CARE HOMES FOR OLDER PEOPLE
Woodland Care Home 189 Woodland Road Hellesdon Norwich NR6 5RQ Lead Inspector
Susan Golphin Unannounced 28 April 2005 09:30 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 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. Woodland Care Home I55 s44375 Woodland v220962 (un) 210405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION
Name of service Woodland Care Home Address 189 Woodland Road Hellesdon Norwich Norfolk NR6 5RQ 01603 787821 01603 403874 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Alphacare Services (UK) Ltd Mrs Jane Bunyan Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (46) of places Woodland Care Home I55 s44375 Woodland v220962 (un) 210405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Forty-six (46) older people may be accommodated. Date of last inspection 30 September 2004 Brief Description of the Service: Woodland Nursing Home is situated in the residential area of Hellesdon. Purpose built in 1990 the accommodation is on the ground and first floors comprising of eighteen single rooms with en-suite facilities a further four single rooms with en-suite bathrooms, and 12 double rooms. There are five communal lounges, which are within easy access of service users own rooms. The home also offers a range of adaptations and aids to promote mobility and independence. The grounds are accessible by wheelchair users and there are car parking facilities to the front and side of the premises. Woodland Care Home I55 s44375 Woodland v220962 (un) 210405 Stage 4.doc Version 1.20 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and not all the standards were inspected on this occasion. The inspection took place between 9.30am and 2.30pm. A brief tour of the premises was undertaken by the inspector whilst in contact with staff, visitors and service users. During the brief tour the service users rooms seen were appropriately furnished and equipped to meet individual need and well maintained. The inspection was carried out with Mr John Palgrave the Clinical Nurse Manager. At the previous inspection carried out in September 2004 seven requirements were issued and part of this inspection was used to review the progress of the homes’ own action plan to meet the requirements within the given timescale. During the visit the inspector spoke to two members of staff, four service users and one visitor. Care plans and administrative documentation relevant to this inspection were also seen during the visit. What the service does well: What has improved since the last inspection?
Since the last inspection the management and staff have made notable progress in meeting the requirements and achieving compliance. Two additional staff have commenced NVQ 2 training and additional NVQ training places are being sought New special equipment has been purchased and installed recently and includes pressure relieving mattresses and adjustable beds. The consumer questionnaire for the home was distributed in February 2005 and to date there have been 17 replies (out of 43) and the initial outcome about the service provision is a positive and complimentary one.
Woodland Care Home I55 s44375 Woodland v220962 (un) 210405 Stage 4.doc Version 1.20 Page 6 There is a dedicated member of staff responsible for and providing diversional therapy and social activities for the service users, and involves promoting individual and personal interests as well as group activities. Service users said how much they are enjoying both the individual activities as well as the group sessions that are now regularly taking place. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Woodland Care Home I55 s44375 Woodland v220962 (un) 210405 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Woodland Care Home I55 s44375 Woodland v220962 (un) 210405 Stage 4.doc Version 1.20 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3 The home have a statement of purpose and service users guide which is issued to all prospective service users and their representatives. The information is up to date and enables prospective service users to make an informed choice about living in the home. There is clear assessment process in place which gives a good account of each service users health care needs and how they can be met by the home. EVIDENCE: Copies of the information are accessible by staff service users and their representatives. The information is updated regularly and also includes the outcome of the annual survey carried out with service users and relatives. Three service users assessment of need and individual healthcare arrangements were seen during the inspection, the information is detailed and clear. Staff can access the information at any time. The trained nursing staff maintain and monitor the clinical care records and audit special care input Woodland Care Home I55 s44375 Woodland v220962 (un) 210405 Stage 4.doc Version 1.20 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10 The care planning process is in place and provides staff with appropriate information to meet service users healthcare needs. Specialist needs are met by the clinical nursing staff with the support of other healthcare professionals Individual care and support in this home is offered in a respectful and dignified way, and actively promotes privacy and independence. EVIDENCE: Three service users care plans were seen on the day of the inspection all three service users were aware of the agreed arrangements in place but could no longer recall the details. Reviews are held on a regular basis and service users or and their representatives are invited to be involved in the process. \there is evidence in the records to demonstrate consultation with service users and their relatives or representatives. During the discussions service users gave examples of good care practice respectful approach to situations and personal kindnesses shown by staff . One service user said how much they benefited from one to one ‘chats’ with the staff and whilst appreciating their work commitments each day would ideally like more personal social time with key staff.
Woodland Care Home I55 s44375 Woodland v220962 (un) 210405 Stage 4.doc Version 1.20 Page 10 One visitor commented very favourably on the service offered to his father, and has felt supported throughout by the management and staff Woodland Care Home I55 s44375 Woodland v220962 (un) 210405 Stage 4.doc Version 1.20 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,15 The arrangements for meeting the social and recreational needs of the service users is in place and promotes both individual interest and group activities on a daily basis. The meal arrangements in place offer a a good range of choices with specialist meals and dishes to meet identified dietary needs . EVIDENCE: Susie Mennie is the appointed diversional / activities organiser for the home and is developing both individual and group activities for the service users. A diary of all the daily activities is being kept to record service users views and responses to the recreational and social can be used to decide on each weekly programme, and also to build up trust and confidence with the service users. Some of the activities are taking place in the privacy of service users own rooms and range from musical interests, card playing, chatting and walking, reading and painting. In addition there are also the standard group activities which are also popular. Services users were seen engaging enthusiastically in the range of activities and responded very positively about having a dedicated member of staff to promote all the social interests and activities. This improvement in recreational and social activities in the home is commendable.
Woodland Care Home I55 s44375 Woodland v220962 (un) 210405 Stage 4.doc Version 1.20 Page 12 Service users commented favourably about the choice of meals and the standard of service. One service user said that irrespective of the planned menu he has been offered a choice of alternative dishes and favourite meals especially when feeling unwell or poor appetite. The inspector was able to discuss with the cook the range of meals and choices available to service users and also special dishes prepared for those with identified dietary needs or special requests. The meals served on the day of the inspection looked appetising and well prepared. Woodland Care Home I55 s44375 Woodland v220962 (un) 210405 Stage 4.doc Version 1.20 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 There is a satisfactory complaints process in place in the home, with evidence to support any complaints made by service users and their representatives are listened to and acted on The arrangements for the protection of vulnerable adults is in place and there is evidence to show that staff knowledge and understanding of adult protection issues is growing. EVIDENCE: There have been no formal complaints about the home or its management in the last year. Complaints or concerns brought to the management by service users, relatives and staff are documented and addressed directly and action taken as may be necessary. A complaints file is maintained and audited by the senior staff / management each month . Woodland Care Home I55 s44375 Woodland v220962 (un) 210405 Stage 4.doc Version 1.20 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 The overall standard of the premises is good and provides a homely and attractive environment for service users. EVIDENCE: This standard was not inspected in any detail other than observations made during the short tour of the premises and whilst talking to service users and visitors. The home caters for service users who have a range of nursing needs . On the day of the unannounced inspection the home was clean and well maintained with a good arrangement in place for dealing with individual continence needs and linens. Staff were observed routinely monitoring service users confined to bed and their rooms checked by domestic support staff to ensure good levels of maintenance and hygiene. Woodland Care Home I55 s44375 Woodland v220962 (un) 210405 Stage 4.doc Version 1.20 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28 Progress has been made in promoting the stability and skill mix and training of the staff group to maintain the consistency of care in the home. EVIDENCE: There has been a minor turnover of staff in the last six months, and staff have been recruited recently. The staffing rota reflected the numbers of staff on duty and the minimum standards to meet service users needs. The manager is reviewing the staffing levels at crucial times of the day and when demand for personal attention is at its highest to monitor practice and routines to ensure that any delay in responding to service users is minimised. This review will also look at the unpredictable demands of the transitional bed unit and how the resource can meet short term needs of service users without detracting from the long term care needs of service users. Two further staff are undertaking NVQ 2 training and further places are being sought for this year . One member of staff is currently training to be an NVQ assessor.( see requirements) Woodland Care Home I55 s44375 Woodland v220962 (un) 210405 Stage 4.doc Version 1.20 Page 16 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32 The manager has a good development plan for the home and offers clear direction and leadership. There is an open style of management which promotes good communication systems and a clear understanding of roles and responsibilities. EVIDENCE: Staff and service users were complimentary about the management of the home and gave good examples of staff in put and response to concerns or personal issues. The clinical nurse manager confirmed that the promotion of team work and creating a stable working environment within the nursing and care group is developing . Staff meetings and supervision are also beginning to contribute proactively to the growing stability and professional development of the staff. Woodland Care Home I55 s44375 Woodland v220962 (un) 210405 Stage 4.doc Version 1.20 Page 17 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. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3
COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 2 28 2 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x x x x x Woodland Care Home I55 s44375 Woodland v220962 (un) 210405 Stage 4.doc Version 1.20 Page 18 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 27 Regulation 18 Requirement The providers and management must continue and complete the review of staffing levels at crucial times of the day to meet service users needs with the minimum of delay. The review must also incorporate the levels of support in the transitional bed unit to meet short term needs. The providers must continue to promote NVQ and relevant training opportunities for all staff. Timescale for action September 1st 2005 2. 28 19 ongoing 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. Refer to Standard none Good Practice Recommendations Woodland Care Home I55 s44375 Woodland v220962 (un) 210405 Stage 4.doc Version 1.20 Page 19 Commission for Social Care Inspection 3rd Floor - Cavell House St Crispins House Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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