Inspection on 13/04/05 for Woodlands

This inspection was carried out on 13th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Woodlands 26/07/07

Woodlands 10/07/06

Woodlands 27/07/05

Woodlands 02/11/04

Woodlands 10/05/04

Woodlands 15/09/03

Woodlands 10/06/03

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Woodlands 84 Long Lane Ickenham Middlesex UB7 7UG Lead Inspector Gavin Thomas Announced 13th and 18th April 2005 at 11.30am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Woodlands Version 1.10 Page 3 SERVICE INFORMATION Name of service Woodlands Address 84 Long Lane, Ickenham, Middlesex, UB7 7UG Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01895 634830 01895 624 887 Mrs Sybil Agatha Rose & Ms Marcia Loren Patterson - James Ms Marcia Loren Patterson-James CRH-PC 21 Category(ies) of OP, Old Age (21) registration, with number of places Woodlands Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd & 4th November 2004 Brief Description of the Service: Woodlands is a care home currently registered for twenty - one older people. The home can only accommdoate twenty service users. The home is located on a busy main road between Ickenham and Hillingdon. The nearest shops are at Ickenham High Road, situated about one mile away. Ickenham and Hillingdon Underground Stations are within walking distances. The home is privatley owned. There were three service user vacancies at the time of this inspection. There are fourteen bedrooms. Eight single and six double. There is a large lounge/dining room, which accommdoates all service users at any one time. There is a small ground floor room, formerly an office, which is now designated a meeting/visitors room. There are three bathrooms. One has a Parker bath. This room also has a shower. There are two bathrroms without any specialist appliances. One bathroom is used additionally for hairdressing. The kitchen and laundry room are on the ground floor. There is a small room where staff have lockers and can store their clothing. There are no further staff facilities. The Registered Manager is one of two Providers. There is a team of day and night staff. Three staff are on each shift during day and there are two waking night staff. There is a cook and a domestic worker. Woodlands Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. What the service does well: What has improved since the last inspection? What they could do better: The home had identified the need to improve upon the care planning system. Whilst in the midst of this change, individual plans of care must reflect any changes in the service users assessed needs. Social activities and stimulus must be documented in more detail to demonstrate how the home meets the needs of service users individually and as a group, for both indoor and outdoor activities. Woodlands Version 1.10 Page 6 The Quality Assurance and Monitoring system must be developed to demonstrate how the quality of care and operational systems are reviewed and how the homes maintains good standards of care. The home must improve the recruitment and selection processes to ensure that proper checks are carried out on all prospective staff prior to offer of employment. There were major shortfalls with the majority of staff records examined. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Woodlands Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Woodlands Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 The home has produced a detailed Statement of Purpose and Service User Guide. The Service User Guide should be kept under review to ensure that the current format is suitable for intended Service Users. EVIDENCE: A Statement of Purpose and Service User Guide were in place. Both documents were very informative. All service users were in receipt of a copy of the Service User Guide. Details relating to the size of rooms must be more explicit in the Statement of Purpose. The organisational structure must also be included in the Statement of Purpose. This home does not provide intermediate care. Standard 6 does not apply to this establishment and was therefore not assessed. Woodlands Version 1.10 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 10 Although individual plans of care were in place for all service users, the current format is restricted and does not allow for specialist needs to be recorded. The new methodology will encompass service users’ overall and specialist care needs. Facilities were in place for maximising service users privacy. EVIDENCE: Individual plans of care were in place for all service users. Where possible, individual plans of care must be agreed and signed by service users or their representatives. One care plan examined was dated February 2004. There was no evidence to suggest that this care plan has since been updated. Associated care planning documents included service users’ mental health, physical health, behavioural needs, falls and pressure care. The home was in the process of implementing new care planning methodology. Draft documents were examined. Service users health needs were set out in their individual plans of care. Continence needs were being managed by the home with no intervention from Woodlands Version 1.10 Page 10 specialist health professionals. All service users were registered with a GP. Risk assessments were in place to minimise the risk of falls. Service users weights are taken and recorded on a monthly basis. Service users had access to primary health care. The dentist and optician visit the home on a monthly basis. One care plan examined did not give sufficient information to ensure the after care for one service user who had undergone a medical procedure. Screens are provided in the double bedrooms. Service users have access to a payphone, which is situated in the hallway on the ground floor. Service users may also use the telephone in the office for added privacy. One relative stated in a survey that it has been known for clothes to be mixed up. The home has now obtained name labels for all service users. A new system was also being introduced for relatives to label service users clothes prior to admission. One relative stated in a survey that they are unable to visit a service user in private. The management of the home confirmed that visitors on request may use the small meeting room on the ground floor. Woodlands Version 1.10 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 & 13 Social activities were provided. However, the home must devise a programme of activities and record the activities in sufficient detail to demonstrate the types of activities and service users who engage in activities at any one time. EVIDENCE: One staff member co ordinates activities in the home. Two service users said they enjoy the sing a long sessions. A range of games are provided in the home including skittles, puzzles and a selection of music. One service user said they like to read. Birthdays are celebrated and this is an event that service users said they look forward to. A volunteer brings a “pat a dog” to the home. A visit from the dog is popular with service users. An activities programme was not in place. This programme must be devised to demonstrate the types of indoor and outdoor activities offered to service users. Two service users said they have regular visitors and look forward to this. One service user said they join in with friends at a church bingo club on a weekly basis. Trips into the community are arranged in accordance with service users preferences and if the weather is favourable. Woodlands Version 1.10 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The homes procedures for managing complaints were satisfactory but a complaints record must be devised and implemented. The adult protection procedure contained relevant information but further details would enable staff to carry out correct procedures in the event of suspected or known abuse. EVIDENCE: The home has a complaints procedure. This procedure must include the telephone number for the CSCI and the home’s contact details. The complaints procedure is included in the Statement of Purpose and Service User Guide. Two relatives stated in their surveys that they were not aware of the home’s complaints procedure. Although the complaints procedure is displayed in the home, the management team was advised to issue a copy of the revised complaints procedure to relatives and significant others. Three service users said they had no reason to complain about the quality of care. A complaints record was not in place. Although the management team stated that they had not received any complaints within the last twelve months, a complaints record must be devised and put into place. The CSCI received one complaint with regards to recruitment practices. This complaint was fully investigated on the second day of this inspection. This Woodlands Version 1.10 Page 13 complaint, which was in relation to the recruitment of staff, was not upheld. However, the section headed Staffing in this report outlines the requirements as a result of the findings when staff records were inspected. An adult protection policy and procedure was in place. The procedural guidance was limited and must be updated to include further guidance for staff to follow in the event of suspected or known abuse. The home was not in receipt of a copy of the Department of Health “No Secrets” guidance document or adult protection procedures for Placing Authorities. These documents must be obtained. Staff attended training on adult protection in September 2004. Woodlands Version 1.10 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 26 The premises were well maintained. The grounds of the home were also well kept. Good practice systems were in place to minimise the risk or spread of infection. EVIDENCE: All parts of the home inspected were clean, warm and well presented. None of the areas inspected required attention. One service user said, “There is no place like home, but the facilities at Woodlands were decent and comfortable”. The maintenance program for the period April 2004 to April 2005 had been achieved. The home was working towards a program of routine maintenance for the period April 2005 to April 2006. The maintenance program should include actual dates when work has been carried out for quality and monitoring purposes. All exits to the home were secure. Service users have access to the garden via the lounge/diner. Decking has now been laid to the rear of the garden. Woodlands Version 1.10 Page 15 A policy on the control of infection was in place. Hand washing facilities were sited prominently throughout the home. All staff are provided with protective clothing. A new washing machine was installed in February 2005. The laundry facilities are sited away from the food preparation area. Separate sluicing facilities are provided. Woodlands Version 1.10 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 29 The home maintains staffing levels in accordance with the needs of the service users. The staffing structure needs to be more specific to outline those staff who are responsible and accountable for the running of the home in the absence of the Registered Manager or other members of the management team. Recruitment checks on prospective staff were poor. This must improve to demonstrate the fitness of all staff appointed. EVIDENCE: Staff rotas were in place. The staff rotas examined for a period of three weeks showed that the majority of staff work long days to accommodate other commitments such as study. One member of staff had worked a total of fifty hours in one week. The home should review the arrangement for staff working excessive hours. The maximum number of hours care staff work within a week should be in keeping with the Working Times Regulations. Although the staff rotas indicated who were shift leaders and Care Assistants, the rotas must also indicate which staff are appointed as Senior Carers. The staff rota indicated that one member of staff who is also a student with a visa to work for a maximum of twenty hours per week, was working in excess of these hours. The home has a minimum of three staff on day shifts and two staff on waking night shifts at all times. Service users spoken to said that the staff were kind and very helpful. One of the service users spoken to said that sometimes they are left on the toilet too long before they are assisted by staff. Six service users who completed surveys said that they are well cared for and treated well by staff. Woodlands Version 1.10 Page 17 A recruitment policy and procedure was in place. There has been a low turn over of staff since the last inspection. On examining staff records, shortfalls were noted. In particular: • Only one reference had been obtained for some staff. • In one instance, two staff from the home had supplied references for a member of staff • In some cases, application forms were not available. • Not all of the applications forms on file were complete or signed and dated by the applicant. • Recruitment checks had not been carried out for two of the management team. A valid visa was not in place for one member of staff who is a non-UK passport holder. • One staff file could not be located for inspection purposes. • The home does not contact referees to ensure that they are the bearer of references supplied. • The Assistant Manager Designate said that a POVA First check had been carried out for two members of staff most recently employed. Evidence was not available to support this. CRB checks for these members of staff have been processed. Enhanced Criminal Records Bureau checks had been carried out for all other staff including domestic staff and the handy person. The Deputy Manager did advise the Inspector that plans were in place to carry out an audit on all staff files. The person responsible for the Pat a Dog is the only volunteer who visits the home. Although the management team advised that these visits are supervised at all times, the home was not in receipt of a valid CRB check for this person. None of the staff in post have been issued with a copy of the General Social Care Council codes of conduct and practice. Woodlands Version 1.10 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 & 38 The home was making steady progress in developing quality assurance and monitoring systems. However, further work is required to demonstrate a full review of the quality care, which takes into account all aspects of the day-today running of the home. Whilst practices were in place to safeguard the health, safety and welfare of the people using the service, some of the current systems need to be more detailed to demonstrate how these systems are promoted. EVIDENCE: A Quality Assurance policy was in place. The policy was very specific about the frequency of service users meetings. The frequency of service users meetings as stated in the policy did not reflect the frequency of when service users meetings actually take place. The home had issued Quality Assurance surveys to service users, relatives and significant others. Although the home was working towards elements of quality Woodlands Version 1.10 Page 19 monitoring systems, a full quality assurance system and an annual development plan were not in place. The policies and procedures examined were reviewed and updated within the last twelve months. It was noted however, that the review date for these policies and procedures was set for 2009. A shorter timescale should be considered. Of the five relatives who completed the CSCI surveys for this inspection, all relatives said they are made to feel welcome in the home, one relative said they are not able to visit a service user in private, one relative said they are not kept informed of important matters and they are not consulted about the service user’s care. All relatives were of the opinion that there is always sufficient staff on duty. Four relatives said they were of the complaints procedure. Of the six service users or their representatives who completed the CSCI surveys for this inspection, all six service users said they like living in the home. One service user said that sometimes they would like to be more involved in decision-making. All service users said their privacy is respected. All service users said they like the food, they feel safe in the home and they would know who to speak to if they were unhappy with their care. Health and safety policies and procedures were in place. The health and safety policy lacked sufficient evidence to demonstrate how Health and Safety Regulations are applied within the home. Six staff attended recent training on moving and handling, fire safety, food hygiene and First Aid. Further staff are due to attend this training later in the year. Health and safety monitoring systems were in place. Hot water temperatures are taken periodically. It was noted however, that the hot water in washbasins was tested more regularly than bathing and showering facilities. The method of recording hot water temperatures did not indicate when and what action is taken if the temperature of hot water is too hot or too low. The report for a legionella test carried out in March 2005 showed a satisfactory outcome. Inspection of records showed that gas, electrical and fire appliances are tested routinely by approved contractors. A fire risk assessment was in place. Regular fire drills are carried out. The record of fire drills must include the full names of staff and service users who take part in fire drills. An accident record and health and safety risk assessments were maintained. Woodlands Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 x 15 x COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 x x 2 x x x x 2 Woodlands Version 1.10 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 4(1)(c ) Schedule 1(4)(16) Requirement Details relating to the size of rooms must be more explicit in the Statement of Purpose. The organisational structure must also be included in the Statement of Purpose. Where possible, individual plans of care must be agreed and signed by service users or their representatives. All individual plans of care must be kept under review. Where appropraite, specialist care needs must be more explicit and detailed in individual plans of care. An activities programme must be devised to demonstrate the types of indoor and outdoor activities offered to service users. The complaints procedure must include the telephone number for the CSCI. A complaints record must be devised and put into place. The adult protection procedure must be updated to include further guidance for staff to Version 1.10 Timescale for action 31 May 2005 2. 7 15(1) 30 June 2005 30 June 2005 31 May 2005 30 June 2005 3. 4. 7 10 15(2)(b) (c) 12(1)(a) (b) & 15 (2)(b) 16(2)(m) (n) 5. 12 6. 16 22(1)(7) (a) 17(2) Schedule 4 (11) 13(6) 31 May 2005 31 May 2005 30 June 2005 7. 8. 16 18 Woodlands Page 22 follow in the event of suspected or known abuse. 9. 18 13(6) The home must obtain a copy of the Department of Health “No Secrets” guidance document and adult protection procedures for Placing Authorities. The rotas must indicate which staff are appointed as Senior Carers. The plan of care must be reviewed for one service user who stated that they are sometimes left on the toilet too long. All current staff files must be brought up to date and in keeping with the required checks as stated in Scehdule 2 of the Care Homes Regulations 2001. Future staff must only be appointed once satisfactory recruitment checks have been carried out. The recruitment file for one member of staff which could not be located for this inspection must be found and made accessible at all times. The home must ensure that references are validated and must also include the authors name and desgination. The home must provide evidence for POVA First checks carried out. The home must obtain a CRB check for one volunteer who visits the home regularly. The Quality Assurance policy must be updated with the actual timescales of when service users meetings are held. A full quality assurance system including an annual development Version 1.10 30 June 2005 10. 11. 27 27 18(1)(a) 12(1)(b) 31 May 2005 13 May 2005 12. 29 19 Schedule 2 31 May 2005 13. 29 19 Schedule 2 19 Schedule 2 19(1)(c ) 30 June 2005 13 May 2005 14. 29 15. 29 31 May 2005 13 May 2005 31 May 2005 31 May 2005 31 July 2005 Page 23 16. 17. 18. 29 29 33 19 Schedule 2(7)(a)(b) 19 Schedule 2(7)(a)(b) 12(3) & 24 24 19. 33 Woodlands plan must be devised and implemented. 20. 38 13(3)(4) (a)(b)(c) & 23 13(4)(c ) 13(4)(c ) The Health and safety policies and procedures must be updated to demonstrate how Health and Safety Regulations are applied within the home. The hot water in bathing and showering facilities must be tested more regularly. The method of recording hot water temperatures must indicate when and what action is taken if the temperature of hot water is too hot or too low. The record of fire drills must include the full names of staff and service users who take part in fire drills. 30 June 2005 21. 22. 38 38 13 May 2005 13 May 2005 23. 38 23(4)(e) 13 may 2005 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 19 Good Practice Recommendations The maintenance program should include actual dates when work has been carried out for quality and monitoring purposes. The home should review the arrangement for staff working excessive hours. The maximum number of hours care staff work within a week should be in keeping with the Working Times Regulations. The home should obtain the General Social Care Council codes of conduct and practice. The codes of conduct and practice should be issued to the staff team. A shorter timescale should be considered for the review of all policies and procedures. 2. 3. 4. 5. 27 27 29 33 Woodlands Version 1.10 Page 24 Commission for Social Care Inspection Ground Floor 58 Uxbridge Road Ealing London W5 2ST 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 Woodlands Version 1.10 Page 25 - 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. 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