Inspection on 26/07/06 for Woodhouse Road Care Home

This inspection was carried out on 26th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Woodhouse Road Care Home 09/10/09

Woodhouse Road Care Home 10/10/07

Woodhouse Road Care Home 20/10/05

Woodhouse Road Care Home 27/04/05

Woodhouse Road Care Home 03/12/04

Woodhouse Road Care Home 26/05/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Woodhouse Road Care Home 31 Woodhouse Road Mansfield Nottinghamshire NG18 2AY Lead Inspector Joanna Carrington Key Unannounced Inspection 26th July 2006 09:30 26/07/06 Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 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 Woodhouse Road Care Home DS0000008769.V301276.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 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. Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodhouse Road Care Home Address 31 Woodhouse Road Mansfield Nottinghamshire NG18 2AY 01623 651398 01623 651398 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) www.mencap.org.uk Royal Mencap Society Audrey Baranski Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Home for 8 Service Users with Learning Disabilities Date of last inspection 20th October 2005 Brief Description of the Service: 31 Woodhouse Road provides long-term personal care and accommodation for 8 adults who have a learning disability. The home is located near Mansfield town centre and is close to shops, pubs, the post office and other amenities. The premises consist of a large end of terrace house. Bedrooms are single with no en-suite facilities and are located on the second and third floors. The premises are not accessible to full-time wheelchair users. There is a goodsized enclosed garden and greenhouse. The fees are £335 per week. Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over six hours on 26th July 2006. This was the home’s key inspection for this financial / inspection year. The main method of inspection was called ‘case tracking’ which meant selecting three service users and tracking the care and support they receive through checking their records, observation of care practice and discussion with them and with staff. Staff records were looked at and a partial tour of the premises also took place in order to assess environmental standards. Altogether three service users and two staff members were spoken with. The manager was not available on the day of the inspection. The deputy manager was available for discussion and feedback throughout. Overall the inspection found there to be very positive outcomes for residents. What the service does well: Prospective service users do not move to the home until their needs have been assessed and there has been opportunities for them to be introduced and ‘test drive’ the home. Care plans and risk assessments are thorough and provide detailed information on how service users’ needs are to be met. Step-by-step guidance is provided on how to support service users with their personal care and their individual preferences are included. Staff are committed to promoting choices and enabling communication with service users. The views of service users are listened to and valued. Specialist health and social care professionals are accessed when necessary to help in meeting the needs of service users. Service users have good opportunities to participate in meaningful and fun activities both in the home and in the community. Support is given to maintain contact and relationships with family and other significant people. Service users’ complaints are taken seriously and to assure that service users’ are safeguarded from abuse the Nottinghamshire Policy and Procedures are adhered to. Training and support for staff is good, which ultimately the service users’ benefit from. The necessary checks are made before new staff commence their employment. This is important for the protection of service users. The environment is maintained to a good standard. There is plenty of communal space for service users and it is homely throughout. Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 5 Quality for this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Prospective service users have the information they need to make an informed choice about where to live and have their needs assessed prior to moving into the home. All service users have a contract, which details the terms and conditions of their placement. EVIDENCE: For all three service users case tracked there was the placing authority’s community care assessment on their file. For the service user that has recently moved to the home a lot of information including an up to date assessment had been obtained about their needs before they moved to ensure that the home would be suitable. A copy of the signed tenancy agreement is retained on individuals’ files and to accompany this there is a document presented in a more accessible format for adults with a learning disability explaining what the tenancy agreement means and what their responsibilities are in relation to this. A service user spoken with confirmed that he has a copy of the Service User Guide. The Statement of Purpose was seen. This contains all the necessary information about the service and was updated in June this year to reflect the current staff team and their qualifications etc. Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 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 and 9 Quality for this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. There are good arrangements in place for meeting the needs and choices of service users. Service users are supported to make decisions in their lives, to be independent and take acceptable risks. EVIDENCE: All service users case tracked have clear care plans in place on how to meet their individual needs. There was evidence that care plans are reviewed and service users spoken with said that they are involved in the development and review of their care plans. An incident record seen was cross-referenced with daily records and subsequently amendments had been made to the relevant care plan with the signature of the service user to say they are in agreement with the change. There are risk assessments in place accompanying care plans that as well as covering the usual health and safety issues such as bathing also cover individuals preferred activities, including smoking, swimming and holidays, to ensure these can be participated in safely. Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 Page 10 It is evident that service users are supported to make decisions and choices in their everyday lives. Staff spoken with gave good example of how they involve service users in the running of the home. There are regular house meetings and minutes of these meetings are presented using pictures and symbols. The home has a ‘lay visitor’, who has a learning disability also. She visits the home to meet with service users to discuss any issues of concern to them about their home and their lives. Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality for this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. There is a commitment from the staff team in safeguarding residents’ rights and enabling residents to experience a fulfilling quality lifestyle. EVIDENCE: Service users spoken with said that they enjoy going out with their key workers, favourites mentioned were going down the pub for a drink and going for walks to the local park. Daily records show that there have recently been trips to Skegness, Whitby, trip on a boat and out shopping. Most service users attend day centres or go to college at least on a part time basis. An older service user chooses to go to a retirement centre two days per week. There are care plans in place identifying ways that individuals’ can be supported in maintaining relationships with family and friends. For Mothers Day family were invited and service users bought flowers and presents for their mum. Staff help service users to make phone calls. Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 Page 12 Staff spoken with demonstrated how they maintain individuals’ dignity when carrying out their support role. Service users said that staff always knock on their bedroom door before entering. Any restrictions of liberty are clearly identified in care plans, with reasons why this is necessary. Staff were observed interacting with service users in a respectful and meaningful manner. Menu records show that a varied and wholesome diet is provided to service users and those spoken with stated that they enjoy their meals and mealtimes. House meetings give service users the opportunity to discuss what meals they would like and each day a service user helps out with preparing the meal. Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. 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. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 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 and 20 Quality for this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users receive personal support in the way they prefer and require and health care needs are generally well met. Medicine management is satisfactory but further action will ensure the safety and rights of service users. EVIDENCE: Daily records show that there is flexibility with when service users choose to go to bed and get up, which was confirmed by those service users spoken with. Support with personal hygiene and tasks such as dressing and washing are identified in relevant care plans and the preferences of service users with their personal support for example wanting to have a shower over a bath are also included. Specialist health and social care professionals such as psychiatrist, community nurse and occupational therapists are involved in service users care when appropriate. Appointment records show that service users have regular health checks and access to primary healthcare services when needed. It was noted on one service user’s care plan that they had requested administering their medication independently. It points out in the record that the service user was observed doing this wrongly and the doctor said it would Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 Page 14 be unacceptable for the service user to self-administer. As it is an individuals’ right to do this themselves a risk assessment must also be carried out covering all aspects of self-administration. This can then be periodically reviewed in case the service user at some point will manage to do this independently. Medicine storage appeared to be well organised and medication administration records (MAR) gave clear instructions. For tablets in boxes a stock control sheet is used which is attached to the MAR. This sheet would not be necessary if any left over quantities are carried over onto the next cycle’s MAR. For one service user’s ‘as required’ medication there was no stock control sheet because it has not been administered during the last two cycles and no quantity has been recorded on the current or previous MAR sheets. This means that these tablets are not accounted for. For the service user case tracked that has ‘as required’ (PRN) medication for anxiety and ‘unsettled’ behaviour there is a care plan in place stating the procedure to be followed prior to this medication being given. This includes contacting the manager and two staff members having to agree when this would be appropriate. This is good practice and helps to protect their rights. In addition to this a care plan is required on what strategies should be used for defusing situations, then there is clear guidance to staff at what stage behaviour modifying medication is required. Daily records showed some quite serious incidents and there were entries stating ‘PRN medication been administered’ but no record of reasons for administration / circumstances. As this is a form of restraint an incident record should therefore be filled in. Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 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 and 23 Quality for this outcome area is good. This judgement has been made using available evidence including a visit to the service. There is an appropriate complaints procedure in place, to ensure that residents and their representatives’ views are listened to and acted on. The Local Adult Protection Procedures are appropriately followed, which helps to assure that residents are safeguarded from abuse. EVIDENCE: The Complaints Procedure is displayed in both written and picture format. Service users spoken with confirmed that they know how to make a complaint. There have been no complaints made since the last inspection. There has however been one incident that resulted in invoking the Nottinghamshire Safeguarding Adults Policy and Procedures. The Commission were notified of the situation at the time and Social Services were involved. Adult abuse is covered in the Learning Disability Aware Framework induction and foundation training and training records show that some staff have been on the Nottinghamshire Adult Protection Unit training, which provides practical information on the Policy and Procedures. Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 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, 26 and 30 Quality for this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents live in a clean, safe and comfortable home. EVIDENCE: On a tour of the premises it is evident that the home is kept clean and hygienic. The laundry facilities are well organised and appropriate to the needs of service users. Service users have some responsibilities for doing their own laundry each week. The home is decorated pleasantly throughout, and there is a choice of communal areas for service users to use. One service user explained how the conservatory is often used for listening to music and dancing. There is also a good-sized and well-presented garden for service users to access. There is a green house and a vegetable patch, which some service users look after. Bedrooms are nicely personalised with individuals’ own items and pictures. Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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, 34, 35 and 36 Quality for this outcome area is good. This judgement has been made using available evidence including a visit to the service. Training and support for staff is well managed, which service users ultimately benefit from and recruitment practices protect service users. EVIDENCE: The home is well on its way to achieving the target of at least 50 of the staff team being qualified to at least a National Vocational Qualification (NVQ) level 2. Seven out eleven care staff either have the qualification or are in the process of studying for it. Staff spoken with confirmed that training opportunities are good and that as well as attendance of mandatory courses there is also specific training relevant to the individual and collective needs of service users. This was evident in training records. Staff said they feel supported by the management team and on staff files there were copies of supervision records. There was also evidence that the necessary checks are carried out before staff commence their employment. There were two written references and a Criminal Record Bureau disclosure on three staff files looked at. Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. 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 home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 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, 39, 41 and 42 Quality for this outcome area is good. This judgement has been made using available evidence including a visit to the service. The health, safety and welfare of service users are promoted and protected. The home is well run and systems for monitoring the quality of care are in place, to ensure the home is run in the best interest of service users. EVIDENCE: The home receives a full service review from the provider Mencap every three years. A form is filled in every month identifying areas for improvement and action to ‘make support even better’. This is looked at by the Service Development Manager, who makes an unannounced visit every month. It is evident that service users’ views are obtained and form the basis of improvements identified. The minutes of house meetings were seen and service users spoken with confirmed that they feel listened to by staff. The accident book contained a record of accidents that have resulted in a medical practitioner being called on. These must be notified to the Commission, in accordance with Regulation 37 of the Care Home Regulations 2001. Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 Page 19 The fire log shows that all necessary fire safety testing and drills have been carried out. The servicing of equipment and electrical and gas systems are all up to date. As recommended at the last inspection there is now a central management record of all accidents and incidents that have occurred in the home and there is now a risk assessment in place for lone working in the community that identifies precise action to take in the event of an emergency situation. Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 Page 20 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. 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 4 2 4 3 X 4 X 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 4 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 X 3 X 3 X 2 3 X Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 Page 21 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 YA20 Regulation 15(2) Requirement Timescale for action 01/09/06 2. YA20 17 3. YA41 37 Develop a care plan for strategies for defusing situations, so that there is further guidance as to when it may become appropriate to administer as required behaviour modifying medication. Ensure that there is a record of 01/09/06 any incident that has resulted in behaviour modifying medication being administered. Ensure all notifications are made 01/09/06 to the Commission in accordance with this regulation. 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 YA20 YA20 Good Practice Recommendations Devise a risk assessment for the named resident for selfadministration of medication. In accordance with guidance, use the Medication Administration Record to carry over drugs from the previous cycle, for effective stock control. Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Woodhouse Road Care Home DS0000008769.V301276.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!