CARE HOMES FOR OLDER PEOPLE
Woodland Vale Woodland Vale Community Care Support Centre New Street Torrington Devon EX38 8DN Lead Inspector
Susan Taylor Unannounced Inspection 13th January 2006 14:50 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 Vale DS0000033150.V274160.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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 Vale DS0000033150.V274160.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Woodland Vale Address Woodland Vale Community Care Support Centre New Street Torrington Devon EX38 8DN 01805 622206 01805 622713 tstach@devon.gov.uk 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) Devon County Council Mrs Thea Stephanie Stach Care Home 23 Category(ies) of Dementia - over 65 years of age (23), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (23), Old age, not falling within any other category (23), Physical disability over 65 years of age (23) Woodland Vale DS0000033150.V274160.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 10th August 2005 Brief Description of the Service: Woodland Vale is a new purpose built home run by Devon County Council, which provides 24-hour care to older people, some of whom may have dementia. The home overlooks the River Torridge and is on the outskirts of Great Torrington. Outside there is a garden. There is level access into the main entrance of the home. There is ample car parking available. Internally, the home is on one level. It is divided into two separate units; each has its own lounge, dining area and conservatory. All bedrooms are ensuite with either a disabled access shower or assisted bath. All of the bedrooms are single. Three are large enough to accommodate couples or people wishing to share. Woodland Vale DS0000033150.V274160.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took four and half hours over one day. The purpose was to focus on key national minimum standards that had not been covered at the last inspection. These covered the sections on health & personal care, daily life and social activities, complaints and protection, staffing and management. The inspector looked at records, policies and procedures. Eight residents gave their views of the home to the inspector. Four staff also gave their views about the home to the inspector. The people living at Woodland Vale are referred to as ‘residents’ at the home. This term is used throughout the report. What the service does well:
Medicines are dealt with in a safe and professional way, ensuring that residents receive the right medication at the right time. The home provides varied and interesting activities to suit individual resident’s expectations, preferences and capacities. Few restrictions exist and residents have a great deal of freedom about their lives at Woodland Vale. The staff team ensure that residents maintain close links with families and friends. Meals are varied, appetising and provide residents with plenty of choice. Concerns are properly investigated, and the staff respect residents views about the service they receive. Policies, procedures and training are in place to ensure that staff recognise abuse and take steps to prevent it happening to residents. The team of staff at the home are stable, well qualified and experienced in caring for residents with dementia. Woodland Vale is a well run home, where resident’s needs are well met. Procedures are followed, which protect resident’s financial interests. The health and safety of residents, staff and visitors is promoted at Woodland Vale. Woodland Vale DS0000033150.V274160.R01.S.doc Version 5.1 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. Woodland Vale DS0000033150.V274160.R01.S.doc Version 5.1 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 Vale DS0000033150.V274160.R01.S.doc Version 5.1 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 the following standard(s): None EVIDENCE: Woodland Vale DS0000033150.V274160.R01.S.doc Version 5.1 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 the following standard(s): 9 Medicines are generally well managed by suitably qualified and experienced staff to provide the best outcomes for the residents. Consultation with the pharmacist and next of kin, for people with dementia, needs to be evidenced where changes are made to the mode of administration of the individual’s medication. EVIDENCE: The inspector observed that all medication is taken to the residents for administration to take place and it is recorded immediately after administration. Risk assessments were in place for all residents looking after any of their medicines and secure storage space are provided. In addition to this, all of the residents had a medication profile outlining concerns in respect of known allergies, sensitivities or side effects. Hand written entries made on the Medication Administration Record (MAR) charts had been signed and dated. Hand transcribed entries made on the MAR sheet were signed. A record of ordering of medicines and all receipts of medicines into the home had been recorded. Medicine requiring refrigeration was kept as per guidance. A resident told the inspector “we get tablets in the morning usually.” Controlled drugs were kept in secure storage facilities and a register kept as required.
Woodland Vale DS0000033150.V274160.R01.S.doc Version 5.1 Page 10 The inspector tracked the administration of medication for a resident with dementia. A written agreement had been obtained from the GP to allow staff to crush medication for that individual. However, there was no evidence that the pharmacist or the resident’s next of kin had been consulted about the matter and this is recommended. Woodland Vale DS0000033150.V274160.R01.S.doc Version 5.1 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 the following standard(s): 12,13,14,15 There are varied and interesting activities to suit individual resident’s expectations, preferences and capacities at Woodland Vale. Few restrictions exist and residents have a great deal of freedom about their lives there. Residents are encouraged to maintain close links with families and friends. Meals are varied, appetising and provide residents with plenty of choice. EVIDENCE: Staff and residents verified that the home had an activities organiser who is employed for 30 hours per week. The ‘Pool Activity level instrument’ had been used to assess individual capability to identify appropriate activities for each individual resident. Planned activities for the day were listed on prompt boards in both lounges. The inspector was shown receipts for aromatherapy sessions that had been run by a therapist every six weeks. A resident told the inspector that she had had her nails painted and had enjoyed having a hand massage. Minutes of resident’s meetings were seen, which demonstrated that activities had been discussed. A resident told the inspector “family visit occasionally”. The inspector read the signing in book, which demonstrated that friends and family of residents visit the home frequently.
Woodland Vale DS0000033150.V274160.R01.S.doc Version 5.1 Page 12 Residents described the food as being “lovely” and “very tasty”. The inspector observed the evening meal being served to residents seated at tables in groups of two or three. A four week menu was seen, and records of meals provided. Records demonstrated that alternatives had been offered at every meal. Woodland Vale DS0000033150.V274160.R01.S.doc Version 5.1 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 the following standard(s): 16,18 Residents are able to voice concerns about their care safe in the knowledge that their views will be respected and properly investigated. Policies, procedures and training to protect residents from abuse are evident at this home. EVIDENCE: Information about the complaint procedure was detailed in the ‘Resident’s handbook’. Records had been kept of complaints received, how they were investigated and what the outcomes were. No complaints had been received during the previous six months or at inspection. One service user said “there’s nothing I would change. It’s lovely here.” The staff verified that they would have no hesitation in discussing any issue of concern with their line manager, and had a clear understanding of the procedure. Training records verified all, except one of the staff had attended an Adult Protection course. The inspector was shown a letter confirming that the individual concerned had a place had been booked on the next course. Staff interviewed had a clear understanding of what constituted abusive practice and verified that they had seen the “No Secrets” video. Information for service users, and visitors about abuse and the reporting procedure was seen in strategic places such as the entrance hall. Interactions observed were responsive and caring to service users and visitors alike. Woodland Vale DS0000033150.V274160.R01.S.doc Version 5.1 Page 14 Woodland Vale DS0000033150.V274160.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None EVIDENCE: Woodland Vale DS0000033150.V274160.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 Woodland Vale has a competent and qualified team of staff that meet residents needs. The home is to be commended on exceeding the national minimum standards in this respect. EVIDENCE: Training records verified that 14 out of 20 care staff have achieved either an NVQ level 2 or 3 in care. In addition to this an assistant manager had completed the Registered Manager’s Award and NVQ level 4 in Management and Care. 75 of the staff have an NVQ award or equivalent in care, which is commendable and exceeds the current national minimum standard. Woodland Vale DS0000033150.V274160.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,35,38 Woodland Vale is a well run home, where resident’s needs are well met. Procedures are followed, which protect resident’s financial interests. The health and safety of residents, staff and visitors is promoted at Woodland Vale. EVIDENCE: Training records verified that the registered manager had attained the Registered Manager’s Award and NVQ level 4 in Care and Management. A suspense account is held known as ‘Woodland Vale residents account’. The inspector was shown records that demonstrated that a weekly reconciliation had been completed. Four residents had their own savings accounts, and records had been kept of these. The inspector was able to easily track transactions against balances, and found these to be correct. Woodland Vale DS0000033150.V274160.R01.S.doc Version 5.1 Page 18 Fire exits were unobstructed and clearly labelled. A fire risk assessment had been done and had been due to be reviewed since 2004. A member of staff told the inspector that they “regularly attend fire updates”. The fire alarm system had been checked regularly, and maintained by an external contractor. The health and safety poster was displayed in a prominent position. The home had comprehensive health and safety procedures in place. The inspector observed staff using a hoist for manual handling purposes in a safe manner. Cleaning schedules were seen, with accompanying records that demonstrated the schedule had been followed. COSHH risk assessments had been completed and staff verified that they had access to safety data sheets. The inspector saw that chemicals were stored in locked cupboards. Woodland Vale DS0000033150.V274160.R01.S.doc Version 5.1 Page 19 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 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 x x x x x x x x STAFFING Standard No Score 27 x 28 4 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x 3 x x 3 Woodland Vale DS0000033150.V274160.R01.S.doc Version 5.1 Page 20 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. Standard Regulation Requirement Timescale for action 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 OP9 Good Practice Recommendations Where a resident is unable to swallow medicines in the normal manner, the pharmacist and their next of kin (for individuals with cognitive impairments) should also be consulted about proposals to crush medication. A written record of this should be documented. Ensure that the fire risk assessment for the home is reviewed as planned. 2 OP38 Woodland Vale DS0000033150.V274160.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Woodland Vale DS0000033150.V274160.R01.S.doc Version 5.1 Page 22 - 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!
