Random inspection report
Care homes for adults (18-65 years)
Name: Address: Woodcrofts 164 Warrington Road Widnes Cheshire WA8 0AT two star good service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Janet Marshall Date: 0 7 0 4 2 0 1 0 Information about the care home
Name of care home: Address: Woodcrofts 164 Warrington Road Widnes Cheshire WA8 0AT 01514245347 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Terence Lyons Type of registration: Number of places registered: Conditions of registration: Category(ies) : Woodcrofts Residential Homes Limited. care home 21 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Conditions of registration: 21 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 21 Date of last inspection Brief description of the care home Woodcrofts is a privately owned two-storey care home providing accommodation to 21 adults with mental health needs. Three members of the family, one of which lives on the premises, share the day-to-day management responsibilities.
Care Homes for Adults (18-65 years) Page 2 of 14 3 0 0 9 2 0 0 8 Brief description of the care home The home is located approximately three-quarters of a mile from Widnes town centre and is close to a church, shops and other community facilities. There are adequate car parking facilities available adjacent to the home. Residents accommodation consists of seventeen single and two double bedrooms [used as single accommodation]. There are a variety of communal facilities available. These include three lounges, one of which is the designated smoking area and a dining room. Woodcrofts has an adequate number of toilets and bathrooms available for residents. Care Homes for Adults (18-65 years) Page 3 of 14 What we found:
We visited the home unannounced on the 7th April 2010 after receiving a letter detailing a number of concerns about the home. The areas we looked at were directly related to the concerns raised. On arrival to the home we looked at the rear yard, we were told that this is the designated smoking area for both residents and staff. The yard was clean but we saw items or rubbish including an old mangle, scaffolding, car parts and bits of wood and bricks. There was also a shed, which had no door on it. The shed contained tools, small machinery and potentially dangerous substances. This was discussed with the owner who agreed to secure the shed and remove the rubbish within an agreed timescale. Areas of the home used by residents must be made safe to ensure their health and safety. We asked what the arrangements were for laundering residents clothes. We were told that all the laundry is done by one of the owners on a part time basis. We were told that none of the residents are allowed in the laundry to help with laundering their own clothes and that it is locked by staff when not in use. We saw two black bin bags on the step outside the laundry, we looked inside the bags and found they contained dirty clothing belonging to a resident. We were told that it is usual for the resident to do this because they are not allowed inside the laundry. The home must provide residents with facilities to wash, dry and iron their own clothes if they wish. We looked around the laundry. There was no disposable aprons, but there was gloves. We were told that staff used the same brown cloth apron through out the day for cleaning duties. There was no red bags for contaminated laundry and two people were shown in their care records as having continence issues. We also noticed that there was no arrangements for the disposal of contaminated waste. The practices followed at the home increase the risk of crossinfection. The owner agreed that he would provide red bags and put in place a contact for removal of contaminated waste within the timescale agreed. Equipment must be provided at the home and it must be used and disposed of appropriately to avoid infection and the spread of infection. We looked around the kitchen and found it to be clean and tidy. We checked food stores and found them to be well stocked with a variety of nutritious and wholesome food. All cooked or uncooked food was stored correctly. We were told that the cook has recently completed food hygiene training and that she has many years experience of working in this area. We discussed menus, meals and meal times with people. We found that there are no menus made available to residents and that if they wanted to know what the meal is they could ask the cook when she arrives on duty usually an hour before the meal served. We were told that it is then that residents can request an alternative if they wish. We were told that residents are happy with this arrangement, however it gives them very little time to make a decision about the food they eat. Residents made the following comments: The food is very nice, we are given good portions, I dont know what is for lunch today, We never know what the meal is going to be until we get it. Menus should be made available to residents more in advance so that they have more choice and control over the food they eat. People told us that meal times are not relaxing because they are rushed to fit in with a strict routine. People made the following comments about meal times: Meals are rushed and not relaxing, The meal is served as quickly as possible and as soon as residents have finished tables are cleared and the dishes are washed,
Care Homes for Adults (18-65 years) Page 4 of 14 Meal times are not flexible, There is a choice at meals times but it is very little because the meals are so rushed. Meals times should be relaxed, unrushed and flexible so that residents can enjoy them. We looked at and talked to people about the availability of refreshments during the day. We noticed there were no facilities available at the home for residents or their visitors to make snacks or refreshments for themselves whenever they choose. We were told that fresh water is available at all times and that fresh tea and coffee is served at set times, including meal times. We were told that at breakfast time flasks of tea and coffee with milk added are made up and left in the dining room up until 11am. We were told that milk is also added to the tea and coffee pots before being served to residents at the set times. This is institutionalised practice and does not allow residents the opportunity to control the amount of milk they have in their drinks. Adequate facilities must be provided at the home so that residents can safely prepare their own food and drinks. We talked to people and looked at records to find out what activities are available to residents that live at the home. Some residents told us they are able to go out without the help of staff and that whenever they choose they take themselves to the local shops, for walks and to visit friends, one resident said, I never get bored. We were told that residents who rely on the help of staff to access the community get very few opportunities to do so. We were told that this is because staff dont have the time because as well as supporting residents they are required to carry out cleaning duties during their shifts. Some residents were seen resting in their bedrooms and others were seen sitting in the lounge areas watching TV. We noticed that there were no newspapers, magazines or boardgames in the lounges. Comments made by people included: We watch TV most of the time, I go out on my own to the shops, I go out to see my family, There are organised activities once a week usually on a Friday, Staff have little time for activities because they are so busy doing other things, there isnt enough time for activities. We looked at care plans for two people living in the home. Records viewed showed that the care plans did not support those people to maintain their independence or to have a lifestyle that was in keeping with their needs choices or preferences. We could not find any records to show that the residents have been offered and or supported to take part in activities either in the home or the local community and there were no structured activity programmes in place for either of the residents whose care plans we looked at. The home must discuss with residents a programme of activities and make arrangements to provide facilities for recreation, fitness and training, which meet their individual needs. When looking at care plans we noticed that there was no date on them to show when they had been written or evidence that the residents had been included in writing their care plan. Care plans were based on physical needs and mental health needs although briefly mentioned they were not shown to be a priority. Residents must have a written care plan with detailed information about how all their needs are to be met. Residents or a representative of theirs must be fully involved in putting together and reviewing their written care plan and they must be signed on completion and following each review to show their involvement and that they agree with their plan of care. We looked at the care plan for a resident who we were told has certain restrictions placed upon them. The restrictions were explained to us and we were told that the reasons they have been put in place is to ensure their health and safety and others living at the home. The justification for these decisions was unclear in the care planning and read more as a
Care Homes for Adults (18-65 years) Page 5 of 14 punishment rather than a need. There was no clear explanation within the care plan as to why the restrictions were put in place, as to why these actions were taken or what other arrangements are being considered. Care plans, which were looked at lacked detail and were not person centred and supportive in nature. They also lacked emphasis on development and promotion of independence and choice. Care plans should be more person centred so that residents have more choice and control over their own lives. A record of any limitations must be kept and agreed with the resident or their representative, to show why the decisions have been made. We looked around the all shared parts of the home and a selection of residents bedrooms. We found the areas to be generally clean and tidy and there were no unpleasant smells. However, we did notice damp patches in some rooms and wallpaper peeling off walls, we also noticed that some furniture and fittings particularly in bedrooms and bathrooms were broken or showed obvious signs of wear and tear due to age. The owner told us there is an ongoing programme of refurbishment and redecoration of the home, we noticed that some rooms, including residents bedrooms had recently been redecorated. All parts of the home and equipment used in it must be maintained and kept in a good state of repair to ensure residents comfort and dignity. We looked at the medications and noticed that the medication administration records (MARs) were not accurate. Times that medication was given was not record correctly on the medications. A review of four peoples medications showed that staff did not always have the instructions needed to give medications safely. As an example were people have were to have medications as needed there was no clear instructions in any of the records to support staff to determine if the medication was needed. We checked for people living in the home that they were given their medications correctly. We noticed that on at least four occasions people living in the service had not received their medications as prescribed by their doctor. We looked at training for staff for medications. We noticed that not all staff had received training in medications and none had evidence that they had been assessed as competent to give out medications. The lack of training and competency of for staff places people living in the service at risk of not receiving their medications correctly. Medications must be stored, handled, administered, recorded and disposed of correctly to ensure residents health, safety and welfare. We looked at the staff duty rota. It showed 2 staff on duty during the day and evening and 1 member of staff during the night. The manager who was not on duty at the time of our visit was not listed on the duty rota. The owner told us he slept in each night and was on call, neither his duties or the duties of the cook and laundry assistant were recorded on the rota. An accurate rota of all staff that work in the home should be kept to show that residents are supported by an effective staff team. We were told that there are no designated cleaning staff employed at the home and that support workers are required to carry out cleaning duties at intervals throughout their shifts. We were told that because of this arrangement staff dont have the time to support residents with activities both in and outside the home. The owner told us that he is hoping to employ a cleaner at the home so that support staff can be relieved of some of the cleaning duties they are currently required to do during their shifts. Staffing levels must be sufficient in numbers to meet the needs of the residents. What the care home does well:
Care Homes for Adults (18-65 years) Page 6 of 14 We saw staff treating residents politely and talking to them in a respectful way. Residents told us that the staff are all very nice and that they work hard. Residents said they liked the food they get at the home and that the portions are generous. The kitchen was clean and tidy. Food stores were well stocked and all food was stored in the correct way. Residents who are able to go out without staff support access the community when they choose, one resident said, I go to the shops most days and I visit my family when I want. What they could do better:
Areas of the home used by residents must be made safe to ensure their health, safety and welfare. The home must provide residents with facilities to wash, dry and iron their own clothes if they wish. Equipment must be provided at the home and it must be used and disposed of appropriately to minimise the risk of cross infection. Menus should be made available to residents more in advance so that they have more choice and control over the food they eat. Meals times should be relaxed, unrushed and flexible so that residents can enjoy them. Adequate facilities must be provided at the home so that residents can safely prepare their own food. The home must discuss with residents a programme of activities and make arrangements to provide facilities for recreation, fitness and training, which meet their individual needs. Residents must have a written care plan so that staff have all the information they need about how all their needs are to be met. Residents or a representative of theirs must be fully involved in putting together and reviewing their written care plan and they must be signed on completion and following each review to show their involvement and that they agree with their plan of care. Care plans should be more person centred so that residents have more choice and control over their own lives. A record of any limitations must be kept and agreed with the resident or their representative, to show that decisions have been made in the best interest of the resident. All parts of the home and equipment used in it must be maintained and kept in a good state of repair to ensure residents comfort and dignity. Medications must be stored, handled, administered, recorded and disposed of correctly to ensure residents health, safety and welfare.
Care Homes for Adults (18-65 years) Page 7 of 14 An accurate rota of all staff that work in the home should be kept to show that residents are supported by an effective staff team. Staffing levels must be sufficient in numbers to meet the needs of the residents. 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 2. Care Homes for Adults (18-65 years) Page 8 of 14 Are there any outstanding requirements from the last inspection? Yes R No £ 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 34 19 A thorough recruitment procedure that fully protects the people receiving a service must be implemented. [Timescale of 07/09/06 not met]. 12/10/2007 Care Homes for Adults (18-65 years) Page 9 of 14 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, 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 6 18 Residents or a representative 27/07/2010 of theirs must be fully involved in putting together and reviewing their written care plan and they must be signed on completion and following each review to show their involvement and that they agree with their plan of care. 2 6 15 Residents must have a written care plan so that staff have all the information they need about how all their needs are to be met. 07/07/2010 3 13 16 The home must discuss with residents a programme of activities and make arrangements to provide facilities for recreation, fitness and training, which meet their individual needs so that they are given appropriate opportunities to take part in activities of their 30/06/2010 Care Homes for Adults (18-65 years) Page 10 of 14 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 choice. 4 16 17 A record of any limitations must be kept and agreed with the resident or their representative to show that decisions have been made in the best interest of the resident. 5 16 16 Adequate facilities must be provided at the home so that residents can safely prepare their own food and drinks. 6 16 16 Residents must be provided with laundry facilities to wash, dry and iron their own clothes if they wish. 7 20 13 Medications need to be given 07/05/2010 in accordance with the prescribers instructions. In order that people living in the service receive medications as they should. Effective training and assessment of competency for staff giving out medications need to be in place. In order to make sure that people living in the service receive their medications correctly. Records of medication need 07/05/2010 07/05/2010 31/05/2010 07/05/2010 8 20 13 9 20 13 07/05/2010
Page 11 of 14 Care Homes for Adults (18-65 years) Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 to be accurately maintained up to date and keep a clear record of when and how medications were given. In order to maintain the safety of mediations and enable checks to take place that medications were given correctly. 10 24 23 All parts of the home and 31/08/2010 equipment used in it must be maintained and kept in a good state of repair to ensure residents comfort and dignity. 11 24 23 Areas of the home used by 14/04/2010 residents must be made safe to ensure their health, safety and welfare. 12 30 13 Equipment must be provided 10/04/2010 at the home and it must be used and disposed of appropriately to minimise the risk of cross infection. 13 33 18 Staffing levels must be sufficient in numbers to meet the assessed needs of the residents. 07/05/2010 Care Homes for Adults (18-65 years) Page 12 of 14 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 6 17 Care plans should be more person centred to give residents more choice and control over their own lives. Meals times should be relaxed, unrushed and flexible so that residents can enjoy them. Menus should be made available to residents more in advance so that they have more choice and control over the food they eat. An accurate rota of all staff that work in the home should be kept to show that residents are supported by an effective staff team. 3 17 4 29 Care Homes for Adults (18-65 years) Page 13 of 14 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 14 of 14 - 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!
