Inspection on 22/09/05 for Woodlands

This inspection was carried out on 22nd September 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Woodlands 08/05/07

Woodlands 25/07/06

Woodlands 14/03/06

Woodlands 22/02/05

Woodlands 01/09/04

Woodlands 02/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Woodlands Well Park Road Drakewalls Gunnislake Cornwall PL18 9ED Lead Inspector Philippa Cutting Unannounced Inspection 22nd September 2005 09.45a Woodlands DS0000044246.V251086.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 Woodlands DS0000044246.V251086.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. Woodlands DS0000044246.V251086.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Woodlands Address Well Park Road Drakewalls Gunnislake Cornwall PL18 9ED 01822 832451 01822 833305 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) The Regard Partnership Limited Julie Ann Callaghan Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Woodlands DS0000044246.V251086.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 5 people with a learning disability (LD) aged between 16 and 25 years. 22nd February 2005 Date of last inspection Brief Description of the Service: Woodlands is an older style detached property set in its own grounds in the rural village of Gunnislake, on the edges of the moor. It approximately 20 minutes from the nearest town at Tavistock and a further 20 minutes onto Plymouth. Gunnislake has rail & bus connections with the southwest. The home is owned by the Regard Partnership and provides care and accommodation in single rooms for up to five younger people with a learning disability. It aims to concentrate on promoting independent living & social skills that will enable the service users to ultimately move on to a more independent life, rather than providing a permanent home. To this end high staffing levels are required, usually at least one:one. Woodlands DS0000044246.V251086.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection during the working day. There were three service users resident in the home at the time of the inspection, two were at home, one was out with a support worker. The inspector spoke with the staff who were on duty and the service users. Records and the premises were inspected. There has been a dramatic improvement in the home since the last inspection in February 2005. A registered manager has been appointed, the staff group stabilised and senior managers are now visiting the home to carry out thorough reviews and audits of the services provided with the staff. Most of the improvement can be attributed to the registered manager who has provided clear guidance and experience but the staff who have struggled to maintain services for the service users are to be congratulated on what they achieved with little support from the organisation. What the service does well: What has improved since the last inspection? What they could do better: Woodlands DS0000044246.V251086.R01.S.doc Version 5.0 Page 6 The home needs to consider its long term aims as it has not been fully occupied for some considerable time. To this end the registered manager must ensure that there are robust assessment procedures in place when meeting with prospective service users. 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 DS0000044246.V251086.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 Woodlands DS0000044246.V251086.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): 2,5 Information that is provided for service users should be reviewed to ensure its accuracy as there have been no new service users for a considerable time. EVIDENCE: There have been few new service users in recent months and some of those who have been offered accommodation have not stayed. It would seem to be important therefore for the registered manager and other senior managers in the organisation to be quite clear about the client group that Woodlands aims to help. Where people are referred from another county a workable manner in which information and preadmission assessments can be carried out, must be drawn up. Needs must be identified and quantified for a fee structure, that can be justified, to be drawn up. Terms and conditions need to state these clearly. Woodlands DS0000044246.V251086.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): 6,7,8,9,10 The home is revising the service user plans to reflect choices and individual needs whilst addressing risk taking. EVIDENCE: Two service users’ care plans have been completely reviewed, the third will be done shortly. Service users and families are included in the preparation of the care plans as much as possible. Families living locally can obviously be more involved but relatives coming from further afield are contacted and issues discussed with them. Risk assessment plays a large part in the care plans. If an incident occurs with a service user this is documented. In response to her query as to what happened to that information, the inspector was told that staff were about to start correlating it to see if there were patterns that could be identified so that avoidance measures could be put in place. If, on occasions, a sanction is needed with a service user it is important to ensure that the reasons are understood. Documentation could be expanded to demonstrate this. Woodlands DS0000044246.V251086.R01.S.doc Version 5.0 Page 10 Service users have opportunities to participate in the running of the home and encouraged to do as much as they are able. Woodlands DS0000044246.V251086.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 Service users are provided with opportunities for personal development and learning to be more independent. They are consulted on all aspects of their lifestyle. EVIDENCE: Personal development is at the heart of the service provided by Woodlands. The service users are at different stages in their progress so all have individual programmes. Further educational and work opportunities are sought and service users are supported in leisure activities of their choice especially if these occur outside the home. Service users’ rights are respected but they are also learning to respect the rights of others. Service users are encouraged to help with meal preparation. This can involve cooking for everyone to preparing snacks or breakfast for themselves. A rota is drawn up so that everyone cooks or clears away after meals. Woodlands DS0000044246.V251086.R01.S.doc Version 5.0 Page 12 A daily routine for each service users is available to see. The ‘leisure periods’ still seemed to include a lot of television and videos. Daily diaries, written with service users, record what activities have been done and how the day has gone. Woodlands DS0000044246.V251086.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): 18,19,20 Service users’ physical and emotional needs are met in a way appropriate to them as individuals. EVIDENCE: The records contained evidence of the assistance that had been sought on behalf of service users’ health care problems. This included both physical and psychological input where there was a need. The organisation has its own trainers who advise on behavioural problems and assist the compilation of action plans to address problems. It was interesting to note that the charts supplied by Regard did not include a paragraph where ‘good behaviour’ could be noted, only unsatisfactory behaviour. Woodlands has added its own positive comments section. Medication is undertaken for service users at present. It was stored securely and recorded in full. Some formal training for staff on the safe handling of medication would be prudent. Woodlands DS0000044246.V251086.R01.S.doc Version 5.0 Page 14 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): 22,23 Service users’ views are listened to but some may need help in expressing difficulties. EVIDENCE: The home has participated in a PoVA investigation that was concluded successfully. Training for staff regarding PoVA issues is on going. It was not possible at this inspection to ascertain if all the service users understood or would know how to make a complaint if that were necessary. It is likely that some would demonstrate distress or anger etc, through their body language. This is an area that may need further thought. Woodlands DS0000044246.V251086.R01.S.doc Version 5.0 Page 15 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): 24,25,26,27,28,29,30 Woodlands provides adequate space for the current service users. They are encouraged to help maintain their environment. EVIDENCE: The home is not fully occupied. There is one ground floor bedroom so service users need a degree of mobility to manage the accommodation on the first floor. It would not be possible for instance, for a wheelchair to manoeuvre the path from the car park, as it is too narrow. Everyone uses the backdoor through the kitchen as the main access to the home. Whilst this is an everyday practice in many domestic situations, it should be discussed with the Environmental Health Officer (food hygiene). Equally the office is off the kitchen and staff need to ensure that they cannot be overheard if discussing confidential matters. Service users’ rooms are of a satisfactory size and contained personal possessions. Service users are responsible for keeping their rooms clean and tidy, with help if necessary. It was noted that beds were unmade or poorly pulled together. There appeared to be no under blankets so in at least one case the sheet had fallen off the bed and the service user could have been Woodlands DS0000044246.V251086.R01.S.doc Version 5.0 Page 16 sleeping directly on the mattress. Staff need to gauge how to help service users attend to these types of domestic tasks without compromising their independence. A copy of the House Rules was displayed in service users’ rooms. Communal space is provided on the ground floor although the sun lounge is being used as a store for ladders etc; some re decoration has been taking place. Externally the gardens are mainly grass. Service users are encouraged to use the garden and a football goal has been put up so that staff and service users can play if they wish. Woodlands DS0000044246.V251086.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): 31,32,33,34,35,36 The staff team who support the service users has improved as there is now guidance to focus their work and training needs. EVIDENCE: New staff have been recruited so that there are now identified night staff. This has enabled people who usually work in the daytime to resume this and not have to cover nights as well. PoVA checks and Criminal Records Bureau clearance is sought on all new staff before they start work. They receive induction into health safety, basic food hygiene, risk assessment, first aid and moving & handling. Regard now has trainers who put on courses relevant to the staffs’ work such as challenging behaviour and the LDAF course. The registered manager and her deputy provide supervision for staff and appraisals are about to begin. These had lapsed for some considerable time before the present registered manager took up her post. Woodlands DS0000044246.V251086.R01.S.doc Version 5.0 Page 18 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): 37,38,39,40,41 The management of the home has improved significantly and service users can be confident that the current establishment is protecting their interests. EVIDENCE: The registered manager has considerable experience in the field of learning difficulties and is currently working towards her registered manager’s award. She looks through the documentation and marks places where further detail or attention is needed. A new area manager now visits the home and has undertaken an audit of the services provided. Together the registered manager & area manager have brought stability to the home and are identifying areas where training is needed and are arranging for this to happen. Staff are asked to read and sign the policies and procedures. These are being reviewed as well and staff will be advised when new ones are introduced. Woodlands DS0000044246.V251086.R01.S.doc Version 5.0 Page 19 The registered manager has experience of working with children, so is familiar with the additional records and requirements should a service user under 18 be accommodated. The record keeping has improved. Records required by statute were inspected and found to be in order. Woodlands DS0000044246.V251086.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 2 X X X Standard No 22 23 Score 2 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 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 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Woodlands Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 X x DS0000044246.V251086.R01.S.doc Version 5.0 Page 21 yes 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 2 Regulation YA14 Requirement The registered providers must produce a comprehensive and workable plan for assessing prospective service users. It must include staff from the home. The registered manager must ensure that there is a complaints procedure that is understood by all service users. Timescale for action 02/01/06 2 22 YA22 02/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA20 YA24 YA26 Good Practice Recommendations Staff should undertake a course in the safe handling of medication The access to the house should be reviewed. Service users’ bedding should be reviewed to ensure that they are warm and comfortable when in bed. Woodlands DS0000044246.V251086.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 DS0000044246.V251086.R01.S.doc Version 5.0 Page 23 - 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. 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