Inspection on 11/01/06 for Woodgate

This inspection was carried out on 11th January 2006.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Woodgate 18/04/07

Woodgate 27/09/05

Woodgate 03/12/04

Woodgate 28/07/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Woodgate Queens Road Maidstone Kent ME16 0JG Lead Inspector Lynnette Gajjar Unannounced Inspection 11th January 2006 08:30 Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 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 Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 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 and Care Homes for Adults 18 – 65*. 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. Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Woodgate Address Queens Road Maidstone Kent ME16 0JG 01622 677235 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) MCCH Society Limited Miss Caroline O`Brien Care Home 6 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (2) of places Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Care for 2 service users with Learning Disability who are over the age of 65 whose dates of birth are: 4 December 1935 and 31 August 1939. Service users with a Learning Disability may also have a physical disability, age range 40 years and over. 27th September 2005 Date of last inspection Brief Description of the Service: Woodgate is one of a group of small care homes managed by MCCH Society Ltd in the South East of England. It is a care home providing service residential and personal care for six adults with learning and physical disabilities. The home provides care for those persons over 40 years of age and predominately of the older person age range. Two service users are over the age of 65 years. The home is staff by a small team of support workers as well as the manager and 1 senior support worker. All staff work on a 24-hour shift roster, which includes a sleep in duty; the home does not provide waking night cover. Woodgate is a detached bungalow set off the main Queens Road in Maidstone. The accommodation comprises of six single rooms, a lounge, kitchen with dining area and purpose built adapted bathroom and separate shower room. The home has adequate parking for approximately five cars. There is a garden to the front and patio to the rear. The home is located close to a local pub and shop approximately ¼ mile away, with bus services to the town centre. Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the second in the year running from April 1st 2005 to March 31st 2006. The visit lasted from 08.30am until 16:00pm. The home agreed for some aspects of the inspection to be shadowed by the lead care manager for a new service user admitted to the home. The home currently has 6 people in residence, and no vacancies. The visit was spent talking directly with those living at the home privately and collectively, through staff interpretation and support; and four care workers and the manager. Due to the nature of the service and limited communication for some service users, it is difficult to reliably incorporate accurate reflections of the service users in the report. Some judgements about quality of life and choices were taken from direct conversation with service users living in the home and observation followed by discussion with staff and evidencing records held at the home. A tour of the premises and grounds was undertaken. Documentation was in good order, with good monitoring systems in place by the manager. The requirements and recommendations from the previous inspection had been implemented. What the service does well: What has improved since the last inspection? Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 6 Clear guidelines and agreement have been identified for the use of the audio devise to monitor service users nocturnal epileptic seizures to maintain personal confidentially and privacy with the service users agreement. Safer access to the rear garden has been achieved through the levelling and laying of a new patio area for those with limited mobility and wheelchair users. 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. Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 Service users are given all the information they need to make an informed choice about whether to live at Woodgate. EVIDENCE: The homes statement of purpose and service user guide gives clear information about the services provided. Both documents are in both written word and object reference pictorial formats. This just requires the current fees to be updated and was in hand by the manager. The key working and person centre planning process continues to develop, to offer clear promotion and support in identifying personal aspirations and meeting individual care needs. Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 9 The home has had a new admission since the last inspection. Due to their home closing and limited information available, the manager and staff have worked hard with the service user to get to know them and develop a more detailed assessment of their care needs, likes and dislikes and interests over the past two months and this is evidently ongoing. The care manager has been supportive and in regular contact monitoring the service user settling in and adjusting to the change of home and staff support with regular reviews. The new service users care plan contained a written tenancy agreement, which gives the persons’ security and rights of residency, detailing the tenants and landlord’s rights and responsibilities. The housing officer and advocate on their behalf have signed this. Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14, and 33 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 Clear, structured and directive guidance is in place to ensure consistent and respectful style of care is provided to personal wishes and preference. EVIDENCE: The care plan of the new service users was assessed. Staff have begun to develop a good care plan, guidance and supporting risk assessments to ensure consistent, safe care and support is given on the current assessments they have access too. It is evident that this is evolving daily as staff work more closely with the individual and each other and their knowledge increases. Due to previous life experiences and routines many basic aspects of personal care are requiring slow desensitisation programmes, empathy and dedicated time by staff to support this individual in maintaining their physical and mental Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 11 health and well being. The care plan seen was easy to understood and follow. Records are stored securely. Interaction between service users and staff continues to be good showing genuine respect, friendship and appropriate familiarity with each other. Often with appropriate two way banter and fun. Service users discuss daily as well as getting together formally through service user meetings, what they would like to do, daily routines and chores, activities and issues for the home. Service users are involved in making decisions and participate in all aspects of the home today, to the best of their abilities through object referencing, pictures, photos etc. The home has had on trial an epilepsy-monitoring pad, which has not proved to be successful, often going off when not in the room. Staff have returned to using an audible devise as well. Clear guidelines and agreement have been put into place to ensure correct use of this whilst maintaining the individual’s confidentiality and privacy. Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. 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. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Service users are given encouragement and support to make choices about aspects of their daily lives, including a range of local social and recreational interests. Menus provide wholesome and nutritious food. Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 13 EVIDENCE: Continued support from staff enables individuals to access local amenities and surrounding area including shopping, walks, and trips out to lunch, garden centres, cinema, bowling, woodwork, fitness groups and various activity centres. Three service users were out for the morning at activities. The others remained in the home relaxing and were supported out on activities that afternoon. Due to their maturing age and disabilities, current service users do not aspire to attend education or work environments but to concentrate their time in social, leisure and recreational activities. All service users have had a holiday (going away separately). Two discussed this in detail and shared their personal experiences and photographs with some happy memories. Staff discussed how they had looked up appropriate facilities to cater for physical care needs and then shared this with the service user who then made the final choice of where they would like to go. The facilities proved to be very suitable and within easy access of all places of interest to the individual. Service user families are in regular contact, with an open door visiting policy. Service users are supported to visit or meet relatives outside the home. Service users who are able also make regular telephone calls too. Staff actively supports those with limited communication and writing skills to send cards and letters to their friends and relatives. “I visit my brother (name) every other week more often if I am passing and we have time. It’s good as (name of other relatives) are there too as he needs help around the home.” “They did a 70th birthday party for me all my family was there, it was at the bowling club” “Brenda, yeh good good good my friend” Service users have pets, a cat and fish. Due to hard work of looking after the guinea pig it was agreed that he was found a new home and he has settled well. Service users were not unhappy and didn’t appear to miss the guinea pig. The kitchen is stocked with fresh produce and meals were served with ample portions. Service users were supported to help themselves to drinks and snacks as and when they wanted. All had dinner of fish’n’chips today with a light tea planned for the evening. Snacks are available on request as is fresh fruit as a healthier option between meals. Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 14 Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) Service users retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicines. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20,21 The health, social and personal care needs of residents are well supported with regular contact with specialists and external professionals. Residents are treated with genuine respect and dignity by care staff. EVIDENCE: Through discussion with a staff and records viewed, it is clear that residents are given full support and encouragement to maintain personal contact with practices nurses, GP, community learning disability staff, mobility advisors, physiotherapists and occupational therapists and consultants, as well as chiropodist and dentists, to maintain good standards of health and well being. The manager evidenced good work with one service user in exercising choice and understanding of a proposed medical treatment. Further exploration of Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 16 consent to medical treatment guidance from DOH for those with learning disability and professional advice from the learning disability nursing team, will assist in making sure that all areas are addressed satisfactorily to enable this to be processed with confidence and dignity for the individual. Following the new service users admission it is evident that accessing such services are exceptionally distressing to them and even many basic aspects of daily personal care such as teeth cleaning. Staff are working on desensitisation programmes in these areas at present with some small steps of progress being evident already. Staff have made referrals to physiotherapists, speech and language therapists. They have been registered with local GP, Chiropodist, dentist etc. This will be an evolving area for a long time for this service user. Staff spoken with today evidenced they were aware, of the type and nature of the support required for individuals personal and intimate cares needs. Every effort is made to maintain privacy and dignity when people are being supported with bathing, washing and dressing. Some practice observed by the inspector was discussed with the manager as an area to follow up with staff and reassess understanding of homes protocols in relation to medication and continence management. Staff through the recent death of a friend and attending their funeral has supported a service user well. Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Systems are in place to enable those living and visiting the home to raise concerns or complaints with staff. Protection from abuse is promoted through staff training and understanding of actions they may need to take. EVIDENCE: Copies of the complaint procedure are available in the home in formats easily understood by those living there. Complaint records evidenced no formal complaints being received. Due to the nature of the service and those living here, using this system can be limiting. One-service user continues to be able to indicated through discussion, who they would talk to if they were unhappy about something. Other service users will rely on others such as relative/ advocates to identify concerns and raise them on their behalf. Staff spoken with continue to showed a good understanding of how to protect and prevent abuse, including reporting under local procedures. There are no current adult protection alerts relating to this home. Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 18 Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 19 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30 Service users live in a warm, safe and clean home, which will be enhanced further with the completion of works to the rear garden to make access safe. EVIDENCE: The home is a purpose built bungalow, well presented, and bright, with adequate internal space and equipment for those requiring full physical care. There are good standard of hygiene and cleanliness. Ongoing work continues by staff to try to address leaking shower tray. A detailed home repair and maintenance programme is in place. Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 20 Service users share the open plan kitchen/dining area and separate lounge. Work surface by the sink needs replacing due to chips and gaps which are not conducive good food hygiene management. Units and doors should be considered for replacement in future modernisation planning. The dishwasher macerator makes a very load, high pitch and offensive noise through parts of the cycle that made conversation very difficult. Consideration to sound proofing this would be of benefit to service users. Staff try to be considerate to usage at times when service users are not resting/sleeping. A similar noise also was heard through out the day from the washing machine. Staff stated that they and service users had become used to the noises and blocked them out. Individual specialist equipment is assessed through Occupation Therapists and purchased on an individual basis, from comfortable chairs, beds, and hoists, grab rails and bathing equipment. Service users received visitors in communal areas or privacy of their rooms. Bedrooms are personalised to individual taste and personal choice. The home and garden is well maintained, with work completed in levelling and laying of new patio to the rear garden has made access safer for those with physical disabilities and will be further enhanced with the fitting of extra grab rails once accessed by the occupational therapist. Due to current issues of continence management for service users living at the home and modern clothing washing guidelines alternative sluicing facilities should be explored to offer safe washing of clothing that cannot be washed at 90 degrees plus. It is recommended that advice be sought from the infection control nurse advisors for a suitable solution. Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 21 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,36 Service users have benefited from stabilizing of the staff team, resulting in good morale and enthusiasm to improve the service users whole quality of life. EVIDENCE: The home has benefited from the stabilizing of staff team through three new staff who are working through their probation period. All have undertaken a thorough and comprehensive recruitment and working through their induction programme including all core training with set targets set with the manager. The organisation continues to encourage and support care staff to completed their NVQ 2 and 3 in care, but new staff have to achieve full probation before being put foreword for this. The home currently has three staff holding NVQ 2 Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 22 or 3 in Care and a further two working towards this at present but nearing completion. Staff feel supported by the manager and senior managers of the organisation. Some conflicts were discussed with the manager who is supporting individuals through this. Full-recorded supervision takes place at least monthly including set action points and goals. New staff have additional 3 and six monthly appraisals as part of their probation period. Yearly appraisals also take place. The manager has clear levels of expectation from the staff team and has extended probation periods for staff to develop into their roles. Care staff spoken with and directly observed evidenced clear and good understanding of different individual care needs. Service users reacted fondly towards individual staff and their help. With positive conversation, appropriate touch and nodding ad shaking of heads to yes no questions by the inspector. Staff were seen to support individuals respectfully but also with respectful familiarity resulting in some fun joking and banter from both parties. Staffing rosters have reflected changing care needs of individuals. Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,42 Service users living here have their personal preferences, support and care needs encouraged through the registered managers open leadership, monitoring systems and the promotion of a safe home and working environment. EVIDENCE: Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 24 The manager has worked with this service user group for many years. She has since the last inspection completed NVQ 4 in Care and nearing three units required for verification for the Registered Managers Award. Service users, professionals and staff continue to express a high regard for their management approach to the home. Service users through the interaction observed appeared very comfortable and well supported by the manager. Her arrival to the home today brought an air of relaxation and confidence that gave a calming effect on the home, routine and staff during the busy morning routine. Monitoring health and safety in the home is to a good standard, with health and safety walking routes taking place, and equipment serviced as required to maintain a safe home and facilities. Risk assessments are completed for individual’s activities but little are formally recorded for staff activities and duties. Full fire protocols and records are maintained satisfactorily. Tests were undertaken during this visit as part of routine checks for a Wednesday. Staff evidenced a good understanding of accident/incident recording and reporting under regulation 37 to the Commission, as well as assessment and monitoring of falls. The introduction of a monitoring /auditing tool will assist the manager with observing for patterns and triggers at a glance rather than searching though paperwork. Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 X 36 3 CONDUCT AND MANAGEMENT Standard No Score 37 3 38 4 39 3 40 X 41 X 42 2 43 X 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Woodgate Score 3 3 3 3 DS0000024095.V277134.R01.S.doc Version 5.1 Page 26 yes 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. 1. Standard YA24 Regulation 23(o) Requirement The registered person shall having regard to the number and needs of service users ensure that: External grounds, which are suitable for, safe for use by. Service users are provided and appropriately maintained. This is evidently nearing completion with the patio re bock paved. The home is just waiting on OT advice regarding additional grab railing that may be required but this s clearly heading for completion before the summer months. Timescale for action 31/03/06 Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 27 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 3 4 5 6 Refer to Standard YA6 YA18 YA20 YA24 YA24 YA24 Good Practice Recommendations It is recommended that the home continue to develop the information, records pertaining to new service user and ensure accuracy of birth date, financial systems. It is recommended that the home continue to develop consent to medical treatment following DOH guidelines with a service user, through multi disciplinary process. It is recommended that staff are familiar with the homes medication protocols when medication is dropped. It is recommended that consideration be given to installing gate to the gap leading to the slopping garden area, off the patio area and back door exit. It is recommended that consideration be given to sound proofing the macerator to the dishwasher in the kitchen. It is recommended that consideration be given as part of the home rolling maintenance programme, to review current kitchen layout, units and work surfaces to meet the needs of those with physical disabilities such as lower working surfaces and cupboard access, to promote involvement and skills development. It is recommended that poor drainage from the shower tray be corrected/ replaced. It is recommended that consideration be given to planning a private area for visitors, consultations or treatment as part of the homes development plan. It is recommended that Homes providing a service to people with a physical disability provide specialist equipment, as needed for each individual in particular a call system. It is strongly recommended that worktops that are chipped and damaged be replaced to promote effective food hygiene management. It is recommended that consideration be given to alternative sluicing facilities at the home by seeking advice and guidance from the infection control nursing team. It is recommended that the manager develops an monitoring /auditing tool for accident and incident at the home. DS0000024095.V277134.R01.S.doc Version 5.1 Page 28 7 8 9 YA27 YA28 YA29 10 11 YA30 YA30 12 YA42 Woodgate 13 YA42 It is recommended that the cupboard storing COSHH materials is kept locked at all times. Current locking device is ineffective. Woodgate DS0000024095.V277134.R01.S.doc Version 5.1 Page 29 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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