CARE HOMES FOR OLDER PEOPLE
Woodland View Nursing Home Lightwood Lane Off Norton Lane Sheffield South Yorkshire S8 8BG Lead Inspector
Shirley Samuels Key Unannounced Inspection 16th November 2006 09:30 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 View Nursing Home DS0000021818.V302825.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 View Nursing Home DS0000021818.V302825.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Woodland View Nursing Home Address Lightwood Lane Off Norton Lane Sheffield South Yorkshire S8 8BG 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) 0114 271 6688/7 0114 253 0714 woodlandview@sct.nhs.uk None Northern Counties Housing Association Ltd Deborah Ann Keeling Care Home 60 Category(ies) of Dementia - over 65 years of age (60) registration, with number of places Woodland View Nursing Home DS0000021818.V302825.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Ten places could instead be used for people in the category DE Dementia, who are 55 years of age or over. 27th February 2006 Date of last inspection Brief Description of the Service: Woodland View is a single storey modern spacious home providing care for sixty service users aged sixty-five plus who have dementia. The home can offer 10 places for younger adults in this category from aged 55. The home is divided into four cottages, which have fifteen service users in each. The cottages are domestic in design. Woodland View is situated at Norton, adjacent to Lightwood training centre. The home is close to public transport. There is a large car park. The fees range from £435.00-483.00. There are extra charges for Hairdressing, chiropody, mileage for outings in the minibus, toiletries, magazines and newspapers, outings and holidays. Information about the home and activities is displayed in each of the cottages along with a copy of the Commission For Social Care Inspection reports. Woodland View Nursing Home DS0000021818.V302825.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This site visit was carried out over eight hours 9:30am-5:30pm. Three service users, three relatives, nine staff and three managers were spoken to. A selection of records including, service users care plans, medication records, complaints, staff rotas, menus and financial records were checked. An inspection of the building was made to see how clean and well decorated the home was. And to make sure the service users were being kept safe. Before the inspection the manager sent information to the Commission For social care Inspection. Telling us all about the building, policies and procedures, the people living at the home and the staff working at the home. They also told us about the other people who come to the home, like doctors, hairdressers, chiropodist and social workers. What the service does well: What has improved since the last inspection?
Woodland View Nursing Home DS0000021818.V302825.R01.S.doc Version 5.2 Page 6 In the main care plans detailed what staff had to do to meet the needs of the service users. Care given to service users and activities they took part in was recorded in the daily recordings. Service user could reach the pull cord in the bathrooms, when they were in the bath. Staff who work at the home to cover when there is a shortage, go though full recruitment checks. Staff were trained in food hygiene, health and safety and first aid. The manager said this training was provided on a rolling programme. Service users and relatives were asked what they thought of the service. This information was put together and displayed for service users and relatives. All staff were receiving regular supervision sessions, where they talked to their manager about their job, training needs and the service users they care for. 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 Nursing Home DS0000021818.V302825.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 View Nursing Home DS0000021818.V302825.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area was good. This judgement has been made using available evidence, including a visit to the home. No service user moved into the home without having their needs assessed. This was to make sure that the home could meet their needs. The Home does not provide intermediate care. EVIDENCE: Three service users files were checked all contained assessments carried out by a social worker. A representative of the home also assessed potential service users. This assessment was also contained in the files. Woodland View Nursing Home DS0000021818.V302825.R01.S.doc Version 5.2 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): 7,8,9,10 &11 Quality in this outcome area was Good. This judgement has been made using available evidence, including a visit to the home. In the main service users health, personal and social care needs were set out in a plan of care. This ensured that staff had the information they needed to care for individual needs. Access to health care professionals ensured that service users health care needs were met. Service users were treated with respect. This ensured that their rights and privacy was upheld. At the time of death service users and their families were treated with respect. The medication practices were not always implemented in line with the policies and procedures. This placed service users at risk of harm. Woodland View Nursing Home DS0000021818.V302825.R01.S.doc Version 5.2 Page 10 EVIDENCE: Each service user file contained a plan of care. In the main they included all the information required. For one service user information was being gathered from family members who were in a position to contribute to the care plan. Relatives spoken to said they were “consulted about the care plan” and felt that the staff “kept them informed”. Service users and their relatives said that health care needs were met. Staff said that the doctor visited the home twice weekly and also visited on request. Service users records detailed service users health care needs and recorded when the doctor had visited and what the outcome of that visit was. There was a written procedure in place for the safe management of medication. Qualified nursing staff had sole responsibility for administration and management of medication. Good practice was seen and service users were supervised during administration. There were examples of medication not being booked into the home and medication administration sheets not being signed. Codes to indicate why medication has not being administered were not being used correctly. This was brought to the attention of the manager, who said that as part of the homes monitoring system issues had been identified and action was being taken to reduce the risk to service users. The manager added that supervised drug rounds and further training took place where this was needed. There was no lock fitted to the refrigerator containing medication. Since the inspection the manage has responded positively to the issues raised about the medications system. This includes providing further training and monitoring. Staff spoken to were able to verbalise how on a daily basis they respected the rights of the service users and gave examples of how they did this. They gave service users and their relative’s information and encouraged them to make choices. Woodland View Nursing Home DS0000021818.V302825.R01.S.doc Version 5.2 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 Quality in this outcome area was good. This judgement has been made using available evidence, including a visit to the home. Service users and relatives said, activities did take place this allowed service users to take part in activities if they wished. Family and friends were able to keep in touch with service users. Service users were encouraged to make choices this allowed them to have some control over their lives. Meals that were suited to individual needs were provided. This ensured that service users were offered a balanced diet. EVIDENCE: The records showed, activities that took place included, weekly café, sensory garden, media groups, weekly swimming, outings in the minibus and evening meals in the local pub and restaurants. Service users and relatives said they were “able to keep in contact by visiting, over the phone and by letter”. Relatives said “they were kept informed and were made welcome when they visited the home”. Woodland View Nursing Home DS0000021818.V302825.R01.S.doc Version 5.2 Page 12 The menus showed that the meals provided were varied. Service users said “they enjoyed the meals” and special diets were catered for. For those service users who needed assistance, this was provided in sensitive manner. Each unit had a kitchen where snacks and light meals could be prepared. The main meals that were cooked chilled were prepared outside of the home. In the main this worked satisfactorily. Woodland View Nursing Home DS0000021818.V302825.R01.S.doc Version 5.2 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 Quality in this outcome area was good. This judgement has been made using available evidence, including a visit to the home. A complaints procedure is available and made accessible to service users and their relatives. This ensures that complaints will be listened to and taken seriously. There are procedures in place to protect service users from abuse. This ensures that any allegations are investigated and action taken to protect service users. EVIDENCE: Since the last inspection one complaint has been made to the home. The Manager said in the pre inspection record that the complaint was upheld. The records at the home did not give enough detail of the investigation and the action taken to resolve the issues. Relatives said if they had any concerns they “felt (in the main) able to approach the staff or the manager”. Since the last inspection one allegation of abuse was made. Immediate action was taken to protect the service user. The allegation was referred to the social services adult protection team and notified to the Commission for social care inspection. An Investigation was carried out under the adult protection procedures. The allegation was not upheld. However some recommendations were made and implemented. Woodland View Nursing Home DS0000021818.V302825.R01.S.doc Version 5.2 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 the following standard(s): 19 & 26 Quality in this outcome area was adequate. This judgement has been made using available evidence, including a visit to the home. The home was reasonably maintained clean and hygienic. This ensured that service users lived a comfortable, safe and homely environment. EVIDENCE: The nurse call system was accessible to service users while they were in the bath. Some decoration had taken place in some parts of the home including bedrooms. On each unit there were two housekeepers this ensured that the hygiene standards were maintained. Soiled pads and linen were stored in one of the bathrooms. This left an offensive odour.
Woodland View Nursing Home DS0000021818.V302825.R01.S.doc Version 5.2 Page 15 In some of the easy chairs in the lounge plastic sheeting was used to cover the chairs. This was very visible and impacted on service users dignity. Service users said they were “happy with their bedrooms”. Bedrooms were personalised and it was clear that service users were able to bring personal possessions into the home with them. The communal areas were reasonably decorated, furnished and homely. There was enough space available for activities to take place and for service users to have some quiet space if they wished. Woodland View Nursing Home DS0000021818.V302825.R01.S.doc Version 5.2 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): 27,28,29 & 30 Quality in this outcome area was good. This judgement has been made using available evidence, including a visit to the home. In the main there are enough staff on duty. This ensures that service users needs are met. Staff receive regular training, which keeps them up to date with current good practice. This ensures that service users are in safe hands. The recruitment procedures included all the checks detailed in the requirements. Some gaps were noted in the actual practise. This could place service users at risk. EVIDENCE: The staff rota showed that there were enough staff on duty to meet the needs of the service users. Staff said in their view “staff worked well together to meet the needs of the service users”. Service users and relatives said that the “staff were caring and always available to talk to”. Relatives said “they were kept informed of any changes in the service users condition”. Staff were observed responding to calls for help in an appropriate manner and buzzers were answered promptly. Staff responded sensitively, attentively and with great care to service a user who was terminally ill. Woodland View Nursing Home DS0000021818.V302825.R01.S.doc Version 5.2 Page 17 The staff said “they received regular training”. They were able to identify training needs though their supervision sessions, and felt that any request for training was considered. The manager said that 60 of the staff group were trained to National Vocational qualification level 2. The service remained committed to ensuring that all staff are trained to this level. Three staff files were checked. They contained the majority of the information required by the regulations. There were examples were a photograph, qualifications and details of experience was not recorded. Woodland View Nursing Home DS0000021818.V302825.R01.S.doc Version 5.2 Page 18 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): 31,33,35 & 38 Quality in this outcome area was good. This judgement has been made using available evidence, including a visit to the home. The home has a registered manager in post. This ensures that the home is run in the best interest of the service uses. Service users and relatives are asked to comment on the quality of the service. This ensures that their views are taken into consideration as part of the review of the service. There were procedures in place for the appropriate management of service users finances. This ensured that service users finances were safeguarded. Policies, procedures training for staff and equipment are in place to ensure that the health safety and welfare of service users are promoted and protected. Woodland View Nursing Home DS0000021818.V302825.R01.S.doc Version 5.2 Page 19 EVIDENCE: The manager is experienced and is trained to national Vocational qualification level 4 in management. The staff and service users said “the manager was approachable and available to talk to”. The manager works co operatively with the Commission For Social care Inspection and demonstrates a good understanding of the Care Homes Regulations 2001 and the National Minimum Standards. Service users and relatives said “they were asked about what they thought of the service and for suggestions on how the service could be improved”. There was evidence that this information was collated. Three service users financial records were checked. Accurate records were kept and included details of income and expenditure. Receipts were in place for all transactions. Residents Financial Services an independed agency managed some service users finances. Staff were observed using safe moving and handling techniques. Staff said “they had received moving and handling training and that this was regularly updated”. The records supported this. Records were kept of weekly fire system checks. Staff had received fire instruction in the last six months and fire drills had taken place. The manager stated in the information provided before the inspection that the gas electric and heating system had been checked. Appropriate accident records were kept and the Commission For Social Care Inspection was notified of incidents as required by the Care Homes Regulations. Staff understood their responsibilities for their own safety and for that of the service users. They reported any identified risk and action was taken to maintain a safe environment and protect service users and staff from harm. Some of the external paths were covered with moss and leaves and posed a risk of slipping. Woodland View Nursing Home DS0000021818.V302825.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 3 2 x x x x x x 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 2 Woodland View Nursing Home DS0000021818.V302825.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 15 Requirement Service users care plans must include details of their needs and the action required by staff to meet those needs. The service users medication record must accurately record administration of dressings. Previous timescale 28/04/06 not met. The medication management procedures must include Accurate booking in of medication received into the home. Lock fitting to the medication fridge. Written instruction must be transferred in full from the medication container to the medication administration sheet. Accurate codes must be used to indicate why medication has not been administered. Timescale for action 01/01/07 2 OP9 13 01/01/07 3 OP9 13 27/12/06 Woodland View Nursing Home DS0000021818.V302825.R01.S.doc Version 5.2 Page 22 Accurate records must be kept of medication administration. 4. OP16 22 The details of investigations and the outcome of complaints must be recorded. Along with the details of whether the complainant is satisfied with the outcome of the complaint. Previous timescale 28/04/06 not met. All bedrooms must be decorated to a satisfactory standard. Previous timescale 28/07/06 not fully met An alternative to the plastic sheeting on some of the easy chairs must be found. Soiled pads and linen must be stored appropriately. Recruitment checks must include obtaining a recent photograph. This must be kept on the staff file. The external paths must be cleared of moss and leaves. 01/01/07 5. OP19 23 01/02/07 6 7 8 OP26 16 16 19 27/12/06 27/12/06 01/01/07 OP26 OP29 9 OP38 13 27/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Woodland View Nursing Home DS0000021818.V302825.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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