CARE HOMES FOR OLDER PEOPLE
Woodend Nursing & Residential Centre Bradgate Road Bowdon Cheshire WA14 4QU Lead Inspector
Elizabeth Holt Unannounced Inspection 30th January 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Woodend Nursing & Residential Centre DS0000006731.V270553.R01.S.doc Version 5.0 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.V270553.R01.S.doc Version 5.0 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.V270553.R01.S.doc Version 5.0 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. 26th May 2005 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. Within this maximum number, accommodation is provided for 15 older people who require personal care only. 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 side and rear of property. There are two patio areas accessible to wheelchair users. There is ample parking within the grounds of the home. Woodend Nursing & Residential Centre DS0000006731.V270553.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on the 30 January 2006 and was carried out by two inspectors. During the course of the inspection time was spent in discussions with residents, relatives and staff. Records relating to the care plans, staff files, and fire safety were examined. A tour of the premises was undertaken. During this inspection only a selection of the key National Minimum Standards were assessed. Therefore, in order to gain a full picture of how the home meets the needs of the residents this report should be read with the previous and any future reports. What the service does well: What has improved since the last inspection?
Since the last inspection an up to date Statement of Purpose and Service Users Guide to provide prospective residents with the information they required to make an informed choice about where to live was provided as a result of changes in management of the service to BUPA. Improvements were seen in the care planning documentation since the last inspection as these included information for staff to meet the residents’ needs. The home had commenced procedures to monitor accidents in the early morning hours following an audit of the occurrence of accidents in the home. Woodend Nursing & Residential Centre DS0000006731.V270553.R01.S.doc Version 5.0 Page 6 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.V270553.R01.S.doc Version 5.0 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.V270553.R01.S.doc Version 5.0 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): 1 Information provided to residents was up to date and assisted prospective residents to make informed choice about where to live. EVIDENCE: These standards were assessed during the previous inspection, however it was pleasing to see that a new Statement of Purpose and Service Users Guide had been provided as a result of changes in management of the service to BUPA. This enabled prospective residents to have the information they need to make an informed choice about where to live. It is recommended that the Statement of Purpose reflects the social care needs of clients receiving residential support as opposed to nursing care. Woodend Nursing & Residential Centre DS0000006731.V270553.R01.S.doc Version 5.0 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 and 10 A care planning system is in place setting out the health, personal and social care needs of the residents accommodated. EVIDENCE: Since the last inspection the company have introduced new care planning documentation. A sample of the new care plans were examined and found to be clear and provide staff with the information required to meet the residents needs. Risk assessments were included in the plans of care. Daily statements gave evidence of the care given. Care plans included evidence of the residents’/ relatives’ involvement and relatives spoken to said they were included in the care plan for their relative and ongoing discussions. The staff at the home were seen to treat the residents with respect and dignity. The care plans included the residents need for privacy and dignity at all times. Staff were seen talking to residents in a respectful and courteous
Woodend Nursing & Residential Centre DS0000006731.V270553.R01.S.doc Version 5.0 Page 10 manner. Thank you cards and letters from relatives for the care and attention given by the staff were available. A requirement made at the previous inspection concerning medication practice had been actioned. This involved the home being able to provide an adequate audit trail. All staff have signed a tracking form to confirm they had read the homes medication policy. Appropriate support was being provided to 10 residents requiring care of pressure areas. The daily reports on each resident of the care plans examined were informative and maintained on a daily basis. A resident told the inspector that “the staff are very kind and attentive to her”, another said “the staff are lovely”. One relative said she was always made to feel welcome by the staff and could relax at home feeling her husband was well cared for. Woodend Nursing & Residential Centre DS0000006731.V270553.R01.S.doc Version 5.0 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 Residents in the home have a flexible lifestyle and attempts were made to meet residents’ social, cultural and recreational needs. EVIDENCE: A weekly programme of activities was available and external entertainers are brought into the home. The activities organiser was present in the home during the inspection and spent time talking to individual residents finding out their likes and dislikes. Residents and relatives spoke of the enthusiasm the manager and the staff put in to the “party nights” they had, for example on bonfire night and over Christmas. A small group of residents were seen enjoying a game of scrabble whilst another resident was enjoying listening to classical music in the privacy of his bedroom. A discussion with the manager invloved the residents with a dementia type illness or short term memory loss and how their recreational needs and interests were met. A requirement was made to address this more fully which the manager was keen to address. The satellite kitchen in the residential section was found to be suitably stocked with provisions. Menu charts indicated alternatives were available and showed that residents are consulted on a daily basis. Conversation with some of the residents showed they were satisfied with the food whilst some others said
Woodend Nursing & Residential Centre DS0000006731.V270553.R01.S.doc Version 5.0 Page 12 there were not enough different dishes to choose from. Monthly meetings for relatives and residents are held to look at operational issues. Woodend Nursing & Residential Centre DS0000006731.V270553.R01.S.doc Version 5.0 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): EVIDENCE: These standards were assessed at the previous inspection. It was pleasing to see that following a recommendation made at the last inspection a tracking sheet had been introduced for staff to sign once they had read and understood the Adult Protection policy. Woodend Nursing & Residential Centre DS0000006731.V270553.R01.S.doc Version 5.0 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 Woodend provides a comfortable environment and the home was clean and tidy. EVIDENCE: A maintenance programme for the redecoration of bedrooms was in place. A recommendation made at the last inspection in relation to the provision of emergency lighting in the laundry has not yet been addressed. It was confirmed by the manager the issue of providing locks on bedroom doors would be discussed on admission to the home and provided where requested by individual residents. A requirement made at the last inspection to improve the boundary fencing between the garden and the golf course had been addressed. Woodend Nursing & Residential Centre DS0000006731.V270553.R01.S.doc Version 5.0 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): 29 and 30 Procedures for the recruitment of staff were generally robust and protected the residents living in the home. Staff undertook training to assist them to be competent in their work. EVIDENCE: At the time of the inspection the home accommodated 75 residents. Three residents were in hospital at the time of the inspection. Staff commented that staffing levels had been increased to meet the needs of residents accommodated as the dependency needs of the residents had increased recently. The home’s recruitment process was compliant with the information required by Schedule 2 of the Care Homes Regulations 2001. POVA first checks and Criminal Records Bureau disclosures were available. There was evidence of new employees receiving induction training. Staff records included a matrix for appropriate mandatory training and certificates for training undertaken. The registered nurses had undertaken training in venepuncture. Staff spoken to confirmed that they could volunteer for additional training they chose to undertake which was financed from a central budget. Woodend Nursing & Residential Centre DS0000006731.V270553.R01.S.doc Version 5.0 Page 16 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): 33 and 38 Residents’ interests were met by the home. The health and safety of residents and staff are promoted and protected. EVIDENCE: Following discussions with the manager and some of the staff members it was clear there was an emphasis on developing the staff team and valuing the staff. Staff spoken to felt the environment was very positive to work in. Residents and relatives meetings are held on a monthly basis. Minutes were available for these and included operational issues, staffing and laundry. One relative said; “you can go to Neil about anything, he is easy to talk to and acts on what I have requested.” Monthly visits to the home were carried out in accordance with the requirements of Regulation 26.
Woodend Nursing & Residential Centre DS0000006731.V270553.R01.S.doc Version 5.0 Page 17 Records relating to fire safety tests and checks were in order and maintained at the required intervals. The fire door on the first floor closed into its frame very slowly and may compromise fire containment. This must be adjusted to ensure a fire smoke seal is in place. Woodend Nursing & Residential Centre DS0000006731.V270553.R01.S.doc Version 5.0 Page 18 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 3 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X X STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X 2 Woodend Nursing & Residential Centre DS0000006731.V270553.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP12 Regulation 16 Requirement Training must be provided to ensure staff can meet the social and recreational needs more fully of residents with short term memory loss or a dementia type illness. An audit of the fire doors must be carried out to ensure they close effectively. Timescale for action 30/06/06 2. OP38 23 24/03/06 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 OP1 OP19 Good Practice Recommendations The Statement of Purpose must reflect the social care needs of residents receiving personal care only. The home is advised to check on the provision of emergency lighting in the laundry facility. Woodend Nursing & Residential Centre DS0000006731.V270553.R01.S.doc Version 5.0 Page 20 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
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