Inspection on 19/01/06 for Woodlands

This inspection was carried out on 19th January 2006.

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

Woodlands 31/10/08

Woodlands 08/08/06

Woodlands 03/08/05

Woodlands 29/03/05

Woodlands 03/09/04

Woodlands 10/02/04

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

CARE HOME ADULTS 18-65 Woodlands 4 Gaskells End Tokers Green Reading Berkshire RG4 9EW Lead Inspector Catherine Kane Unannounced Inspection 19th & 20th January 2006 16:30 Woodlands DS0000013218.V279317.R01.S.doc Version 5.1 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 Woodlands DS0000013218.V279317.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 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. Woodlands DS0000013218.V279317.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Woodlands Address 4 Gaskells End Tokers Green Reading Berkshire RG4 9EW 0118 9724913 0118 9724913 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) Caretech Community Services Limited Ms Katrina Player Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Woodlands DS0000013218.V279317.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd August 2005 Brief Description of the Service: Woodlands is a three-bedroomed detached house in a quiet cul-de-sac in a small village; it is registered for three people with a learning disability, although only two residents are currently accommodated at the home. CareTech is the provider organisation and is a national company providing accommodation with personal care to people with learning disabilities. The service provides long-term, rather than respite or emergency accommodation and Woodlands has been home to the current residents for many years. The home accesses local services for both health and social activities. Woodlands DS0000013218.V279317.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit took place during the day of Thursday 19 January 2006. The manager and staff did not know the inspector was planning to visit. The inspector returned to the home on Friday 20 January 2006 for a follow-up visit and to meet the new manager. The time spent in the home was over three hours. The purpose of the visit was to see how the home is meeting National Minimum Standards. The inspector met both residents and the two staff who were on duty at the time. During the inspection she had a look round the home, read notes and looked at other records kept in the home. After a period of instability following the absence of the named registered manager staff morale has greatly improved with the appointment of a new manager. The inspector would like to thank both residents for making her feel very welcome and inviting her to stay for lunch. She also thanks the manager and staff on duty for their assistance during the inspection. What the service does well: What has improved since the last inspection? Staff morale has improved. Action has been taken to make improvements following an internal audit. Woodlands DS0000013218.V279317.R01.S.doc Version 5.1 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. Woodlands DS0000013218.V279317.R01.S.doc Version 5.1 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 Woodlands DS0000013218.V279317.R01.S.doc Version 5.1 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 The home has a clear admission procedure. EVIDENCE: It is important to make sure that the home is the right place, the wishes of all the people who already live in the home are carefully considered and the staff team have the right skills before offering a place to any new resident. There have been no new admissions to this home since the last inspection. Woodlands DS0000013218.V279317.R01.S.doc Version 5.1 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 and 9 Care plans had all the essential information staff need to be able to care for residents. Residents’ care plans and other record keeping systems used in the home could be improved. EVIDENCE: The inspector viewed the care plan files for all three residents; each had the essential information that staff need to be able to care for people. The care plans are very large and cumbersome with a lot of information in them. Basic information, risk assessments and individual support requirements need to be quick and easy to read for new staff or agency staff so that they can provide the right care support for the people who live in this home. The inspector saw that a person centred care planning system was being introduced and some work had started to gather information from residents about their hopes and wishes. The further development of the person centred care plans should be completed in a timely fashion. Woodlands DS0000013218.V279317.R01.S.doc Version 5.1 Page 10 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): 12,13, 15, 16 and 17 Residents have opportunities to take part in a variety of activities within their local community. Residents are free to move around the home. Meals served are freshly prepared and the menu is varied. EVIDENCE: Residents, helped by staff, told the inspector about some of the different activities they take part in. Care notes and information shared by the manager indicated that residents are helped by staff to keep in touch with their families. The inspector and the manager discussed using the services of an advocacy agency to help residents make decisions about their lives. A freshly cooked meal was served in the evening of the inspection. Both residents indicated to the inspector that the food served is nice. Residents’ special dietary needs are catered for. Woodlands DS0000013218.V279317.R01.S.doc Version 5.1 Page 11 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): 18 and 19 Staff help residents to get to see their local GP, dentist and other community healthcare services when it is needed. EVIDENCE: Information needed by staff to be able to provide personal and health care support was included in care plans. Woodlands DS0000013218.V279317.R01.S.doc Version 5.1 Page 12 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): 22 The complaints procedure is easy to follow. EVIDENCE: The manager related that she has received no complaints. Woodlands DS0000013218.V279317.R01.S.doc Version 5.1 Page 13 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): 24, 26 and 30 The standard of décor throughout the home is generally good and is a homely and comfortable environment. EVIDENCE: The manager confirmed by telephone following the inspection that the difficulty to open patio doors leading to the garden would be repaired. As these doors would be used as a fire exit they must be kept in good working order at all times. The manager also confirmed by telephone that full risk assessments and guidance to minimise risk to residents have been put in place in relation to the glass greenhouse situated in the garden. Residents’ bedrooms seen by the inspector were spacious and clearly furnished and decorated in the occupant’s choice of style. On the day of the inspection the home was seen to be clean and tidy. Woodlands DS0000013218.V279317.R01.S.doc Version 5.1 Page 14 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, 35 and 36 The systems for recruitment, selection and performance management of staff who work in this home could be improved. EVIDENCE: There is a well-established core staff team providing consistent care support to residents. Staff have a good understanding of residents’ support needs and communication methods. The relationships between staff and residents are good. The manager provided details of the range of training opportunities to enable staff to do their job. The files kept in the home for a recently recruited member of staff had all the necessary documentation in place. However, the inspector recommends that CareTech consider how appropriate references are obtained on prospective new staff before making an appointment. Staff morale has improved since the appointment of a new manager. Formal supervision sessions are now to take place between the manager and her staff team following a period when this did not happen. Woodlands DS0000013218.V279317.R01.S.doc Version 5.1 Page 15 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): 37, 39 and 42 This home needs a period of stability where staff have clear guidance and leadership for residents to receive the consistent quality care they need. EVIDENCE: The named registered manager has been absent from the home for several months. Staff morale has greatly improved with the appointment of a new manager. Staff confirmed that the area manager has visited the home regularly to provide support during recent months. The responsible individual must provide CSCI with clarification on the current status of the registered manager and the arrangement for the management of this home. The inspector receives copies of the proprietors’ representative’s monthly visit reports. Well maintained health, safety and welfare records were kept in the home and were made available for inspection. Woodlands DS0000013218.V279317.R01.S.doc Version 5.1 Page 16 CareTech, who run this service, has financial and accounting systems subject to internal and external audits. The latest internal quality standards audit made available by the manager indicated that a number of areas require improvement: the inspector could see that the manager has taken immediate action to begin to address these. Woodlands DS0000013218.V279317.R01.S.doc Version 5.1 Page 17 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 X ENVIRONMENT Standard No Score 24 2 25 X 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 2 X 3 X X 3 X Woodlands DS0000013218.V279317.R01.S.doc Version 5.1 Page 18 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 YA37 Regulation 9, 38, 39 Requirement Timescale for action 15/02/06 2 YA24 13(4)(a) 23(4)(b) The responsible individual must provide CSCI with clarification on the current status of the registered manager and the arrangement for the management of this home. The manager must ensure that 15/02/06 patio doors used as a fire exit must be kept in good working order at all times. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA34 YA6 Good Practice Recommendations The inspector recommends that CareTech should consider how appropriate references are obtained on prospective new staff before making an appointment. The inspector recommends that residents’ care plans and other record keeping systems used in the home should be reviewed to make written information easier to read. The further development of the person centred care plans should be completed in a timely fashion. Woodlands DS0000013218.V279317.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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. 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