Inspection on 07/06/07 for Woodland House Nursing Home

This inspection was carried out on 7th June 2007.

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 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

Woodland House Nursing Home 17/08/09

Woodland House Nursing Home 17/09/08

Woodland House Nursing Home 12/11/07

Woodland House Nursing Home 20/07/06

Woodland House Nursing Home 11/10/05

Woodland House Nursing Home 19/04/05

Woodland House Nursing Home 17/11/04

Woodland House Nursing Home 21/09/04

Woodland House Nursing Home 11/08/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Woodland House Nursing Home Middle Warberry Road Torquay Devon TQ1 1RN Lead Inspector Rachel Proctor Unannounced Inspection 7th June 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 Woodland House Nursing Home DS0000028763.V337420.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. Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodland House Nursing Home Address Middle Warberry Road Torquay Devon TQ1 1RN 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) 01803 296809 01803 380144 Woodland Healthcare Ltd Vacancy Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (30), Old age, not falling within any other category (3), Physical disability over 65 years of age (3) Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Registered for a maximum of 30 DE(E) Registered for a maximum of 3 OP Registered for a maximum of 30 MD(E) Registered for a maximum of 3 PD(E) Date of last inspection 20th July 2006 Brief Description of the Service: Woodland House is a nursing home that provides care to people who suffer from mental health problems, mainly elderly people with dementia. It is located in the suburb of Wellswood, which is approximately one mile from the town centre of Torquay. The home has eighteen (18) single rooms and six (6) shared rooms spread between three floors that are accessible by two shaft lifts. The lower ground floor is actually a modern extension to the main home. There are two lounges (one on the ground floor and one on the lower ground floor) and a medium sized dining room on the ground floor. The Statement of Purpose is available in the entrance hallway of the home. Fees from £467 -£575 dependant on care needs. Chiropody, hairdressing and daily papers extra. Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection, the site visit took place on 7th June 2007. Four of the people living at the home had their care followed. Their care planning records, medication records and their personal rooms were viewed. Some records relating to the management of the home were viewed. A tour of the home was completed. People who live at the home, visiting relatives and staff were spoken to during the visit. Some of the comments made in comment cards and comments made on the day have been incorporated into this inspection report. What the service does well: What has improved since the last inspection? What they could do better: Although the people who live at Woodland House have clear risk assessments relating to their risk of pressure sore development. These do not appear to have been followed through in one case and the appropriated pressure relief mattress provided. By staff not acting on an identified risk of pressure sore development people will not be protected from pressure sore development. People living at Woodland House do not appear to have many opportunities for stimulation through leisure and recreational activities that have regard for their care needs and abilities. Staff on duty were responding to those people with Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 6 behaviour that challenged and the one to one support and activities the manager had said take place in the afternoons did not appear to be involving those people sitting quietly in the lounge or the people who were in their own rooms. People living at Woodland House do not always have the support they need to eat their meals and maintain their nutritional intake. The times meals are given for people who require assistance to eat did not appear to be evenly spaced though out the day to meet individual people’s care needs. The numbers of staff provided for each shift does not appear to be meeting all the care needs of the people living at Woodland House. Basic care needs are being met, however the number of staff provided does not appear to give staff time to spend with individual people to enhance their experience of care. The evidence to support that the home manager has a safe recruitment practice that will protect people from unsuitable staff is incomplete. With out clear recruitment information for staff employed the people who live at Woodland House may not be protected from unsuitable staff. 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. The summary of this inspection report can be made available in other formats on request. Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good, 3,6 This judgement has been made using available evidence including a visit to this service. The people living at Woodland House have their care needs assessed by a staff team who understand them and have their best interests at heart. The home does not provide intermediate care. EVIDENCE: Four people who live at Woodland House had their care followed as part of this inspection. The home staff had completed an assessment of care for these people and where a social service assessment of care needs had been completed copies of these were available with that persons care plan. Pre admission assessment had also been completed for new people admitted since the last inspection. The manager had signed the pre admission assessments seen. The manager confirmed that a registered nurse accompanies her to all pre admission assessments. Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 9 The four assessments viewed included risk assessments for manual handling, pressure sore risk, risk of falls and nutritional risk. The manager advised that the registered nurses review the assessments and a care plan is developed from their assessment of need. Since the last inspection the manager has introduced computer generated care plans, which are up dated monthly with changes the registered nurses have made. These were seen during the inspection. One of the carers advised that she had been asked to complete social care plans/life story for the people at the home. An example of this was seen in one of the care plan of a person whose care was followed. They advised that they had recently agreed the role and had not had the opportunity to complete them for all the people living at the home as yet. The manager confirmed that social care plans/life story for people were in the process of being completed. Social care plans had not been provided for all the people whose care was followed at this inspection. Each of the four people whose care was followed had a plan of care developed from their assessment of need. The registered nurse advised that they worked with the manager to get these completed using hand written care plans to transfer them to the computer. Two relatives spoken to during the inspection advised that the staff were caring and friendly and appeared skilled in the care of the people living at the home. Both said that staff made them feel welcome and were kept informed about their relatives care. Two relatives who contacted the Commission prior to the inspection also made the same comments. Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 10 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): Quality in this outcome area is adequate 7,8,9,10 This judgement has been made using available evidence including a visit to this service. Lack of attention to detail in the planning of individuals care may mean they do not have all their care needs met by the staff caring for them. By not providing pressure relief equipment for people assessed as at high risk staff are putting people at risk of developing pressure sores. EVIDENCE: The four people whose care was followed had a plan of care in place to address their assessed need. All had been reviewed monthly or sooner if their care needs had changed. One person who had challenging behaviour had a plan of care in place, which guided staff how to manage this. Staff observed caring for this person were skilful in their care for this individual. They were able to change conversation to something the person was interested in away from something that was causing them distress with ease. Another person whose care was followed who had challenging behaviour was being managed by giving them quite space. The care plan for this person did not fully deal with Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 11 the management of their challenging behaviour and how staff should work to reduce the risk. The manager advised that they had found the person was less distressed if they were in a quite environment. She also confirmed that she was in the process of reviewing this person’s plan of care with the registered nurse. The involvement of health professional in the care of the people living at Woodland House was clearly recorded in their plan of care for those whose care was followed. The registered nurse advised they regularly contacted the community psychiatric nurses for advice and support regarding the care of the people living at Woodland house. The four people whose care was followed had risk assessments in place regarding pressure sore risk. Where a risk had been identified a plan of care had been put in place. One person whose care was followed had been identified at very high risk of pressure sore development. However this person did not have the pressure-relieving mattress on their bed. The registered nurse on duty advised that this person was easily able to alter position in bed. They were unable to state clearly why the person had not been provided with a pressure relief mattress. Continence assessments had been completed for those people whose care was followed. These guided staff regarding the actions they should take to promote continents for the individual. During the inspection staff were assisting people and prompting them to go to the toilet in a discreet supportive way. The manager advised that where possible staff established a pattern of toileting for individuals to reduce the risk of incontinence without the use of pads. Those people identified as at risk of falls had an assessment in place in the care plan to address identified risk. The manager confirmed that she regularly reviews the accidents records to look for trends. And where possible changes are made to reduce the risk. The medication practices and systems within the home were reviewed with the registered nurse. The storage system for medication was secure. A separate controlled drug storage area was kept. The controlled drug record was checked against stock for one person as correct. A record of drug disposal was being kept, which two members of staff had signed. The nurse in charge advised that one of the registered nurses in the home took responsibility for the medication stock control, ordering and returns for the people living at the home. All the medication being kept was within date and prescribed for people living at the home. The nurse in charge advised that medication for a person who had died a few days earlier was being kept for the seven days recommended in the Standards. Reference material for medication was available for staff in the treatment room of the home. Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 12 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): Quality in this outcome area is poor 12,13,14,15 This judgement has been made using available evidence including a visit to this service. The staff time appears to be taken up with the people who had behaviours that challenge. This means that other people may be denied the opportunity to have one-one support from staff. The number of booked and planned activities has reduced since the last inspection. This may mean that people have less opportunity to experience the social stimulation planned activities provide. The number of staff available over meal times does not allow the people living at Woodland House to have the assistance they need with meals at a time that suits their needs. This may mean that although the meals are of good quality, people do not get the nutritional intake they need to maintain their health. EVIDENCE: Since the last inspection the weekly activities provided by an external activities group have stopped. There were activities organised on a two weekly basis from different types of entertainment including a singer and a man who brings animals to the home. The manager confirmed that she is exploring different options including more outings. She advised that staff provide one to one Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 13 support for individual people in the afternoon. However speaking to staff it became clear that they were finding it difficult to cope with the high dependence people who needed more support to prevent falls and manage challenging behaviour. Observation during the afternoon and staff interaction with the people in lounge showed that the staff were reacting to a small number of people who needed attention to reduce the risk of injury. Others in the lounge were sitting with very little interaction from staff. On the day of inspection no music was being placed and no activities had been organised. The lounge was very hot despite two fans being used. Four of the people in the lounge appeared agitated; staff suggested that this was because of the heat in the lounge. A staff member advised that they were unable to take people into the garden where it was cooler because a fencing panel was broken and this posed a risk. The provider advised that there had been a problem obtaining fencing panels but hoped to have one soon. None of the current people living at Woodland House are able to manage their own financial affairs. The manager advised that the person’s relative or advocate manages their finances and the home does not manage money for any of the people living there. She further commented that fees and items bought on behalf of the person are processed through a billing system. This system used a computer database. Individual rooms entered during the inspection had been personalised with items of that person’s choice. Visitors were coming and going through out the inspection. Those spoken to said staff always made them feel welcome. Meal times appeared to be when the staff were able to assist the people to eat. Breakfast on the day of the inspection was still being served at 11.30 am. The staff spoken to advised that because all of the people living at the home needed assistance to get up and dressed it made it difficult to get every one up with the number of staff available. At the lunchtime meal one person who had their breakfast at 11.30 was having their lunch fed to them at 12.30. This did not allow sufficient time between their meals. Three staff were feeding three people in the dining room at lunchtime. A further three people who required promoting to eat had their meals put in front of them before staff were available to prompt them. This meant that hot meals were cooling before people could be assisted to eat them. The registered nurse said that because 6 of the people required assistance to eat and a further 14 required prompting this sometimes caused a delay in staff getting to them. These figures were also provided with the pre-inspection information completed by the manager. The manager advised that the lunchtime had been split into two sittings to accommodate this. The meals were attractively presented and nutritionally balanced. Menus showed that the people had a varied diet, which included fresh vegetables and meat. The housekeeper had completed training in relation to better food safer business. Nutritional screening for individuals included a monthly record of their weight. Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good, 16,18 This judgement has been made using available evidence including a visit to this service. The people who live at Woodland House can have confidence that any concerns they have will be dealt with sensitively by the staff team. EVIDENCE: The Commission has received three concerns/complaints relating to staffing levels in the home since the last inspection (see ‘staffing’). A further complaint had been received regarding the loss of a personal item. The manager confirmed that complaints continue to be dealt with as they occur; records of concerns raised and action taken to address these were available for inspection. Relatives spoken to during the inspection said staff listen to them and dealt with any concerns they had sensitively. The complaints policy was easily available in the reception area of the home. Policies and procedures relating to adult protection were available for staff. The adult protection-training package in use at the last inspection has continued. Since the last inspection the manager has completed a dementiatraining course. The manager advised that the organisation had appointed a training manager who would be overseeing the training needs and training provision for the group. Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good, 19,26 This judgement has been made using available evidence including a visit to this service. The improvement to the environment has continued to ensure that people live in a clean pleasant environment that is free from odour. EVIDENCE: The home has a large communal lounge and separate dining room both of which are being used by people living at home and their relatives during the inspection. Two fans had been provided in the lounge area. However the lounge still became hot during the afternoon of the inspection. There is a garden area available for the people who live at Woodland house. However on the day of the inspection the garden area could not be used as fencing panel had broken. Staff advised that they felt this could be a risk. The provider advised that they hoped to have a replacement-fencing panel very soon. Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 16 The areas people who live at home have access to have continued to be refreshed and redecorated since the last inspection. New furniture and vanity units have been provided in some individual peoples rooms. The manager advised that she was still awaiting a replacement carpet for the lounge and corridor in the home, which had faded. The shared rooms in use had screening provided. People had separate wardrobes and dressers for their personal clothing. Toiletries for individuals had been stored in separate areas in one shared room viewed. People who live at Woodland house have access to toilets, which are within easy reach of the lounge, dining room and their individual accommodation. Several of the individual rooms provided at Woodland house have en suite facilities. Peoples rooms entered during the inspection had been personalised with items of their choice. These included photographs, ornaments and small items of furniture. The home was clean and fresh in all areas during the inspection. Two housekeeping staff were working in the home during the inspection. One advised that they like to keep the home clean and fresh for the people living there. Although they did comment that they were finding it harder since the occupancy levels have increased. The staff had access to gloves and aprons for use when attending to personal care for individual people. Staff were observed using these when attending to personal care for individual people during the inspection. A Waste Disposal Company disposes of clinical waste for the home. The manager advised that training provided for staff included infection control. Infection control policies and procedures were available staff. The laundry area was situated away from the areas where food is prepared. A disinfecting sluice was provided for cleaning of commode pots. Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 17 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 poor 27,28,29,30 This judgement has been made using available evidence including a visit to this service. The staff are friendly, supportive and skilled in the care of individual people living at Woodland house. However the number of staff provided to care for the number of high dependency people living at Woodland house means that individuals may not always receive the care they need. Although the home has a clear recruitment policy in place, this had not been thoroughly followed, so people may not be protected from unsuitable staff. EVIDENCE: In addition to the registered nurses and health care assistants the home employs a team for housekeepers and a maintenance man. Three staff spoken to during the inspection and said they felt the number of staff on duty did not always enable them to provide quality care for the people who live at Woodland house. One commented that it was difficult to get everyone up washed and dressed for breakfast. The preinspection information indicated that 14 of the people living at Woodland house required the assistance of two with personal care. This information also indicated that the remaining residents required the assistance of one. At the time of this inspection 25 people were living at Woodland house. Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 18 A duty rota lists the number of staff on duty and in what capacity they are employed. This showed that a registered nurse was provided for each shift over a 24-hour period seven days a week. Healthcare Assistants support the registered nurses. The duty rota confirmed that more staff are available for the morning shift. However although 14 people required assistance or prompting to eat their meals only three staff were recorded on duty at the time of the evening meal each day. Staff reported that they found it difficult to ensure that all the people living at home had assistance with their evening meal when they needed it. Other comments from staff included Little things are being missed, no time for one-to-one with individuals. Two of the staff spoken to comment that they were concerned they were not able to provide the “quality care” they would like to for the people at Woodland house with the number of staff available. The manager advised that one of the senior Healthcare Assistants would be taking on the role of support worker. This would enable them to develop life plans for individual people, which would enable little things that are important to them to be recorded. The staff member taking on the role advised that they were looking forward to completing life plans for individuals living at the home. An example of one already completed was shown. This provided information on the things that were important to that particular person and what activities enjoyed. The inspection indicated that seven staff employed had achieved an NVQ (National Vocational Qualification) level 2 or above. Although the information did not indicate if registered nurses were included in this figure. The information also indicated that four staff were working towards their NVQ 2. The home has a robust recruitment policy and procedure, which is based on equal opportunities and ensuring the protection of people. However three staff files viewed during the inspection did not contain all the information required for staff working at the home. One of these had not had any references returned before starting work. Another person did not have evidence that their professional qualification had been checked against the register. All three staff files viewed had a police checks completed and returned. The manager advised that the organisation had appointed a training manager. She further commented that the training manager would be coordinating the training for the home. A training matrix provided for the staff working in the home shows the training staff had received. The manager advised that the training staff require would be identified through their training and development plans once these had been completed. Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is adequate. 31,33,35,38 This judgement has been made using available evidence including a visit to this service. By not ensuring the deployment and/or numbers of staff provided are able to meet the needs of the individual people living at Woodland House, the manager may be putting the welfare of the people and staff at the home at risk. EVIDENCE: Since the last inspection the manager has been approved as a registered manager for Woodland house nursing home. The manager confirmed that she is in the process of completing the registered managers award. A clinical lead has been appointed to support the registered manager. The clinical lead is a first level registered nurse; they take responsibility for peoples health care needs. Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 20 Relatives spoken to during the inspection said the manager was approachable and they felt able to speak to the staff about any concerns they had about their relative. From the information provided the relatives had not had a meeting at the home since the appointment of the manager and the clinical lead. Two relatives spoken to and a comment card received indicated that they would like to have more meetings at the home. A quality monitoring system was in place at the home, which seeks the views of people who live there and their supporters. However the results had not been provided for the Commission at the time of this inspection. The manager advised that she intended to share the information about the quality audit at relatives meetings. However the manager advised that a relatives meeting had not taken place since November 2006. The Commission has been provided with regular reports from the providers about the services and facilities in the home (Regulation 26). The requirements made at the last inspection have been met. The manager advised that she was working towards addressing the recommendations made at the last inspection and some of these had been completed. The manager explained how personal finances are organised for individual people. The computer system used for accounts was viewed. This itemised the purchases made on behalf of people living at the home and their accommodation fee. The manager advised that separate records were provided for each person on the computer database in relation to their finances. In addition to this money held on behalf of people living at the home was stored individually in a locked cupboard. Receipts of expenditure were also available. The manager advised that none of the current people living at Woodland house could manage their own money. She further commented that families are encouraged to do this on behalf of the person where possible. A selection of records kept in a home were viewed during the inspection. Each person whose care was followed had a plan of care that had been reviewed and updated regularly. The manager advised that she was in the process of providing computer-generated care plans for each of the people living at Woodland house. She commented that she felt that these would be easier to read and give a clearer picture of the care needs of the individual. The duty rota provided indicated that the home employs four registered nurses and a further four bank of registered nurses regularly at the home. This has increased since the last inspection. Policies and procedures are available for staff in the office. The Commission is kept informed of incidents and accidents in the home that adversely affect the people living there. Accident records were seen with the care planning information for those people whose care was followed. These are completed in line with good practice. The manager confirmed that she regularly reviews of Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 21 records of accidents to see if any action needs to be taken to address the identified risks. Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 22 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 23 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 OP8 Regulation 12(1)(a)( b) Requirement Timescale for action 01/09/07 2 OP12 16(m)(n) 3 OP15 16(i) You must ensure that the people who live at Woodland House are protected from pressure sore development by seeking professional advice regarding the most effective type of pressure relieving equipment required. People living at Woodland House 01/10/07 must be provided with opportunities for stimulation through leisure and recreational activities that have regard for their care needs and abilities People living at Woodland House 01/08/07 must have the support they need to eat their meals and maintain their nutritional intake. The times meals are given for people who require assistance to eat must meet individual people’s care needs. 4 OP27 18(1)(a) The numbers of staff provided for each shift must be sufficient to meet the care needs and dependency of the people living at Woodland House. 01/08/07 Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 24 5 OP29 19(4)(i) Schedule 2 Staff records kept must evidence that all necessary preemployment checks are carried out prior to their employment starting. 01/10/07 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. Refer to Standard OP3 OP7 OP8 Good Practice Recommendations Social care assessments should be followed with a plan of care to address the persons social care needs People’s plans of care should include a social care plan. A clear plan of care, which identifies how therapeutic interventions for challenging behaviour are managed, should be provided for all the people who have challenging behaviour. People should be given the opportunity to maximise their personal choices. Results of quality audits should be made available to the Commission, the people who live at Woodland House and their representatives. The manager should ensure that the way staff are deployed and/or the number of staff provided each shift protects the welfare of the people living at Woodland House. 4. 5. OP14 OP33 6 OP38 Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton 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. Extracts may not be used or reproduced without the express permission of CSCI Woodland House Nursing Home DS0000028763.V337420.R01.S.doc Version 5.2 Page 26 - 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. 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