Inspection on 26/11/07 for Woodlands Care Centre

This inspection was carried out on 26th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Woodlands Care Centre Woodlands Road Macclesfield Cheshire SK11 8AQ Lead Inspector June Shimmin Unannounced Inspection 26 November & 4 December 2007 10:00 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 Care Centre DS0000069632.V350912.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 Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodlands Care Centre Address Woodlands Road Macclesfield Cheshire SK11 8AQ 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) 01625 432 471 01625 421 570 Canterbury Care Homes Ltd Care Home 30 Category(ies) of Dementia (5), Old age, not falling within any registration, with number other category (30) of places Woodlands Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing: Code N, to people of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category: Code OP (maximum number of places: 30). Dementia: Code DE (maximum number of places: 5). The maximum number of people who can be accommodated is: 30. Date of last inspection 13 September 2006 Brief Description of the Service: Woodlands Care Centre was built as a private residence around 1880 and remained as a private house until 1984 when it was converted into a nursing home. Ownership of the home had recently changed and the new owners are Canterbury Care Limited. The home is about two miles for the centre of Macclesfield in Cheshire. There are high walls around the property, giving privacy, and there is a patio and lawn for the people who live at the home to use. Accommodation is provided on two floors and includes both single and double rooms, some of which have en suite facilities. Access between floors is provided by a passenger lift. There is a large conservatory with lounge space and a dining room and there is a second lounge in the home. There is wheelchair access to the home. Room prices range from £402.60 to £600 per week, depending on the size of the room and whether it is a single or double and the type of en-suite facilities. Woodlands Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on the 26 November 2007 and 4 December 2007. A pharmacy inspector also accompanied the lead inspector to check on the arrangements for medicines in the home. This visit was just one part of the inspection. Before the visit the home manager was asked to complete a questionnaire to provide up to date information about services in the home. CSCI questionnaires were made available for families, staff and care professionals to find out their views. Other information received since the last key inspection was reviewed. During the visit various records and the premises were looked at. A number of people living in the home, a relative, staff members and a visiting nurse assessor were spoken with; they gave their views about the home and the service provided. The new manager started working at the home on the first day of the inspection. The former manager is still working at the home. What the service does well: Staff are highly regarded and provide a good standard of care. One visitor described staff as being “exceptional, perfect.” People have their needs fully assessed before moving into the home so they know their needs can be met there. They are also given information about the home to help them decide if the home has the facilities and services that they need. Care plans are generally well written so that the right actions are taken to meet identified needs. Prompt referrals are made to health care professionals so that people’s health care needs are met. The food provided is nutritious and varied so that people get a healthy diet and people say they enjoy it. The home has a satisfactory complaints procedure so people know their concerns will be taken seriously and acted upon. Staff ensure that the home is kept clean, tidy and free from any unpleasant odours so that any potential infection is controlled. Woodlands Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 Page 6 Staff are well trained and almost 50 of staff have achieved NVQ 2 in care so they are equipped to care for people. The home is well managed and has not been adversely affected by a change of management. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Woodlands Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Woodlands Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who are thinking of moving in are given information about the home and have their needs assessed before moving in so they know their needs can be met there. EVIDENCE: Ownership of the home has changed since the last main inspection. The information leaflets (Statement of Purpose and Service User Guide) have been updated to show this and provide information about the services, facilities and staff working at the home. The new manager said that this information would be displayed on laminated boards near to the entrance of the home. The manager usually undertakes assessments of people wishing to move into the home before they move in to make sure their needs can be met there. The assessments of two people who had recently moved into Woodlands Care Centre were seen. The manager said that the new owners are planning to Woodlands Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 Page 9 introduce new forms, which will cover all necessary information about the person. The assessments included all the physical and other health care needs of people but in one case there was little documented about the person’s social, leisure and spiritual needs so these may not be recognised and met. For the other person there was more information about the person’s life history so that staff would be able to provide care based on knowledge of the person’s individual needs and preferences. One of the people who had recently come to live in the home said that he had heard good things about the home, which had helped him to make the decision to move in. Woodlands Care Centre does not currently provide intermediate care. Woodlands Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The health care needs of people in the home are recorded and kept under review so that they know those needs will be met. Some aspects of the management of medication need to be reviewed so that medication is safely managed. EVIDENCE: The care plans for two people were seen. These were one for a person who had recently come to live in the home and one for someone who had been living there for some time. There were appropriate care plans and risk assessments for identified needs and risks. Although the care plans were pre printed, an effort had been made to make sure that these plans represented the individual care needs of people. The care plans had been evaluated monthly and in one case the care plan focused on the abilities of the person rather than disability, which is good practice. Woodlands Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 Page 11 One area that could be improved on was to ensure that the person or a nominated family member was involved in that person’s care planning and review so that people would know what was happening and could contribute if they wished. Since the last inspection care plans have been moved to be stored in the medication room and a desk has been put there for nursing staff to use. This means that access to care plans is limited and that care staff may not be able to read them easily. It also means that there is less space for storing medication. People said that staff treated them with respect and that their privacy was respected. A relative confirmed this and complimented staff on their caring abilities. One aspect of care affecting the dignity of people was noted in that plastic aprons were being used to protect people’s clothing during lunch. As they are not appropriate for this function, this may lead to the embarrassment of the person. A CSCI pharmacist inspected the medicines. There are two medicine procedures available currently as the home has a new owner. Neither document has specific information to guide staff how to manage medicines at Woodlands. Since the last site visit the nurses’ office has been moved into the medications room, including a desk and a photocopier on a table. Some medicines were stored on the floor. In order to open one medicine cupboard, the waste bin has to be handled. This and the practice of drying medicine pots on the hand basin are not hygienic. There were a number of items in the medicine cupboard, like cigarettes and jewellery, which should not be with the medicines. Also storing documents like care files means that staff that are not designated to handle medicines have access to them. Some medicines had been taken out of the pack in which they were supplied so it was not possible to know to whom they belonged. An oxygen cylinder was stored in the middle of a pile of plastic waste containers covered by a dark coloured coat; this may be a fire hazard. The controlled drug cupboard is too small to hold the amount of medicines in it so they are squashed in, which may damage them. Records of giving medicines have been kept to a reasonable standard although there were some omitted records of giving medicines, recording variable doses and recording medicines received. It was not easy to follow an audit trail of those medicines which are not included in the monitored dose pack. No amount held was carried over to the new record sheet at the beginning of the month when a residue was left at the month end. Also there were medicines in the cupboard received on hospital discharge. These were not accounted for in the records. Two people had been given topical medicines fewer times a day than prescribed and one person had been given a dose of an antibiotic by mistake before the second course was to start. There were no records of Woodlands Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 Page 12 medicines sent as waste as the list was given to the contractor removing the medicines. There was a pack of controlled drugs that had been dispensed in 12/06 that were not accounted for in the records. Woodlands Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 Page 13 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): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People spoken with were positive about the home and the support they received so they could maintain contact with friends and family and make choices about their daily lives. The limited number of social activities available puts people at risk of boredom and social isolation. EVIDENCE: An activities organiser is employed at the home but is currently off on long term sick leave. During the previous week a staff member from another home in the group had started to provide some activities and a painting session was taking place during the afternoon. The new person has received some training and is trying different activities. He said that in the morning he had tried one to one activities with individual people. People spoken with said that they could choose whether to join in activities or not with some people preferring to watch television or stay in their own room. Relatives said that they were made to feel welcome by staff and the nurse assessor commented on the good atmosphere in the home. Woodlands Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 Page 14 People can take their meals in the dining room or eat their meal in their own bedroom or at a small table in one of the lounges. The cook was aware of the individual preferences and choices of people as well as any special diets. He said that he asks people after breakfast what they would like for lunch. Meals provided are varied and nutritious and there is a hot meal choice in the evening together with a variety of sandwiches. It was noted during lunch that a number of people were not prompted to eat their meal until the food was cold and that they did not eat much of the food provided. Woodlands Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 Page 15 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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are managed well at the home and there is a procedure for the home on adult protection but lack of training about this may mean that staff do not know what to do if abuse is suspected or observed. EVIDENCE: There is a complaints procedure for the home and a copy is displayed in the entrance to the home. People said they would know who to speak to if they had any concerns. The manager kept a record of complaints together with the actions taken as a result of the complaint investigation. The manager also kept a record of compliments received by the home. The policy for the protection of vulnerable adults has just been revised. Some of the content of the policy is unclear so that staff may be unaware of their responsibilities. Important contact telephone numbers were not recorded so that people might not know whom to contact. The manager said that two staff were attending training in adult protection that day but that other staff had not undertaken recent training in the subject. Several staff interviewed during the inspection said they would know what to do in the case of alleged abuse although they had not received training on the subject. Woodlands Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 Page 16 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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Woodlands Care Centre is well maintained so that people live in comfortable and pleasant surroundings. EVIDENCE: A number of improvements have been made to the inside and outside of the home since the change of ownership. The outside of the home has been painted, some guttering replaced and the fire escape repaired. A new keypad system has been installed on the front and back doors of the home to make it more secure. Inside the home, thermostatic valves have been put on all radiators and three bedroom carpets replaced. The new lighting on the downstairs corridor has made the home much brighter. Woodlands Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 Page 17 Measures are in place to ensure that any potential outbreak of infection is effectively controlled. During a tour of the premises the home was found to be clean and tidy although maintenance men were working in the home. The new manager said that further improvements are planned for the near future including new carpets to the ground floor and new armchairs and dining furniture. Woodlands Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 Page 18 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): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff members work well with residents and families to improve the quality of life of people living in the home but the staff recruitment process is not thorough enough to make sure that staff are suitable to work with the people who work at the home. EVIDENCE: The recruitment records of two new staff were requested for checking. Only one set of records could be found; these were of a satisfactory standard and indicated that security checks had been carried out before the person started work at the home unsupervised. The second set was eventually found but the new manager said that this was incomplete. The manager also said that the person had stopped working at the home during the previous week. A senior manager for Canterbury Care has carried out a survey to find out what the staff training needs are so that a suitable training programme can be arranged. Information provided by the former manager before the inspection visit indicated that nearly 50 of staff have achieved NVQ 2 in care so that staff are appropriately trained. However, neither staff member spoken with during the visit had been offered this training. The manager said that staff supervision was to start in the near future so that staff can be given guidance about practice issues and training opportunities are discussed. One staff Woodlands Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 Page 19 member had received induction and the other had not yet done any training other than moving and handling. Woodlands Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 Page 20 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 & 38 Quality in this area is adequate. This judgement has been made using available evidence including a visit to this service. The home is being well run and managed on a day-to-day basis but fire safety measures are unsatisfactory so that people in the home may not be safe. EVIDENCE: A new manager started work at the home on the day of the inspection. The new manager had worked as a senior manager for the organisation that formerly owned this home and is therefore familiar with the home and its staff. She is a registered nurse and has achieved NVQ 4 in management. She has over twenty years experience of care of the elderly and has undertaken further courses to update her knowledge and skills. The former registered manager is continuing to work at the home and will support the new manager in her role. Woodlands Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 Page 21 A senior representative of Canterbury Care visits the home every month to assess the quality of care provided and writes a report, which is made available to CSCI. The former manager said that regular staff meetings are held as well as relatives’ meetings. The manager is available in the home one evening a week to meet with the families or friends of people living in the home. Records for fire safety were looked at. These showed that the fire risk assessment was incomplete so that it was unclear whether all precautions had been taken to ensure fire safety in the home. There were no records of fire training or fire drills available so that staff might not know what to do in the event of a fire. Information provided by the manager before the inspection indicated that installations and equipment had been serviced at least annually. The information provided also stated that the monies of people living in the home will be held at the head office of the organisation until a separate account is opened. Woodlands Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 Page 22 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Woodlands Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A 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 OP9 Regulation 13 Requirement Procedures for managing medicines at Woodlands Care Centre must be clear in order to guide staff to manage medicines properly. Medicines must be stored securely and tidily so that staff can easily find and account for each resident’s medicines. Recruitment records must be obtained and kept to demonstrate that the recruitment procedures are thorough so that all necessary checks to make sure that staff are suitable to work with the residents are made. All staff must undertake fire drills regularly in accordance with advice from the relevant authorities so that they know what to do in the event of a fire. All staff must receive annual updated fire safety training so that they know what to do in the event of a fire. The fire risk assessment must be completed any associated actions taken to ensure that DS0000069632.V350912.R01.S.doc Timescale for action 31/12/07 2 OP9 13 31/12/07 3 OP29 19 and Schedule 2 04/02/08 4 OP38 23(4)(e) 04/02/08 5 OP38 23(4)(e) 04/02/08 6 OP38 23(4)© 04/02/08 Woodlands Care Centre Version 5.2 Page 24 people in the home are safe. 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 Each person living at the home or their representative should be involved in their own care planning and review so that they know what care will be provided and if it is effective. Appropriate protection should be used at mealtimes to protect people’s clothing in a way that maintains their dignity. There should be enough individual and group activities available to meet people’s needs so they are not at risk of becoming bored or socially isolated. People’s social needs and preferences should be recorded I their care plans together with any action needed to make sure that they do not become socially isolated. Steps should be taken to make sure that those people who need help or prompting to eat their meal are given this support so they can enjoy their meal and receive adequate nutrition. All staff should undertake training and refresher training in adult protection so that they know what to do if they suspect abuse has taken place. 2 3 4 5 OP10 OP12 OP12 OP15 6 OP18 Woodlands Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Care Centre DS0000069632.V350912.R01.S.doc Version 5.2 Page 26 - 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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