Inspection on 09/06/05 for Woodlands

This inspection was carried out on 9th June 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 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 16/02/07

Woodlands 10/11/05

Woodlands 08/12/04

Woodlands 04/09/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Woodlands 176 Read Road South Church Crookham Hampshire GU13 0AE Lead Inspector Liz Palmer Unannounced 9 June 2005, 10:00 th 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 H54 S12103 Woodlands V230817 090605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Woodlands Address 176 Reading Road South Church Crookham Hampshire GU13 0AE 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) Woodlands & Hill Brow Limited Mrs Theresa Fields Care Home 40 Category(ies) of Dementia, over 65 - DE(E) - 3 registration, with number of places Woodlands H54 S12103 Woodlands V230817 090605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Only three service users in the DE(E) category can be admitted to the home. Date of last inspection 8.12.04 Brief Description of the Service: Woodlands provides accommodation for forty people who are within the category of older people. The home endeavours to provide a homely and relaxed environment for service users.The home is owned and operated by Woodlands and Hill Brow Ltd a family business who also have a second home in the area.The home is situated between the towns of Farnham and Fleet and is located in a residential street in Church Crookham. The home is set within its own grounds. Accommodation is provided on two floors. Woodlands H54 S12103 Woodlands V230817 090605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over three hours. The focus of the inspection was to talk to residents about life in the home and how their needs were met. A tour of the premises was undertaken, assessments and care plans were looked at. Seven residents retuned comment cards and five relatives comment cards were received. What the service does well: What has improved since the last inspection? The home has implemented a new risk management plan to minimise falls. This includes a senior member of staff being appointed as the ‘falls coordinator’. The home is continuing its redecoration programme with bedrooms being decorated as they become vacant. Two bathrooms have been turned into ensuite shower rooms. Woodlands H54 S12103 Woodlands V230817 090605 Stage 4.doc Version 1.30 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 H54 S12103 Woodlands V230817 090605 Stage 4.doc Version 1.30 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 H54 S12103 Woodlands V230817 090605 Stage 4.doc Version 1.30 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) 3. Standard 6 does not apply. Arrangements for assessments are in place but the home must be clear about which residents are admitted in the dementia category to ensure their needs can be met. EVIDENCE: Five assessments were looked at and were seen to include relevant information, for example, health issues, social interests, religious preferences and details of a persons mental state. Assessments are undertaken by the proprietor, the manager or a care manager if applicable. Some assessments included an assessment from a doctor or occupational therapist. Through discussion with the manager the inspector found she was unsure of which residents were admitted in the dementia category and what diagnosis was required. Further training was discussed and a requirement has been made under standard 7. Woodlands H54 S12103 Woodlands V230817 090605 Stage 4.doc Version 1.30 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 and 10 In general the arrangements for care planning ensures that residents needs are met. Training in dementia and improvements to recording of care plans will make sure that those residents diagnosed with dementia have their individual needs met consistently. Arrangements for personal and healthcare promotes the well being of residents and upholds their dignity. EVIDENCE: Seven care plans were looked at and seen to contain the basic information needed for their care to be delivered in an individual and consistent way. Details included health needs, records of GP visits, dietary requirements and risk assessments. The manager stated that new care plans are being introduced which will include a space for residents to sign when changes are agreed. The inspector found discrepancies between information on initial assessments and details on care plans, with regard to service users mental state. For example, one resident was stated by the manger to have dementia, this was not reflected in the persons care plan. Another new resident’s care plan stated they had dementia but this was not reflected in the initial assessment. Woodlands H54 S12103 Woodlands V230817 090605 Stage 4.doc Version 1.30 Page 10 Through discussion with the manager it became clear that there was some uncertainty in her understanding of the difference between short term memory loss and clinical dementia. The manager stated she had attended some talks on dementia. Information about residents who have had a clinical diagnosis of dementia need to be clearer and the manager would benefit from training to enable her to better understand dementia and the implications this has on people’s care. A list of all the residents’ General Practitioners (GP) contact details was seen in the office. All residents spoken to said they could access a GP or other medical practitioner, such as, dentist, diabetic nurse, parkinsons nurse and opticians. Residents said they felt confident in the staff to recognise their health needs. Residents also said their dignity and privacy was always maintained and staff were always respectful to them. Woodlands H54 S12103 Woodlands V230817 090605 Stage 4.doc Version 1.30 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 and 15 The range of activities offered by the home promotes residents’ mental and physical well-being. The arrangements for meals ensures residents have a nourishing balanced diet and are able to choose where to eat. EVIDENCE: The home offers a structured range of social activities, such as, bowls, poetry reading, music and movement, bingo and board games. Residents spoken to said they were happy with the choice of activities and particularly enjoyed the recent introduction of a get together for a drink in the lounge every Saturday night. Other activities enjoyed include the annual garden party and one resident said ‘they pull out all the stops at Christmas’. Social preferences are recorded in care plans, as are religious preferences. Comment cards reflected that residents are happy with the arrangements for activities. A visiting policy displayed in the entrance hall welcomes families and friends to the home, this is reflected in the relatives comment cards returned and comments from residents. Woodlands H54 S12103 Woodlands V230817 090605 Stage 4.doc Version 1.30 Page 12 Residents stated that they have a choice of main meal and are asked each morning what they would like. An alternative is not written onto the menu plan. But the home aims to provide alternatives to those who do not want what is on the menu. Residents can choose where to eat meals. Some for example, choose to have breakfast in their rooms. Preferences regarding this were recorded in care plans. Residents appeared to be enjoying the food on the day. Menus are varied and nutritious. Residents requiring assistance were helped by staff in an unrushed and individual manner. A resident with dietary requirements due to diabetes said they were happy with their food alternatives and diabetic care in general. Woodlands H54 S12103 Woodlands V230817 090605 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed. EVIDENCE: Woodlands H54 S12103 Woodlands V230817 090605 Stage 4.doc Version 1.30 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 and 26. Arrangements for cleaning, decorating and maintaining the home ensures residents live in a safe and comfortable environment. EVIDENCE: The home was clean, bright and homely on the day of inspection. There is a continuing redecoration programme which ensures the standard is maintained. Two bathrooms have recently been converted to en suite shower rooms. Bedrooms are redecorated as they become vacant. Domestic staff are employed and are trained in infection control and aprons and gloves are worn. Woodlands H54 S12103 Woodlands V230817 090605 Stage 4.doc Version 1.30 Page 15 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) None of these standards were assessed on this occasion. EVIDENCE: Woodlands H54 S12103 Woodlands V230817 090605 Stage 4.doc Version 1.30 Page 16 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 and 38. The home actively seeks the views of residents makes decisions based on this information received. All safety checks are completed on a regular basis to promote the safety of residents and staff. The home would benefit from advice from a fire safety officer regarding the wedging open of fire doors. EVIDENCE: Residents meetings are held every six months and a survey is also carried out six monthly, in between the residents’ meetings. Views of residents are therefore sought on a three monthly basis. Comments received include positive comments about the food and how promptly call bells are answered. Any requests, for example, for outings or activities are acted upon and the results of the survey are published. All resident comment cards reflected that residents do not wish to be any more involved in the running of the home. Woodlands H54 S12103 Woodlands V230817 090605 Stage 4.doc Version 1.30 Page 17 The home was visited by an environmental health officer in June 2004. There were no requirements following this visit. Regular testing of fire equipment was carried out. Fire fighting equipment had recently been serviced. Staff had recently received fire training. Fire doors were wedged open on the day of inspection. A requirement for advice to be sought from a fire safety officer was made. Woodlands H54 S12103 Woodlands V230817 090605 Stage 4.doc Version 1.30 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x 2 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 3 x 3 x x 2 Woodlands H54 S12103 Woodlands V230817 090605 Stage 4.doc Version 1.30 Page 19 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 OP7 Regulation 15 Requirement Care plans must reflect those who have a diagnosis of dementia and how this affects their care. The manager must attend suitable dementia training. The manager must seek advice from a fire officer regarding keeping fire doors open. Timescale for action 01/08/05 2. 3. 4. OP7 OP38 18 23 31/08/05 25/08/05 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 Good Practice Recommendations Woodlands H54 S12103 Woodlands V230817 090605 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW 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 H54 S12103 Woodlands V230817 090605 Stage 4.doc Version 1.30 Page 21 - 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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