and resolved the concerns. Residents are supported to take an active role in the running of the home wherever possible completing some household chores and participating in residents meetings. Service users are flexible in their daily routines being enabled by staff to choose how they spend their time. Menu records are maintained including health and safety checks. The records show that a healthy and balanced diet is offered with a range of choices available. Residents are involved in the planning of meals and assist with preparation at times. Mealtimes are arranged into two sittings to enable service users to have a more peaceful and organised experience. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal and healthcare needs of service users are met. Evidence: The personal care needs of individual service users are clearly described within the support plans. The plans have been developed with service users input and take into account individual preferences. Staff were observed to treat residents with dignity and respect. Healthcare records are kept for each service user detailing the healthcare issues and outcomes of any appointments and referrals. There is evidence of input from a range of healthcare professionals including GPs, a specialist Epilepsy Nurse and the Incontinence team. Complimentary healthcare needs are addressed and residents visit Chiropodists, dentists and opticians. An Aromatherapist visits the service every 1-2 weeks. The manager stated that she has plans to develop person-centred healthcare action plans for each resident to improve on the current systems in place. Medication issues are well managed in the home. Documentation relating to administration, the receipt, return and disposal of medicines was all up to date. The manager reported that there had been one error relating to medication in the past 12 Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: months. This event was reviewed and systems were improved to reduce the possibility of a recurrence. Storage facilities are suitable for the home and no Controlled Drugs are in usage. The manager plans to improve facilities by increasing the amount of worktop space. Medication policies and procedures are in place and have recently been reviewed and updated. All staff receive medication training prior to administration duties. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. Service users views are listened to and they are protected from abuse. Evidence: The home has a clear complaints procedure in place, which is displayed in the home and contained within the service user guide. According to the AQAA the home has received two complaints since the last inspection. These were discussed with the manager who stated that they had been addressed and resolved. Information contained in the complaints book confirms these outcomes. The home has policies and procedures in place relating to adult protection and abuse awareness. Staff also receive training covering these topics. It is advised that staff have access to training covering the Mental Capacity Act 2005 and the Deprivation of liberty safeguards. Refer recommendation 3. All staff spoken to demonstrated a good awareness of abuse awareness issues and responsibilities for reporting and recording alleged abuse. There has been 1 Adult Protection alert since the last inspection according to the AQAA. This was discussed with the manager and Area Operations Manager who confirmed that the alert has been closed and issues raised addressed. Care Homes for Adults (18-65 years) Page 18 of 27 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 home is suitable for the needs of the service users. Evidence: Woodbridge House is a modern building in a residential area of Gillingham close to the town centre. The building was completely refurbished, redecorated and adapted a few years ago. A guided tour of the premises was undertaken as part of the inspection process. The house is arranged over two floors with a small, enclosed garden to the rear. There is parking available close to the house and on the drive. The home offers a good range of communal space for the residents including a large lounge, a dining room and some smaller quiet rooms. There are toilets and shower/bath rooms on each floor and all bedrooms are single occupancy with en-suite facilities. The environment is bright, comfortable and airy, however the manager acknowledged that the decor lacks a homely feel and she stated her intention to address this. The home has a room designated as a sensory room. Currently this is used for meetings. The manager agreed that efforts should be made to convert this room back to its original use. Refer to recommendation 2. The kitchen and laundry facilities are suitable for the needs of the home, well equipped, spacious and hygienic. It was reported that the home meets the Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: requirements of the Environmental Health Department and Fire Safety Officer. Hazardous substances are stored securely and the home has infection control measures in place. Care Homes for Adults (18-65 years) Page 20 of 27 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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. There are sufficient numbers of competent and well trained staff. Recruitment practices protect the service users welfare. Evidence: The home operates with a minimum of 5 staff on duty throughout the day, there is often an additional member of staff working office hours to provide additional flexibility. There are 2 waking staff on night duty. Staff spoken to stated that they feel the staffing levels are sufficient to meet the individual and collective needs of the service users. Over 50 of the staff team have achieved an NVQ level 2 or above and there is an expectation from the organisation that all new employees complete this qualification. In discussion staff members demonstrated a good understanding of the needs of the service users and their roles and responsibilities. 5 staff members are currently in their probationary period and are working through the Common Induction Standards. The staff training matrix was examined and cross checked against certificates of training on file for 2 staff members. Training in mandatory topics is being provided within the first 6 months of appointment and additional courses covering medication, adult protection and behaviour management strategies are arranged. It was advised that instruction covering the topics of the Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: Mental Capacity Act and Deprivation of Liberty Safeguards should also be arranged. Refer to recommendation 3. 2 staff personnel files were examined, both of which contained all relevant information including evidence of CRB/POVA checks, 2 written references, proof of identity and the application form. The application form requests the previous 10 years of employment history and it is advised that this should be expanded to include a full employment history. Refer to recommendation 4. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 home is well run and in the best interests of the service users. The health, safety and welfare of residents is promoted. Evidence: The current manager has been in her present role for approximately 6 months. In a relatively short space of time she has introduced a number of positive changes, particularly in relation to record keeping, organisation and staff support. Care staff spoken to stated that the morale in the home is good and that the manager demonstrates good leadership skills. She is supported in her role by a deputy manager. The manager has achieved all required qualifications and has a wealth of managerial experience in care settings for people with learning disabilities. She has, it was reported, applied for registration with the Commission for Social Care Inspection. Refer to recommendation 5. The Regional Operations Manager was also present for part of the inspection visit. She is also relatively new in post, but has clearly established a good report within the home. She conducts monthly monitoring visits and attends the service on a regular Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: basis. Recent monitoring reports were examined that demonstrated clear audit trails and action plans for addressing issues raised. The organisation conducts an annual survey of service users and stakeholders. This exercise is due to be completed in the summer 2009. The manager reported that the organisation is supportive of her role and provides suitable finances and resources for the needs of the service. Health and safety records were examined. These documents are in the process of being reorganised and audited. All required service certificates and safety checks have been completed on the utilities and facilities of the home. The home retains accident records and keeps a fire safety log. The latter remains somewhat disorganised, although there is evidence that necessary checks are being completed. The manager agreed that the records would benefit from being reorganised. Refer to recommendation 6. Environmental and fire risk assessments have been completed and are reviewed. Safe working practices are underpinned by training and policies and procedures. Care Homes for Adults (18-65 years) Page 24 of 27 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 Adults (18-65 years) Page 25 of 27 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 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 1 2 3 4 5 6 11 23 34 37 To continue to develop individual service user plans using a person-centred approach. To review the current use of the sensory room. To provide training for staff covering the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. To request a full employment history for new and prospective employees. The manager to continue to progress through the registration process with the Commission for Social Care Inspection. To maintain fire safety logs and health and safety records in an organised and easily accessible fashion. 6 42 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: 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 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. 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