Inspection on 12/10/05 for Woodland View

This inspection was carried out on 12th October 2005.

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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Woodland View 11/12/06

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

CARE HOME ADULTS 18-65 Woodland View Cherry Knowle Hospital Ryhope Sunderland SR2 0NB Lead Inspector Sharon McDowell Announced Inspection 12th October 2005 10:00 Woodland View DS0000063668.V251713.R01.S.doc Version 5.0 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 View DS0000063668.V251713.R01.S.doc Version 5.0 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. Woodland View DS0000063668.V251713.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Woodland View Address Cherry Knowle Hospital Ryhope Sunderland SR2 0NB 0191 5214497 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) South of Tyne & Wearside Mental Health NHS Trust Helen Patricia Crisp Care Home 6 Category(ies) of Learning disability (4), Physical disability (4), registration, with number Sensory impairment (1) of places Woodland View DS0000063668.V251713.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection New registration Brief Description of the Service: Woodland View is a six bed roomed purpose built bungalow providing personal care for young adults with learning disabilities. The Home does not provide nursing care. The Home is on the outskirts of Ryhope, set in it’s own spacious and private area with a security gate at the entrance, operated by staff in the Home. It has ample car parking and is surrounded by landscaped gardens and has a patio area to the rear of the property. The Home provides it’s own minibus for access to local community services, as the Home is not situated near amenities. Woodland View DS0000063668.V251713.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was conducted as part of the annual inspection programme and was the first inspection following initial registration of the Home earlier this year. During the inspection five residents were present, three relatives, an advocate for the residents and five care staff including the Registered Manager. A number of documents were reviewed including, one residents care plan, staff training and personnel records. Lunch was taken with the residents and staff. One relative sent a comment card to the Commission for Social Care Inspection and the advocate assisted one resident to complete a comment card and wrote comments herself on behalf of the other residents about their views of the care and services in the Home. What the service does well: What has improved since the last inspection? Not applicable as this is the first inspection following registration of the Home. Woodland View DS0000063668.V251713.R01.S.doc Version 5.0 Page 6 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 View DS0000063668.V251713.R01.S.doc Version 5.0 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 Woodland View DS0000063668.V251713.R01.S.doc Version 5.0 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): 2, 3 Assessment information is available in sufficient detail for staff to be able to make a decision as to whether the Home will meet the needs of the prospective resident and that their aspirations will be assessed. EVIDENCE: Detailed assessments are available in residents care plans that were provided as part of the resettlement process for the residents when they came to move to the Home. Some discussion took place about a sixth potential resident who was significantly older than the residents and falls within the older persons age category. The Registered Manager and advocate were reminded the service, which was only opened this year was a scheme for younger adults and that the overall purpose of the Home was to cater for this group of people. Woodland View DS0000063668.V251713.R01.S.doc Version 5.0 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 Residents care plans clearly set out how the needs of the residents will be met and residents can be assured they will be included in making decisions about their lives. EVIDENCE: The Home operates a care package including person centred care planning, which is a way to ensure the residents views are included in how they want to be cared for and to look at what they would like to achieve in the present and future. One resident had a large pictorial plan on their bedroom wall, which he helped explain with the help of their advocate. Some of the things they would like to achieve included holidays contact with family members and various activities. Since they moved into the Home they had been helped to achieve twentythree out of thirty identified aspirations. To assist residents in making their needs known, to make choices and with communication, each resident has an advocate who is independent of the employing organisation. The advocate said that residents were able to make Woodland View DS0000063668.V251713.R01.S.doc Version 5.0 Page 10 choices including activities, colours in their bedrooms, shopping, food and looking after the Home, such as the garden. Residents meetings are held to help them be involved in decisions about the Home. Minutes are available to show what issues were discussed. At one meeting different types of music was discussed and it was agreed that staff would bring in various CDs to allow residents to hear the music and to tell staff what they preferred. Woodland View DS0000063668.V251713.R01.S.doc Version 5.0 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): 11,12,13,14,15,16,17 Residents are assisted to lead active and fulfilling lifestyles and have the opportunity for personal development through the care planning process. Visitors are welcome to the Home therefore residents can be assured they can maintain contact with friends and family. Resident’s rights are respected and routines in the Home are flexible, allowing residents to participate in daily routines, which promote their right to make choices and express their preferences. A range of meals is available for residents to choose from, which contribute to their health and well-being. EVIDENCE: Since the residents moved into the Home a number of positive opportunities have been made available to them that they did not have in their lives previously. They are now assisted to use community facilities and have enjoyed a number of trips out to local areas. They use local shops, leisure services and have visited local attractions, such as the Winter Gardens in Sunderland and Preston Park in Teeside. Each resident has an activity planner, Woodland View DS0000063668.V251713.R01.S.doc Version 5.0 Page 12 which directs staff as to what the resident will be doing through the week. A file is available with information about local activities for staff to discuss with residents. Relatives and visitors are welcome to the Home. Staff said that a benefit for the residents moving in to the area is that they are closer to their relatives and now are able to have more frequent contact with them. One parent said they had ‘never seen their son so happy’. Staff treated residents in a respectful manner, consulting them about what they wanted and what was happening in the Home. The advocate confirmed the residents are encouraged to play an active role in the Home, that staff uphold the resident’s dignity and privacy and that she thought they were happy in the home and with the staff. A two-week menu is available with a range of meals being provided. However it does not illustrate a large choice of food and is currently in written format only, which residents would not be able to make choices from without assistance. The Registered Manager explained residents could have a choice of meals, which is not indicated on the menu. Some residents have a soft diet due to their difficulties with swallowing food but they are helped to have the same food as all other residents as staff liquidise their meals for them. As it is difficult for some of the residents to choose from the menu staff will give the resident the meal that has been prepared but if they indicate they do not like it an alternative will be made. The dietician visited the Home during the inspection to weigh the residents, to monitor their dietary needs and to offer support to staff. Woodland View DS0000063668.V251713.R01.S.doc Version 5.0 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): 19,20 Generally residents can be assured their health and well-being is promoted. However on occasion this can be neglected and result in discomfort for the resident. Measures are in place for the safe handling of medicines to ensure residents receive their prescribed medication. EVIDENCE: The Registered Manager explained that staff are in the process of developing a more social care model for the care plans. However currently there are a good range of assessment documents to help staff get to know the residents and to be able to plan their care involving the resident, these include likes and dislikes information about food, risk assessments for pressure areas and continence and detailed reports from professionals, such as, speech and language therapy, physiotherapy, and occupational therapy, which give staff recommendations for care. The residents have been able to see a number of professionals for health checks since moving to the Home, including dentists, dieticians and doctors and there are arrangements for them to access other services, such as opticians and speech and language therapists. Woodland View DS0000063668.V251713.R01.S.doc Version 5.0 Page 14 One resident had a large number of ‘cold sores’ around their mouth, which they were not having any treatment for. An appointment had been made at the doctors but this was not until nine days after they had been noted. The resident would have experienced some discomfort and a simple treatment is available for this condition. It was also noted in this residents care plan that they had a raised temperature, with a specific temperature recorded, which was raised. An entry stated they had been given ‘paracetamol’ and were to be reviewed two days later but there is no information about a review of their health. One day after the temperature was recorded another entry stated they has their temperature assessed by touch and the staff view was that the resident did not have a temperature. This is not an accurate way to measure temperature and could lead to wrong decisions being made about a resident’s health. Medication is stored in a locked cupboard with keys being held by the personin-charge. All staff who give out medication except registered nurses have completed a safe handling of medicines course so that they are aware of the correct procedures and can give out medication safely. A photo of the resident is attached to each of their medication administration records to enable staff to make sure they are giving the right medication to the right person. There are large stocks of some medications, for example, liquid paracetamol, which might not be used too often and will expire before it is used, which is a waste of resources. This is because it is prescribed for each individual. Advice was given that it might be possible to have a stock prescription for the Home, which needs to be discussed with the supplying pharmacist and Doctor. The Registered Manager said a new drug reference book had been ordered as the current one was from September 2001. Staff have a copy of the Royal Pharmaceutical Society Guidelines for administration of medicines in Care homes, which they can consult if they are unsure of something related to medicines. Information is available about how each resident takes their medicine and information about each medication they take is present so that staff know what the medication is for and what effects it has. Woodland View DS0000063668.V251713.R01.S.doc Version 5.0 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): 23 Adequate measures are in place to ensure staff have the right knowledge and skills to protect residents from harm. EVIDENCE: The local policy and procedures for Protection of Vulnerable Adults are available in the Home for staff reference. Staff signatures have been obtained stating they have read and understood the policies. The Registered Manager confirmed that staff have attended Protection of Vulnerable Adults training as part of their induction programme. Woodland View DS0000063668.V251713.R01.S.doc Version 5.0 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): None of these standards were assessed at this inspection as they were reviewed during the registration process. They will be reviewed at the next inspection. EVIDENCE: Woodland View DS0000063668.V251713.R01.S.doc Version 5.0 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 Staff are employed in sufficient numbers to meet the needs of the resident currently accommodated. However there remains some concern over the need for registered nurses to ensure the residents health needs are met within the Home. Recruitment and training processes ensure that residents are protected and supported by competent care staff. EVIDENCE: When the Home initially opened it was thought the residents needed nursing care, which was provided until assessments by staff concluded that the residents could be looked after in a residential setting. There are a number of nurses still employed at the Home but they refer to local health services for health issues. One set of relatives voiced concern about this as their relative had recently had a health problem and said they would feel reassured if nurses were available at all times due to the nature of the difficulties their relative had. Staff rotas show that there are up to five staff on duty in some days, which includes the Registered Manager and a senior carer. Staff are responsible for cleaning the Home and laundry. However there has been a domestic employed to do ‘deep cleaning’ duties, such as skirting boards. Woodland View DS0000063668.V251713.R01.S.doc Version 5.0 Page 18 A letter from the Human Resource department of the Registered Provider states that personal information is not provided to third parties about staff therefore information about Criminal Record Bureau clearance is not available in the Home. However the letter confirms that all staff have received Criminal Record Bureau clearance. Woodland View DS0000063668.V251713.R01.S.doc Version 5.0 Page 19 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): 41 Residents can be assured that their money is managed in a manner, which safeguards their best interests. EVIDENCE: The Registered Manager is to be appointee for all the residents in the Home so that she will be able to help manage the residents financial affairs as they are unable to do so themselves. She is in the process of trying to get individual accounts at the bank for each resident but currently their money is placed in one residents account. A statement is sent to the Home each month with details of what each resident has in the account. Two signatures are recorded in the finance book for all transaction, which helps safeguard resident’s monies. Woodland View DS0000063668.V251713.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 3 X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Woodland View Score X 2 3 X Standard No 37 38 39 40 41 42 43 Score X X X X 3 X X DS0000063668.V251713.R01.S.doc Version 5.0 Page 21 N/A 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 YA19 Regulation 12 Requirement Staff must ensure they coordinate health care and treatment for residents with appropriate timescales. The healthcare needs of the residents must continue to be monitored to ensure they are being cared for by staff with the appropriate skills. Timescale for action 12/10/05 2 YA32 12 31/03/05 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 YA17 Good Practice Recommendations A four week menu should be considered to demonstrate a varied diet with details of a choice of meals for each mealtime. 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