Inspection on 26/01/07 for Woodend Nursing & Residential Centre

This inspection was carried out on 26th January 2007.

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

Woodend Nursing & Residential... 30/01/06

Woodend Nursing & Residential... 26/05/05

Woodend Nursing & Residential... 17/11/04

Woodend Nursing & Residential... 05/05/04

Woodend Nursing & Residential... 30/01/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Woodend Nursing & Residential Centre Bradgate Road Bowdon Cheshire WA14 4QU Lead Inspector Elizabeth Holt Unannounced Inspection 26th January 2007 12:00 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 Woodend Nursing & Residential Centre DS0000006731.V310824.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. Woodend Nursing & Residential Centre DS0000006731.V310824.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodend Nursing & Residential Centre Address Bradgate Road Bowdon Cheshire WA14 4QU 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) 0161 929 5127 0161 929 5664 ANS Homes Limited Neil Hooley Care Home 79 Category(ies) of Old age, not falling within any other category registration, with number (79) of places Woodend Nursing & Residential Centre DS0000006731.V310824.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. All service users will be aged 60 years or over. A maximum of 64 service users will require nursing care. A maximum of 6 older people who require personal care only may be accommodated in the agreed designated area (lower ground floor). A further 9 service users who require personal care only may be accommodated in the main body of the home. Minimum nursing staffing levels as specified in the Notice issued under Section 25(3) of the Registered Homes Act 1984 on 10 April 2000 shall be maintained. 30th January 2006 4. Date of last inspection Brief Description of the Service: Woodend Nursing and Residential centre is registered to provide nursing care and personal accommodation for a maximum of 79 older people. The home is divided into four designated units, each having a designated staff team. Dunham, six residential residents. Stanford, 23 residents. Tatton, and Arley, 25 residents respectively. Woodend Nursing and Residential Centre is owned by ANS Homes Ltd which is owned by BUPA Care Services. The home is situated in the residential area of Bowden, a suburb of Altrincham and is South to the city of Manchester. There is ease of access to the Manchester ring road and the motorway system. Altrincham town centre is easily reached by car and there is access to the public transport system within walking distance of the home. The passenger lift provides access to each floor. The grounds to the front are pleasantly landscaped and there are well maintained gardens to the side and rear of property. There are two patio areas accessible to wheelchair users. There is ample parking within the grounds of the home. The weekly fees vary from £474.81-£693.00 (Personal care only to nursing care). Extra charges are made for hairdressing, chiropody and newspapers. Woodend Nursing & Residential Centre DS0000006731.V310824.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on the 26th January 2007. All the key National Minimum Standards (NMS) were reviewed during this inspection. Information was gathered as part of the inspection process which included a questionnaire completed by the manager which gave information about the residents, the staff and the building. Information held by the Commission, for example notifications of significant incidents was also reviewed. Time was spent talking to the residents, visiting relatives, the manager and the staff team about day to day life in the home and to establish what life was like in the home for the residents living there. A partial tour of the premises was undertaken and documents and care files for a number of individual residents were also examined. Nine of the ten resident/relatives questionnaires which were left to be forwarded to the Commission were returned. Comments from these have been included in this report. The Commission for Social Care Inspection had not received any complaints about this home since the last inspection. What the service does well: The home makes sure that prospective residents are assessed fully before they are offered a place at Woodend Care Centre to make sure they can meet the residents’ needs. The relationships between the residents and the staff appeared to be friendly and generally relaxed. One resident said, ”I tend to think the home is super”. A residents granddaughter said that “All the family are happy with my gran’s care and she is doing well here.” A choice of menu is available at each mealtime and residents were heard choosing their meal for the following day. A number of residents’ spoken to were satisfied with the quality, choice and quantity of food. The main lounge/dining rooms and the smaller dining rooms were well used and the tables were well presented. The staff files were detailed and contained the information required in line with the regulations. Woodend Nursing & Residential Centre DS0000006731.V310824.R01.S.doc Version 5.2 Page 6 Communication with residents and relatives regarding their care is evident and occurs regularly. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Woodend Nursing & Residential Centre DS0000006731.V310824.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 Woodend Nursing & Residential Centre DS0000006731.V310824.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 using evidence made available and following a visit to the home. Procedures were available to ensure the needs of prospective residents are fully assessed before an offer of a place is made to the home. EVIDENCE: The files of three residents who were recently admitted to the home were reviewed. A pre-admission assessment form is used to record the assessment carried out on a prospective resident. Appropriate information was recorded and held on the individual residents file. The manager or senior nursing staff visited the residents prior to admission. The assessment process included involvement of the prospective resident and their relative/representative. One resident said “I came for respite care prior to being a resident so I knew how caring the home was.” For residents who are referred through Care Management arrangements the home obtains a summary of the Care Management Assessment prior to admission. The home does not provide an intermediate care service. Woodend Nursing & Residential Centre DS0000006731.V310824.R01.S.doc Version 5.2 Page 9 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 using available evidence including a visit to this service. Each resident had an individual plan of care identifying their care needs, which enabled the staff to meet the resident’s health and social care needs. EVIDENCE: A sample of care plans was examined. Care plans were detailed, person centered and included detailed statements of the daily care provided. Risk assessments had been included and evidence was seen that monthly reviews had taken place. Care plans included evidence of the promotion of privacy and dignity. Some of the daily statements were well detailed however a number were brief and repetitive and did not clearly reflect the daily care given. Wound care plans were detailed and included the specific information for the staff to follow. It was good practice to see the wound care plan had been rewritten and updated following advice from the tissue viability nurse. The plans of care documented the pressure relieving mattresses in place. A review of the new care planning documentation for one resident was seen. The personal plan was detailed and person centred. A discussion with the manager Woodend Nursing & Residential Centre DS0000006731.V310824.R01.S.doc Version 5.2 Page 10 highlighted that the staff were in the process of transferring information from the current care plans into the new system. Care plans included evidence of the residents’/relatives’ involvement and relatives did state they had been included in the care plan and ongoing care for their relative. The morning medication round was still being administered at 12.15pm on the day of the inspection and this obviously had a knock on effect to the following medication round. The nurse in charge stated, “It had been one of those mornings, however I will make sure the next drug round is given out later.” This practice should be monitored to ensure residents receive medication at the appropriate times. Medication records were examined and the recordings were satisfactory overall with codes used appropriately. One shortfall identified included a lack of signatures for food supplements provided on prescription. Staff specimen signatures were available. One staff member was observed administering a residents medication in an inappropriate manner. This was discussed with the nurse in charge and appropriate action to be taken was confirmed by the manager. Involvement of healthcare professionals such as General Practitioner’s, Speech and Language therapist, Dietician, Physiotherapist, and Chiropodist were clearly recorded. The Optician was visiting the home on the day of the inspection and residents spoken to were happy with the service provided. From observations made during the inspection and discussions with members of staff and residents it appeared that the nurses and care staff treated the residents with respect and dignity. One resident stated, “The support has been excellent. I have a lot of confidence in the staff.” Woodend Nursing & Residential Centre DS0000006731.V310824.R01.S.doc Version 5.2 Page 11 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 using available evidence including a visit to this service. Activities were provided and residents were able to maintain contact with family and friends. Residents were able to exercise choice and control over their lives and the residents enjoy the meals they chose. EVIDENCE: The home supports the residents to meet their individual lifestyles. An entertainer was present in the home and residents were clearly enjoying this event. One resident’s relative stated, “My mother’s stay at Woodend has been most satisfactory both in the nursing care and in the activities. Our thanks go to the manager and all his staff.” Another resident’s relative stated, “My father never leaves his room, due to his choice however the activities provided for him are very good.” Visiting relatives could enjoy the company of their relative in their own bedroom or in the communal lounges. A weekly programme of activities is made available to residents. Care plans included some information about the residents’ social and recreational interests. Residents and relatives made comments on the fun they’d had on Woodend Nursing & Residential Centre DS0000006731.V310824.R01.S.doc Version 5.2 Page 12 recent trips out and a display of photographs showed some of these experiences. The menus showed that alternatives were available at mealtimes. Residents spoken to were satisfied with the food provided. It was pleasing to see staff asking residents their preferred choice of meal. Meals were provided in pleasant dining rooms and some residents chose to eat in the privacy of their bedroom. The tables at lunch time were well laid with napkins, tablecloths and condiments. Residents were observed to enjoy mealtime as a social occasion and three residents confirmed this. Woodend Nursing & Residential Centre DS0000006731.V310824.R01.S.doc Version 5.2 Page 13 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 using available evidence including a visit to this service. The home has policies and procedures in place that allow people to express their complaints/concerns and to protect residents. EVIDENCE: The home had the policies and procedures in place which gave residents/relatives the information required to make a complaint or raise a concern. Residents and relatives were comfortable in raising any concerns or complaints with the manager or senior staff member. Staff spoken to were aware of the action to take in the event of an allegation of abuse. Staff had received training in the course of action to take in the event of an allegation of abuse. Following a recent investigation under Adult Protection procedures the home had put appropriate measures in place to develop and support the staff members. Woodend Nursing & Residential Centre DS0000006731.V310824.R01.S.doc Version 5.2 Page 14 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 excellent. This judgement has been made using available evidence including a visit to this service. The residents live in a safe, well equipped environment and it was clean and comfortable. EVIDENCE: A programme of maintenance was in place for the redecoration of bedrooms. The home was clean, comfortable and homely. Residents said they were able to have some of their own furniture in their bedrooms. Policies and procedures were in place for dealing with infection control and the safe handling and disposal of clinical waste. Woodend Nursing & Residential Centre DS0000006731.V310824.R01.S.doc Version 5.2 Page 15 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 using available evidence including a visit to this service. The numbers, skill mix and training of staff was sufficient to meet the needs of the residents accommodated. Procedures for staff recruitment were in place to protect residents. EVIDENCE: On the day of the inspection the skill mix appeared satisfactory to meet the needs of the residents accommodated. Staff were observed to respond to residents using the call system effectively. Staff were seen to be respectful towards the residents and showed knowledge and an understanding of their individual care needs. Staff spoken to considered themselves a “positive staff team” and they felt the manager supported and encouraged them in their learning and development. Staff spoken to were very positive about the training and development they received. A sample of staff files were reviewed and these contained the information required in line with the regulations. Staff files showed evidence of a programme of induction and a new staff member confirmed she had received some initial training and her induction was ongoing. The home employs 50 care staff members, of which 10 care staff have successfully achieved NVQ level 2. The manager is advised to evidence how Woodend Nursing & Residential Centre DS0000006731.V310824.R01.S.doc Version 5.2 Page 16 the home intends to take forward the number of care staff who have achieved NVQ level 2 or above. The staff team hold a weekly team briefing. During this staff discussed how they used reflective practice to find ways of improving their care practices and general customer service issues. Woodend Nursing & Residential Centre DS0000006731.V310824.R01.S.doc Version 5.2 Page 17 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager of the home carries out his responsibilities fully. The health, safety and welfare of residents was promoted. EVIDENCE: The Registered manager is fully aware of his duties and responsibilities and demonstrated his knowledge and awareness the residents’ needs well. Mr Hooley has completed his Registered Managers Award and staff said how approachable and supportive he was. One resident said, “I think the manager is excellent. He comes round to see me every day and if I need anything he helps to sort it out.” Fire maintenance safety checks were being carried out in line with the recommended guidance. There was a completed fire risk assessment in place. Woodend Nursing & Residential Centre DS0000006731.V310824.R01.S.doc Version 5.2 Page 18 Evidence was seen of regular fire drills and the staff who had attended had signed. Residents/relatives review meetings are held 6 weekly. The home has the policies and procedures in place to manage the financial interests of the residents. Personal monies were not sampled during this visit however this will be followed up at the next inspection visit. The home has a Quality Assurance system in place to find out from the people who use the service what they think of it. The completed pre inspection questionnaire showed that health and safety checks were being carried out as required. An accident record was held to detail any accidents or injuries occurring in the home. Woodend Nursing & Residential Centre DS0000006731.V310824.R01.S.doc Version 5.2 Page 19 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 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Woodend Nursing & Residential Centre DS0000006731.V310824.R01.S.doc Version 5.2 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP9 OP9 Good Practice Recommendations It is recommended that nurses sign handwritten entries on the medication administration record and have these countersigned for accuracy by a second nurse. The registered person must ensure that all medication records are clearly recorded. Woodend Nursing & Residential Centre DS0000006731.V310824.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Woodend Nursing & Residential Centre DS0000006731.V310824.R01.S.doc Version 5.2 Page 22 - 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. 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