Inspection on 09/01/08 for Woodlands

This inspection was carried out on 9th January 2008.

CSCI found this care home to be providing an Good service.

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 23/05/06

Woodlands 06/12/05

Woodlands 16/06/05

Woodlands 14/10/04

Woodlands 26/04/04

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

CARE HOMES FOR OLDER PEOPLE Woodlands Toll Bar Distington Workington Cumbria CA14 4PJ Lead Inspector Liz Kelley Unannounced Inspection 09:00 9 January 2008 th 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 Woodlands DS0000036573.V351549.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. Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodlands Address Toll Bar Distington Workington Cumbria CA14 4PJ 01946 830065 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) www.cumbriacare.org.uk Cumbria Care Lynne Maria Newbury Care Home 40 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (38), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (1) Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 40 service users to include: up to 38 service users in the category of DE(E) (Dementia over 65 years of age) 1 service user in the category of DE (dementia under 65 years of age) 1 named service user in the category MD(E) (Mental disorder, excluding learning disability or dementia - over 65 years of age). An application to vary the registration must be made to the Commission for Social Care Inspection when care is no longer offered to this person in category MD(E). When single rooms of less than 12 sqm usable floor space becomes available they must not be used to accommodate wheelchair users and where existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 23rd May 2006 2. 3. Date of last inspection Brief Description of the Service: Woodlands is a residential care home registered with the Commission for Social Care Inspection to provide personal care and accommodation for up to forty older people with dementia. Short-term respite care is also offered. The home is owned and run by Cumbria Care which is part of Cumbria Adult Social Care. Mrs Lynne Newbury is employed as the registered manager for the home. Woodlands is located on the outskirts of Distington and consists of a purpose built single storey building set in its own grounds. Accommodation is provided in forty single bedrooms all with wash hand basins. The home is arranged into three living units, each with its own kitchen, sitting and dining areas. Outdoor space is provided in the form of a secure inner courtyard with flowerbeds and seating for residents and a garden area which is accessible to the people living in the home. All referrals are arranged through Social Services. The current scale for charging is £434. A Handbook is available for prospective residents, which Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 5 includes a summary of the latest Commission for Social Care Inspection report. Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection visit took place over one day during which we (Commission for Social Care Inspection, CSCI) met with the people living in the home. We also spent time talking to the manager and staff. As part of the inspection we sent out surveys to people living in the home, their relatives or representatives, care staff working in the home, GPs and other professionals who have contact with people. Before the visit the manager completed an Annual Quality Assurance Assessment (AQAA), which is a self-assessment about what the home does well and what has improved and any plans for the future. It also contains information about the running of the home. Nancy Saich, CSCI Regulatory Inspector, carried out a more detailed observation over two hours. This is called a Short Observational Framework Inspection (SOFI) which is a tool to measure how people are spending their time and includes the interaction between staff and residents. What the service does well: The manager and staff are good at introducing new people to the home, ensuring their needs are carefully matched to the services the home can offer. This leads to a high number of successful placements and relatives reporting that they were well supported by the home during a difficult time. A social care manager stated the home gives • “Sympathetic and sensitive handling of both the users specific and particular needs/circumstances, and those of the immediate family”. Health care needs, including medication, are carefully monitored and residents and relatives are confident that the home can meet their health and personal care needs. Relatives comments in this area were all positive: • “Treats all residents with care and dignity, manages ongoing health issues in a professional manner” • “Creates the necessary environment to prevent residents getting unduly stressed”. The home works closely with other professionals to make sure they can meet the different and sometimes high support needs of people. Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 7 The recruitment practices of the home are good which ensures that service users are safeguarded and that staff have the qualities and aptitudes to work in social care. The manager runs the home in an efficient and effective manner by giving clear leadership and setting high expectations of the standards within the home. This ensures that residents’ interests, safety and welfare are protected. What has improved since the last inspection? What they could do better: While peoples’ personal and healthcare needs are judged to be well met by the staff team the opportunities for stimulation and activities were assessed as only being adequate. One relative said: • “I feel the lack of activities within the home causes my relative to become withdrawn and confused. If there was stimulation or activities then they become much brighter and more alert.” Staff must be employed in sufficient numbers to not only meet personal care needs, but to allow for recreational and social activities. There needs to be an increase in the activities, stimulation and engagement of people to further improve the quality of life experienced by people in the home. In line with current best practice the home also needs to review its provision of facilities for people with dementia, for by example providing more sensory stimulation and specialist sensory rooms. Consideration also needs to be given on how signs and prompts around the home can be used to maximise people’s opportunities to remain independent. The organisation needs to make the following investments and improvements: staff training and knowledge in latest good practice in dementia care; staff time to carry out these approaches; consider employing an activities coordinator; developing practical equipment and resources: producing more detailed care plans with life story’s and pen pictures. One of the lounges was reported as being cold and draughty by residents and staff. Elm unit must be heated to comfortable levels and draughts minimised for the comfort of residents using the lounge. Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 8 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. The summary of this inspection report can be made available in other formats on request. Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 9 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 Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 3 (6 Intermediate care is not offered at this home) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home has robust and well-established procedures in place to introduce new residents and this results in a high number of successful placements. EVIDENCE: The manager is careful to only take people whose needs they can meet, and equally the individual is given the opportunity to vet the home and make an informed choice of where to live. Admissions are not made to the home until full needs assessment has been undertaken. Files contain relevant paperwork, including social work assessments and reports from health care professionals prior to a person Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 11 choosing to stay at the home. The manager also carries out an assessment which includes visits to see the person in their own home or while in hospital. One relative described the introduction to the home that included a series of visits, and another had used the respite facility prior to making a decision. Each resident is provided with a statement of terms and conditions prior to moving to the home. This sets out in detail what is included in the fee, the role and responsibility of the provider, and the rights and obligations of the resident. Information received from relatives of a new resident to the home confirmed this practice. One relative mentioned that choice was limited as this is the only home for people with dementia in the area, but they had been happy with the decision to take up a place for their relative. And another stated “The decision to place my relative in Woodlands wasn’t an informed one. It was driven by circumstances i.e. emergency respite. Having said that I am more than happy with the care she is currently receiving.” These measures ensure that admissions to the home only take place if the service is confident staff have the skills and ability and qualifications to meet the assessed needs of the prospective resident. This results in successful placements. This procedure is in line with the home’s Statement of Purpose. The home has recently produced a new Statement of Purpose and Service Users Guide. The statement of purpose details the care the home can deliver with a commitment to respecting the wishes of the individual, and refer to the skills and ability of the staff group. A copy of these new documents should be submitted to the Commission for Social Care Inspection. Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health care needs, including medication, are carefully monitored and residents and relatives are confident that the home can meet their health and personal care needs. EVIDENCE: Personal healthcare needs including specialist health, nursing and dietary requirements are clearly recorded in each person’s plan. They give a comprehensive overview of their health needs and act as an indicator of change in health requirements. Residents have access to healthcare and remedial services to ensure they stay well, and the manager and staff have developed good links with local healthcare professionals. In particular the mental health care team work closely with the home to work out strategies of the best ways to support people. A District Nurse spoken to at the home said she was happy with the level of contact with the home and felt that staff were competent to follow any instructions given by her regarding individual’s health care needs. Relatives comments in this area were positive: Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 13 • • • • “My husband is always treated with respect…he is a very quiet private man who likes to spend time quietly on his own and he is always allowed to do this. He is never forced into doing anything he doesn’t want to do, the carers are always there for him” “Treats all residents with care and dignity, manages ongoing health issues in a professional manner” “Creates the necessary environment to prevent residents getting unduly stressed” “The residents are cared for with genuine kindness. Their clothes are changed regularly and other personal needs like hair and nails tended to” The manager stated that staff in the home are due to receive training in delivering care in way described as “person-centred” in late Spring. This is regarded nationally as the best type of approach in meeting the needs of people with dementia. Before this training commences there are areas that the home could improve upon now and it is strongly recommended that the home develop personal histories and profiles for each person. This will increase staff knowledge of each person’s background and support them in offering person centred care. This will also lay down the groundwork for strengthening each person’s plan in meeting social, spiritual and psychological needs, and in developing activities that are meaningful to the person. A social care manager stated “Sympathetic and sensitive handling of both the users specific and particular needs/circumstances, and those of the immediate family. This was evidenced recently on the death of a spouse which was a traumatic experience for all but the home responded extremely well in supporting all concerned.” The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Medication records are fully completed, they contain required entries, and are signed by appropriate staff. Regular management checks are recorded to monitor compliance. The home has a good record of compliance with the receipt, administration, safekeeping, and disposal of controlled drugs. Staff have completed an appropriate medication course. An assessment has been carried out to ensure each member of staff is competent to handle, record and administer medication properly. These systems ensure there is a low incidence of medication errors and medicines are stored and administered in line with good practice. Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): All the above Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Resident’s choice and control over their lives is promoted by staff that are skilled in caring for older people. However, the provision of stimulation and activities is basic and needs to be more specialised to meet the needs of people with dementia. EVIDENCE: While peoples personal and healthcare needs are judged to be well met by the staff team the opportunities for stimulation and activities were assessed as only being adequate. At the moment it is the care staff teams responsibility to build in time across the day, after care tasks have been carried out, to do activities with residents. The staff are very busy with these tasks and they have also not had specialist training in activities for people with dementia. Relatives made this point: • “Staff are all very caring and professional in their care, there’s no doubt they would like to do more with residents if more resources were made available. However I’m content in the knowledge that my relative is being given the best possible care the current service can provide”. • “There is a lack of activities and stimulation within the home” Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 15 • “I feel the lack of activities within the home causes my relative to become withdrawn and confused. If there was stimulation or activities then they become much brighter and more alert.” The Short Observational Framework Inspection (SOFI) also highlighted these areas, in that while some people’s hobbies and interests where known to staff, consideration needs to be given on how best to communicate with those who are confused or display limited ways to communicate. One example where this was being used effectively was by staff making up a scrapbook of a sport a resident used to take part in, and this was used to engage in conversation. However when this person mentioned another hobby they had been keen on the carer replied that they didn’t know anything about that, which ended the conversation. More work is needed in this area to develop strategies and approaches to engage with people and provide meaningful activities. The manager needs to address how they can best provide activities in the home that are meaningful and take into account the varying degrees of dementia. Again a starting point for this is to adopt a more person-centred approach to find out what has been, and is now, important to people. The organisation needs to make the following investments: staff training and knowledge in latest good practice in dementia care; staff time to carry out these approaches, possibly considering an activities co-ordinator; and practical equipment and resources. All visitors reported that they are made welcome by the staff, and one said: “My relatives faith is important and his priest is welcomed regularly and I am informed when this has occurred”. The cook has regular contact with residents to listen to their choices and suggestions for the menu. This recently included a tasting session for residents to decide if they would like foods such as pasta or curry. When interviewed, the cook had good knowledge of the needs she is catering for, and is skilled in providing meals that need to be specially prepared, and also to meet the cultural needs of residents by offering local dishes. Care staff are sensitive to the needs of residents at mealtimes, for example the need for encouragement and careful monitoring of amounts consumed. Tables are set attractively with table clothes and napkins and appropriate cutlery and aids to help individuals during their meal. Birthdays and celebrations are made special for individual residents. Mealtimes were observed to be relaxed and unhurried, and are staggered to ensure people get the right amount of support. Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a clear complaints procedure and staff are knowledgeable in safeguarding adults from abuse, which ensures that residents and their families know action will be taken to resolve their concerns. EVIDENCE: Woodlands has a clear complaints procedure which is given to new residents when they move into the home. A copy of the complaints procure is displayed in the home and is given to residents’ families. The manager carries out a preadmission talk with relatives stressing the importance of having an open dialogue and speaking up to sort things out before they become larger issues. A relative said that she had been told that she must feel free to speak about even the smallest of issues and not to let them build-up. This has led to an open and friendly atmosphere in the home. Residents and relatives are confident they can raise any complaints and appropriate action will be taken to resolve their concerns. One relative card stated that “ Once or twice we have raised concerns only to find the staff have already noticed a problem and acted accordingly.” The policies and procedures regarding protection of residents are satisfactory and are regularly reviewed and updated in line with regulations and other Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 17 external guidance. The home has the latest guidance on the local multidisciplinary procedures for reporting abuse. A recent concern was reported and the manager demonstrated that all the right steps were taken to ensure the wellbeing of residents at Woodlands. Staff have received Adult protection training and demonstrate an awareness of the content of the policy and know the immediate action to take, and who to refer to. Feedback from relatives and others associated with the home state that they are very satisfied with the service provision, feel very safe and well supported by the home which has the protection and safety of residents as a priority. Some care plans have instructions on how to handle people when they became agitated and aggressive, which includes using low level physical restraint. This was identified at the last inspection and a recommendation made to provide physical intervention training and ensure that this is in accordance with the latest Department of Health guidance. The manager attended a course but judged that it was not at the right level for the staff and residents at Woodlands, as it was overly restrictive. Since then the organisation has formed a group to look at how to move this forward. However any level of physical intervention training should be provided by an accredited trainer and the first step would be to carry out an assessment of the home to gauge the level of training required. The home needs to provide evidence that an accredited trainer has been consulted. It is also recommended that the manager familiarises herself with the recent report carried out by CSCI on the use of restraint in care homes, and along with this should consider the implications of the Mental Capacity Act in promoting peoples rights within the home. The Mental Capacity Act is relatively new and the manager and organisation need to train staff as to its implications, and reflect this in each person’s care plan detailing their capacity to make decisions and support that is required to do this. Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 22, 23 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Woodlands provides a safe, clean and generally comfortable environment for residents to live-in. However, areas of the home are in need of up-grade and redecoration, with particular attention needed to the environmental needs of people with dementia. EVIDENCE: The home needs to consider how it can help people with dementia by signs and prompts around the home in order to maximise people’s opportunities to remain independent. In line with current best practice the home also needs to review its provision of facilities, for by example providing more sensory stimulation and specialist sensory rooms. Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 19 Some relatives commented that they liked the home environment, for example: • “Woodlands suits him because of all the space. With 3 large lounges, plenty of corridor space, quiet room and quiet areas he can always find somewhere peaceful to sit. • “The outside space is very good and he enjoys being able to walk around out side on his own or with one of the carers” • The bedrooms are always clean and bright” While others stated that they felt the home needed to be up-dated and particularly that en-suites would be advantageous in promoting privacy and independence. Currently none of the bedrooms are en-suite. One of the sitting rooms in particular was noted to be cold and draughty, and this was commented on by residents and staff. This lounge has a greater expanse of windows. The manager needs to ensure that this lounge is improved to ensure it is warm and comfortable for people using it. The manager ensures there is a rigorous cleaning programme and complies with Infection Control guidelines which ensures good levels of hygenine. However, there are still some areas with noticeable odours despite regular shampooing of carpets. The manager needs to replace those carpets that cannot be freshened by this method. Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): All the above Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People using the service, and their relatives, are confident that staff are caring and professional. However the whole staff team need to have a greater knowledge of the specific approaches in caring for people with dementia. EVIDENCE: All relatives and residents were positive about the care given by staff, although a number commented that more staff would improve the quality of staff time spent one to one or in improving activities. Typical comments about the general care where “The staff are very caring and friendly” “ They provide good personal care” “Sympathetic and sensitive handling of both residents and families needs” These are the responses when relatives were asked in a questionnaire if the home meets the specific needs of their relative: • “Difficult to meet the full needs of residents due to staff/residents ratio. They endeavour to balance the needs of individual residents with the needs of all the other residents. In the main, when judgements are being made, they invariably get it right” • “Given the staffing levels and difficult needs of each residents, the carers do give the best care and support they can, given the circumstances, Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 21 Using the Short Observational Framework Inspection (SOFI) to measure staff interactions it was demonstrated that while carrying out care tasks staff were taking the opportunity to interact with people, by for example responding to questions sensitively and engaging in conversations. However, this tended to be with the more vocal residents, and the quieter people received less attention. Staff interactions recorded using this SOFI tool were rated overwhelmingly as good, no poor interactions were observed. Some people however were getting two to three times more staff interactions than others. To further improve on the staff care skills the home needs to ensure that staff have the knowledge and expertise to offer specialist care within a 40 bedded home where all residents are diagnosed with varying degrees of dementia. In addition the manager needs to ensure that there are sufficient staff to meet the social, psychological and recreational needs of residents in the home. They should consider the use of an activities co-ordinator or demonstrate through increased staff hours how they will meet these needs. The recruitment practices of the home are good which ensures that service users are safeguarded and that staff have the qualities and aptitudes to work in social care. The manager can access additional staffing hours through her line manager, and this has proved particularly important when settling new residents or when caring for a person at the end of their life. Overall the staff team were judged to be professional, sensitive and caring in carrying out their duties. Staff are also well qualified in delivering care to older people but would benefit from more specialist training on dementia care delivery and activities. Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall Woodlands is well managed and residents’ interests, safety and welfare are protected. EVIDENCE: The manager has the required qualifications and experience and is competent to run the home. The manager is supported well by a competent senior staff team, and the home generally has a low staff turnover rate. Care staff reported that they receive good support from senior staff and have regular supervision to discuss their role and personal development. The Home operates to Cumbria Cares Quality Assurance standards that Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 23 includes physical aspects of running the Home as well as monitoring the delivery of service. The provider, Cumbria Care carries out regulation 26 monitoring visits and sends a copy of these into the Commission for Social Care Inspection. The home has effective systems in place to ensure the safety and up keep of the physical environment, such as cleaning rotas and maintenance records. Fire Records, annual gas and electrical checks, and servicing of hoists were all checked and these were all up-to-date. The administrative systems within the home were found to be up-to-date and in good order, the manager is supported by an administration assistant, ensuring the home is run in an efficient and effective manner. Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 24 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 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 2 18 3 2 x 2 2 2 x x 2 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 3 x 3 Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO 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 OP25 Regulation 23 Requirement Elm unit must be sufficiently heated and draughts minimised for the comfort of residents using the lounge Staff must be employed in sufficient numbers to not only meet personal care needs, but to allow for recreational and social activities. There needs to be an increase in the activities, stimulation and engagement of people to further improve the quality of life experienced in the home. Timescale for action 31/03/08 2. OP27 18 31/03/08 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 OP7 Good Practice Recommendations Care plans should be in more detail to cover peoples’ history’s prior to living at the home, for example to include pen pictures and life story’s to enable more opportunities for engagement and meaningful activities. DS0000036573.V351549.R01.S.doc Version 5.2 Page 26 Woodlands 2. OP18 Physical intervention training should be provided to staff to assist them in appropriately handling challenging behaviours. This should be in accordance with the latest DH guidance with an accredited trainer used for training and the assessment of the level of training required for the home. The manager and senior team should ensure that they keep abreast of the latest training and guidance in Dementia care. The staff team would benefit from visits to centres of excellence in dementia care, specific training courses and more resources on best practice to use as a resource for care staff to develop their expertise in caring for people with dementia. Activities and opportunities for stimulation need to be developed to improve the quality of life for those living in the home. Staff require training on the Mental Capacity Act as to its implications for people in the home, and reflect this in each person’s care plan detailing their capacity to make decisions and support that is required to do this. In line with current best practice the home also needs to review its provision of facilities, for by example providing more sensory stimulation and specialist sensory rooms. And consideration needs to be given on how signs and prompts around the home can be used to maximise people’s opportunities to remain independent. Carpets should be replaced when they cannot be cleaned to eliminate odours. The manager should audit all carpets and schedule replacements accordingly. 3. OP31 4. 5. OP12 OP17 6. OP19 7. OP26 Woodlands DS0000036573.V351549.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000036573.V351549.R01.S.doc Version 5.2 Page 28 - 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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