Inspection on 20/04/07 for Brendoncare Woodhayes

This inspection was carried out on 20th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Brendoncare Woodhayes 19/01/06

Brendoncare Woodhayes 28/06/05

Brendoncare Woodhayes 15/11/04

Brendoncare Woodhayes 09/06/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Woodhayes Nursing Home 36-40 St Leonards Road St Leonards Exeter Devon EX2 4LR Lead Inspector Teresa Anderson Key Unannounced Inspection 20th April 2007 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 Woodhayes Nursing Home DS0000026707.V331287.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. Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodhayes Nursing Home Address 36-40 St Leonards Road St Leonards Exeter Devon EX2 4LR 01392 667290 01392 667292 wrendal-jones@brendoncare.co.uk www.brendoncare.org.uk The Brendoncare Foundation 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) Mrs Margaret Wendy Rendal-Jones Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Notice of Proposal to Grant Registration for staffing/environmental conditions of registration was issued 15/3/1994 Registered for 27 - Elderly General Nursing Care Registered for 8 Elderly Residents Approved Person in Charge is Mrs Wendy Rendal-Jones RGN Date of last inspection 19th January 2006 Brief Description of the Service: Woodhayes Nursing Home is in a quiet residential area close to the centre of Exeter. It is also within level walking distance of local shops and bus routes. The Home is a listed building, converted from two dwellings, occupying a large corner site, with gardens to the front and parking to the rear. A few steps lead up to the main entrance of the Home, although there is an alternative entrance for those who use wheelchairs or who cannot climb steps There is level access throughout the ground and first floors of the home and a staircase and a passenger lift join these. There is a stair lift leading to the first floor flat that is occupied by residents who have a larger degree of independence and who do not require nursing care. All bedrooms have hand basin facilities. Full laundry and catering services are provided on site. The fees charged range from £670.00 - £772.00 per week. These charges do not include the cost of items such as chiropody, newspapers and magazines, hairdressing or personal toiletries. Further information about his home is available direct from the home or from the Brendoncare Foundation. Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place as part of the normal programme of inspection. The site visit began at 10.00am and finished at 5.00pm. During that time the inspector spoke in depth with three people who live here. The care, services and accommodation offered to these people were looked at as a way of judging the overall quality of care and accommodation provided by this service. Records relating to assessments, care plans, medication, fire safety, residents monies and staff recruitment were inspected. In addition the inspector spoke with approximately eight other residents and with five members of staff, the manager, the administrator and a visitor. Prior to the site visit surveys (asking for comments) were sent to twelve residents and six were returned; to fifteen staff working at the home and ten were returned; to health and social care professionals and three were returned. Their comments are included in this report. In addition, the manager completed a questionnaire giving details about the management of the home and about training. What the service does well: Woodhayes Nursing Home is described by residents, visitors and by healthcare professionals as a homely and happy place to live. All prospective residents are assessed by a registered nurse prior to admission to ensure that the home and staff who work there can meet their needs. When a new resident moves in, they are helped to settle in by sympathetic and understanding staff. Each resident has a plan of care which is easy for staff to understand and follow. This plan identifies the resident’s needs and gives staff clear instructions on how these needs can be met. Frequent reviews and appropriate changes to care planning take place. Each resident has their healthcare needs met and staff ensure that specialist services are used when necessary. This includes chiropodists, opticians, specialist doctors and physiotherapy. Each resident is treated with respect and as an individual and has his or her right to privacy ensured. Staff work hard to ensure that residents continue to make choices in their daily lives. For example each resident chooses what time they get up and go to bed, where they spend their time, what they eat and what they wear. Some staff demonstrated an in depth understanding of the Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 6 importance of this to those people who have already lost some of their independence. The home offers a varied social programme and yet respects the wishes of those residents who prefer their own company. Those people who are unable to join in with the arranged activities due to frailty, are supported by staff and volunteers who might for example read to a resident or play a favourite talking book. Visitors are made very welcome and are encouraged to visit or just to pop in when they can. Visitors are offered refreshments and can have meals at the home if they wish (at a small charge). Residents describe the food as ‘very good’ and ‘nice’. All meals are cooked on the premises and the cook tries to use as much fresh food as possible. Hot and cold drinks are easily available. The home has a positive attitude towards complaints, seeing this as part of the quality assurance processes. CSCI have not received any complaints and the home has received three that they have dealt with. Staff are trained in ‘Safeguarding adults’ and demonstrate a good understanding of what abuse is. Residents say they feel safe and secure. Monies kept on behalf of residents are kept safely and securely and the system for managing these monies is easily auditable. The home is clean and hygienic throughout. Staff are familiar with and put into practice procedures which help to prevent the spread of infection. The grounds are very well maintained and a clear favourite of many residents on sunny days. Staff are well trained and approximately 70 have a National Vocational Qualification (NVQ) in Care at level 2 or above. All staff receive mandatory training on a regular basis. They are recruited using robust procedures to help protect residents. There is always a Registered Nurse on duty. In addition there are five carers on duty in the morning, three in the afternoon and evening and two at night. Residents say that their needs are met. The manager is a Registered Nurse and has worked at this home for fifteen years. She has consistently demonstrated her competence and has continued to develop professionally and to improve standard of care in line with best practice. Staff and residents have great respect for her. Quality assurance procedures are in place to ensure the home is run in the best interests of the people who live here Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: A Registered Nurse carries out an assessment on all prospective residents. However, this does not include an assessment of their moving and handling needs. This is carried out approximately 48 hours after admission, which means that during that time residents and staff may be at risk of injury. When carrying out assessments, these should take into account the size of bedrooms, the need to move furniture out of the way if necessary and any aids or equipments needed to do this safely. Care planning is very good in general, however there are some contradictions and omissions that need to be addressed. In addition, although care plans contain plans on how to manage incontinence, they do not provide instruction for staff on how continence might be maintained or achieved. Some practices in relation to the handling of medication need to be reviewed to ensure that the risk of staff making errors are reduced, to ensure that best practice guidelines are followed, to ensure that medications are stored safely and to ensure that residents benefit as much as they can from the medicines they are prescribed being linked to their plans of care. Although staff are all trained in ‘Safeguarding adults’ they are not familiar with reporting procedures that might place residents at risk. Neither are they recording restraints used (lap belts) and the reasons they are using them. In addition an issue relating to a member of staff being ‘sharp’ was raised during this inspection which the manager has agreed to follow up and address if necessary. In order to ensure residents’ safety in the event of a fire all fire doors must close properly and should never be wedged open. Record keeping is generally very good, however the communication book is sometimes being used to record information about residents’ care and health which should be kept confidential and information regarding active treatment is incomplete. Please contact the provider for advice of actions taken in response to this Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 8 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 9 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 Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3. This service does not provide intermediate care. Quality in this outcome area is good. People who use this service can be assured that they will have a contract and that the home will be able to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In surveys the majority of residents who responded said that they had a contract. We also found that residents have contracts and looked at three. These state what the resident is contracting for and the bedroom they are to occupy. Prior to admission each prospective resident is assessed by either the manager or one of the registered nurses. This assessment gathers basic information about the resident that helps the assessor to determine whether or not the Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 11 home can meet their needs. This information is shared with staff when the resident is admitted. However, information about moving and handling needs are not assessed until approximately 48 hours after admission. This means that care staff do not have the information they need, and may be placing themselves and the resident at risk of injury. During discussions staff demonstrate a good understanding of how difficult moving into a care home can be. The manager reports that each new resident is allocated a key worker who is on duty when the resident is admitted. This person helps them to settle in by for example, introducing them to other residents and to staff and helping them to unpack. In surveys the majority of staff say that they are personally introduced to each new resident and that they are told the name that this person prefers to be called by. This home does not provide intermediate care. Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. People who live here can be assured that their care is generally well planned, that their healthcare needs are met and that they are treated with respect and as individuals. Some practices in relation to the handling of medications may be putting some residents at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In surveys healthcare professionals say that staff at this home ask for advice and put this advice into practice. Staff working at the home say that they are rarely asked to care for anyone outside their area of expertise and that they know what to do if a resident becomes unwell. Care plans show that people living here have access to professional health care such as chiropodists, opticians and specialists. In addition the home has Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 13 designated ‘link workers’ who specialise in keeping up to date with current best practice in some of the more medical conditions. Currently this includes link workers for diabetes, continence, nutrition, Parkinson’s disease and nutrition. There is a good care planning system in place which is readily accessible to staff and which is easy to understand and use. All staff are involved in care planning but one person has the designated responsibility of ensuring these work to enhance the quality of each resident’s life. Care plans seen demonstrate that appropriate assessments are undertaken. These include assessments undertaken by registered nurses in relation to the risk of developing pressure sores and in relation to how much nutritional support the resident might need. These assessments are followed up with plans of action and are regularly reviewed and amendments to the plan of care made where necessary. None of the residents living at this home currently has a pressure sore. In surveys staff say they are given clear instructions about residents’ particular needs and about each resident’s plan of care. Some issues do however need attention. For example in one care plan there are instructions for staff to carry out random pulse readings on one resident. This had not been done. Another care plan directs staff to give full fat milk drinks and puddings to a resident who is low in weight. However, this resident is also receiving medication for high cholesterol that will not work if the resident continues to receive a diet high in fat. Another care plan directs staff to carry out peripheral pulses on a resident with poor circulation. This is not being done. Although the care plans seen contained plans on how to manage incontinence, they did not provide instructions for staff on how continence might be achieved or maintained. Each plan of care is individualised taking into account the preferences and needs of each resident. Staff demonstrate a good awareness of not carrying out instructions in the care plan to the detriment of privacy and dignity. For example recording of bowel movements are only made for those people who might have a problem and not on a routine and generalised basis. Staff ensure that residents are treated with dignity and have their privacy protected in other ways. For example staff were observed being discreet in offering to provide personal care or assistance, all personal care was carried out in private and all residents wear their own clothes which are very well cared for. In addition staff have put into practice recently learned skills in relation to caring for people with communication problems to help one resident maintain their dignity when eating. Staff demonstrate a good knowledge and understanding of the importance of the safe handling, storage and recording of medications and generally carry this out to a good standard. However, some administration records show that Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 14 two people are not always signing to say they have received and understood and correctly transcribed prescriptions made by the doctor verbally. This might place residents at risk. In addition some prescribed creams are not being signed for when they are given and staff are not monitoring how well pain relieving medication is working. In one case the amount of medication given on an ‘as needed’ basis might indicate that medication prescribed on a regular basis may need reviewing. However, staff have not been keeping a record of the residents pain levels or why they administered the ‘as needed’ medicine. An entry in the communication book about poor practice in relation to putting dispensed medication back into the bottle has not been followed up by the manager. Recordings in relation to the temperature of the fridge which stores medication show that this temperature is sometimes below that recommended for storing medication. Recordings are not being kept of the minimum and maximum temperatures of the fridge in a 24 hour period as is good practice. Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is excellent. People who live here benefit from the availability of a varied social programme, from easy contact with their friends and family, from an ethos where making decisions and choices are seen as important and from a varied and wholesome diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Woodhayes employs an activities coordinator who works every weekday. She organises activities such as making hand cream, keep fit, celebrating feast days (e.g St Patrick and St Piran), indoor gardening, cooking and flower arranging. In surveys residents say there are always or usually activities arranged by the home which they can take part in. Staff work hard to provide those residents who are not able to join in with pastimes that suit. For example, one person likes to listen to the radio and has favourite books on tape. Staff ensure that Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 16 these are on or are available. Other residents prefer their own company and choose not to join in with the activities. Staff discreetly check with these people to make sure they have not changed their mind, but without being persuasive. Some residents talked of the friends they had made since coming to live here and some of how much they enjoy sitting in the gardens. In addition this home has a group of volunteers who help out with social occasions and who will provide one to one time with residents, for example playing scrabble or reading to a resident. Residents say they can receive their visitors when they like. One visitor said that she comes and goes as she pleases and is always made welcome. Some visitors choose and are helped to have a meal with their relative or friend, either in the dining room or in private. The residents describe meals as ‘very good’ and ‘nice’. In surveys in answer to the question ‘do you like the meals’, one person said always, another said usually and three said sometimes. All meals are cooked on the premises and use mainly fresh ingredients. Hot and cold drinks are available throughout the day. By coincidence, the environmental health officer also visited the home on the day of this inspection. He found the storage of food to be good, and commented this was usual, and the kitchen to be clean. He inspected the food hygiene management file and found this in order. Residents say they make choices in their daily lives. These include the times they get up and go to bed, what they wear and where they eat their meals. One member of staff talked of how easy it is to make decisions on behalf of residents and that the staff group successfully work together not to do this or to remind each other not to do this. Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. People who live here have their complaints heard as part of the quality improvement processes. Knowledge relating to reporting procedures and recording reasons for using restraint could be improved to help protect residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The commission has not received any complaints about this service. The home itself has received three complaints. All were minor, all were substantiated and all were dealt with within the time period stated within the complaints policy. During discussions, residents said that they felt comfortable speaking with staff about any ‘grumbles’ and would report any complaints to the manager but had not had cause to. One visitor said they had never had cause to make a complaint but was confident that it would be dealt with if they did. Staff have received training in safeguarding adults and demonstrate a good knowledge of the different types of abuse. However, knowledge of reporting Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 18 procedures was less good and might place residents at risk if abuse were reported or seen. Residents say they feel safe and secure and that staff are generally kind. These residents also spoke on behalf of those who are more vulnerable, saying that staff are this way with everyone. They did however describe one member of staff as prone to being ‘sharp’. When asked some staff also thought this. The manager was informed and has agreed to address this issue. Some residents wear lap belts when they are in wheelchairs. The manager reports that this is to prevent the resident from falling out. This should be recorded as an assessment of risk and as part of the plan of care to ensure that any form of restraint used is obvious and that restraint is only used when there is no other option. Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22 and 26. Quality in this outcome area is good. People who live here can be assured of a homely, clean and safe environment. Practices in relation to moving and handling could be improved to further reduce the risk of injury. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In surveys the residents all say that Woodhayes is always clean and hygienic. On the day of this inspection, the home was found to be that way. The laundry is clean, tidy and well maintained as is the kitchen. Staff were observed using practices which prevent the spread of infection such as wearing gloves and protective clothing. Hand washing facilities are available throughout the home and staff use alcohol gel as an additional infection control measure. Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 20 The grounds are very well maintained, are largely level for easier access for those with mobility problems and are secure. However, the safety of residents was potentially being compromised as the laundry fire door was wedged open, the linen store door was not locked as it should be, one bedroom door did not close properly and another had been wedged open by a chair as the magnetic holder would not hold it open. In addition, this older type of building has smaller bedrooms. This does potentially present some moving and handling problems for staff. In some instances, staff have to remove furniture from bedrooms in order to accommodate moving and handling equipment. Although the moving of light equipment is not problematic, staff report they are moving heavier items which may be posing a moving and handling risk. Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People living at this home benefit from good recruitment practices and a staff group who are well trained and employed in sufficient numbers to keep them safe and meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The duty rota shows that there are usually 5 care staff and 1 Registered Nurse on duty in the morning, 3 care staff and 1 Registered Nurse in the afternoon and evening and 2 carers and 1 Registered Nurse at nighttime. Additional support is provided by the cook, housekeeper, kitchen assistant, administrator, manager, activities co-ordinator and maintenance man. Each shift is led by a designated team leader. Agency staff are not used as the home has its own ‘bank’ staff. In surveys residents say they receive the care and support they need and that staff listen and act on what they say. The majority say that staff are usually available when they need them. Staff (in surveys) say they know what to do if a resident is unwell and who they should contact in an emergency. Staff also say that there is a strong emphasis in this home on training. Approximately 70 of staff have a National Vocational Qualification (NVQ) in Care at level 2 and many have achieved level 3. Other training has recently Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 22 included a 5-day course on caring for people with dementia, which two members of staff attended, deaf awareness, person centred care and Parkinson’s awareness. Three recruitment files were inspected. These were found to contain all the information needed to help protect residents from harm. This includes obtaining a police check prior to employing a member of staff or volunteer, obtaining two written references and ensuring that staff receive comprehensive induction training. Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37 and 38. Quality in this outcome area is excellent. People who live here live in a home run for their benefit by a competent manager. The manager ensures that residents’ safety, health and welfare is promoted and their monies are handled safely. Some record keeping could be improved to ensure records are kept confidentially and in accordance with best practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager of Woodhayes is a Registered Nurse and has worked at this home for fifteen years. She has consistently demonstrated her competence and a Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 24 willingness to continue with her professional development and learning. Staff say she is approachable and a positive role model and residents talk of their confidence in her. She is supported by a team, above and below her, who all contribute to the smooth running of this home. Following this inspection the manager took immediate action to rectify any shortcomings identified. She is proactive, receptive to feedback and extremely keen to support her staff to provide the best service to the people who live her. Quality assurance procedures are in place and include surveying residents and their relatives about the quality of services provided. They also ask for suggestions for improvement. The administrator handles the personal allowances of those who do not wish to manage their own money. The system used is clear and easily auditable. All monies are kept safely and securely. Three accounts were checked and found to be in order. Record keeping is generally good. However the communication book contains some information regarding resident’s care and health which is being recorded in a shared way. This is contrary to Data Protection guidance. In addition records relating to resident’s wishes regarding active treatment are incomplete. Mandatory training is given a high priority and includes fire training, food hygiene, infection control and moving and handling. Approximately 75 of staff hold a first aid certificate. The fire log shows that fire drills and checks are undertaken. Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 25 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 4 8 3 9 1 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 2 x x 2 x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 4 x 3 x 3 4 Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 26 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 OP3 Regulation 14 (1) (a) Requirement Timescale for action 31/05/07 2. OP9 13 (2) Each resident who is admitted to the home must have their moving and handling needs assessed before or at admission to reduce the risk of injury to the resident and to staff. Staff must follow best practice 31/05/07 guidance in relation to handling medication. • Dispensed medicines must never be put back into bottles. • Poor practices in relation to medication must be addressed and further training given if necessary. • All hand written entries should be checked and signed by two people. • All prescribed creams should be signed as being applied by the person who applied the cream. The temperature of the fridge where medicines are kept should be maintained at between 3 and 8 C. • The temperature of this fridge should be monitored using a minimum and DS0000026707.V331287.R01.S.doc Version 5.2 Woodhayes Nursing Home Page 27 3. OP18 13 (6) 4. OP18 13 (6) 5. OP18 13 (8) 6. OP19 23 (4) 7. OP37 17 (10 (b) maximum temperature thermometer. • The reason for giving ‘as prescribed’ medications should be recorded. • The efficacy of pain relieving medication should be recorded and used to help plan the care of the resident to whom this is given. Staff must be familiar with the reporting procedures identified in ‘The Alerter’s Guidance’ to ensure that residents are fully protected from harm. The allegation of a member of staff being ‘sharp’ at times should be investigated and addressed by the manager so that residents can feel safe. If restraint of any type has to be used the type of restraint and reason for it should be recorded to ensure that this is only used as a last resort. To ensure residents are kept safe in the event of a fire, all fire doors should be capable of closing fully and should not be wedged open. All information relating to residents care or health should be kept separately for each resident and not shared in the communication book. 30/06/07 31/05/07 31/05/07 30/04/07 31/05/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 28 No. 1. 2. 3. 4. Refer to Standard OP7 OP8 OP22 OP37 Good Practice Recommendations Each care plan should provide clear guidance to staff on how to meet the resident’s needs and any contradictory guidance should be clarified. Care plans should include how each resident might have their continence maintained or incontinence prevented. Where staff have to move furniture appropriate aids or equipment should be provided to prevent injury. Where residents express a preference regarding whether or not to have active treatment, the records relating to this should contain more detail. Woodhayes Nursing Home DS0000026707.V331287.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton Devon TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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