CARE HOMES FOR OLDER PEOPLE
Woodlands Care Home Fairfield Road Broadstairs Kent CT10 2JU Lead Inspector
Brenda Pears Unannounced Inspection 6th March 2006 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 Home DS0000065784.V273635.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 Home DS0000065784.V273635.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Woodlands Care Home Address Fairfield Road Broadstairs Kent CT10 2JU 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) 01843 860998 01843 862865 Ashbourne (Eton) Limited Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33), Physical disability (3), Terminally ill over of places 65 years of age (5) Woodlands Care Home DS0000065784.V273635.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Of the 33beds registered for nursing patients 10 are also registered for the admission of residential clients 1st November 2005 Date of last inspection Brief Description of the Service: Woodlands Care Home is a purpose built two-storey building set in gardens next to Fairfield Manor Care Centre, both of which are owned by the same company. The Home offers personal, nursing and palliative care, it is also registered to care for 3 people with a physical disability. Accommodation comprises of 28 single and one double room all with en-suite facilities. The well-kept garden and patio area are available to service users at the front of the building. The Home stands in extensive grounds, with ample parking facilities and is located in a residential area on the outskirts of Broadstairs. Woodlands Care Home DS0000065784.V273635.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken with a focus on the well being, safety and quality of life of service users living in the home. The methods of inspecting the home included speaking to service users, the clinical manager and staff, undertaking a sampling of records and a tour of the building. There is currently no manager in the home but 2 managers from other homes in the group are overseeing the home and the regional operations manager is also regularly in the home. The clinical manager is the senior staff member in the home and coping with day-to-day matters with the assistance of another staff member who has managerial experience. What the service does well: What has improved since the last inspection?
Daily records have been improved containing more details of each person and how they have spent the day. This now provides a much better picture of the moods and feelings of the service user, to enable full support and monitoring. Staff are currently ensuring any changes to care plans are discussed at staff handover and senior staff are taking responsibility of passing on any changes. Woodlands Care Home DS0000065784.V273635.R01.S.doc Version 5.1 Page 6 Bathroom radiators not in use have been removed to provide a safe environment. Two service user rooms have been decorated prior to new admissions and corridors are currently being decorated. 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 Care Home DS0000065784.V273635.R01.S.doc Version 5.1 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 Home DS0000065784.V273635.R01.S.doc Version 5.1 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 the following standard(s): 3 Pre admission assessments are carried out to ensure any decision to move into the home is appropriate. EVIDENCE: The admission process and assessments have been thoroughly carried out and full care plans developed. Files contain information to support service users and to ensure the needs of the individual can be met. Staff are currently ensuring any changes to care plans are discussed at staff handover. Senior staff are taking responsibility of checking that all staff are aware of any changes. Woodlands Care Home DS0000065784.V273635.R01.S.doc Version 5.1 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 the following standard(s): 7,8,9 Health care needs are met, care plans are in place and are currently being reviewed to ensure the needs of service users are current and appropriate. EVIDENCE: Care plans clearly set out the health needs of service users and these are being met by staff and through contact with appropriate health care teams. Recent training has triggered the introduction of new routines regarding the monitoring and recording of skin viability. While qualified RGN staff deal with all dressings, care staff are trained to monitor skin viability and then report any matters to senior staff. There is alcohol gel around the home for the control of infection. Staff are working to control the amount of medication being held in the home and working with the pharmacy to continue to hold appropriate stocks of medication. Staff are also paying attention to the completion of medical administration records, particularly with regard to any refusals or other reasons for medication not being administered. Records seen at this time evidenced appropriately and clearly completed record sheets.
Woodlands Care Home DS0000065784.V273635.R01.S.doc Version 5.1 Page 10 Woodlands Care Home DS0000065784.V273635.R01.S.doc Version 5.1 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 the following standard(s): 14,15 All requests for individual meals are met at mealtimes, supporting choice and meeting needs. EVIDENCE: Meals continue to be varied and choices are available daily. Service users are able to state what they would like and this is made available. The menu for the day was on display in the dining room at the time of this inspection. Service users wishing to remain in bed, or have a late morning, are supported to do so. Service users stated they enjoy the food, have plenty and are well cared for. Lunch was relaxed and support was being given where appropriate. One new member of staff was asking advice on how to assist one person, how they liked to be helped and how to set food on the plate. One service user is proud of his fish tank, but needs additional space in his room, he therefore wants to pass the fish tank to the home. This will enable
Woodlands Care Home DS0000065784.V273635.R01.S.doc Version 5.1 Page 12 other service users, and the person himself, to continue to enjoy the fish tank that means a great deal to him. The clinical manager is currently making arrangements for this move. Woodlands Care Home DS0000065784.V273635.R01.S.doc Version 5.1 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 the following standard(s): 16,18 There is a complaints procedure in place to support service users and families should they wish to make a complaint. Finances are well maintained, protecting service users from financial abuse. EVIDENCE: The home has a complaints procedure and this is displayed in the main entrance lobby and every service user is issued with a copy. The home tries to work with families to encourage discussion when any matters arise. Finances held on behalf of service users have recently been audited. All records contain full information regarding all cash transactions and balances with all receipts being retained on file. Files evidence that financial transactions are supported by two signatures at all times. Woodlands Care Home DS0000065784.V273635.R01.S.doc Version 5.1 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 the following standard(s): 19,26 Improvements continue through the ongoing refurbishment and re decoration programme. EVIDENCE: The home was found, in the main, to be clean and free from odours at this time, with staff continuing to welcome visitors into the home. However, there were no domestic staff on duty on this day and this was clearly reflected in some service user rooms. The home is currently recruiting for another domestic member of staff. Bathroom radiators not in use have been removed to provide a safe environment. Two service user rooms have been decorated prior to new admissions and corridors are currently being decorated. There are plans in place for the construction of a conservatory to be added to the front of the building. This will add much needed communal space to the home for the comfort of service users. A sensory garden, water feature and
Woodlands Care Home DS0000065784.V273635.R01.S.doc Version 5.1 Page 15 some raised beds are also planned for the front of the building, for the enjoyment of service users. Woodlands Care Home DS0000065784.V273635.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 There is a thorough recruitment process in place to ensure the safety of service users in the home. EVIDENCE: Staff are employed only after the appropriate checks and references are obtained to ensure the safety of service users at all times and a sampling of staff files evidenced this. Files are well organised with indexing and all appropriate paperwork in place. Woodlands Care Home DS0000065784.V273635.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,36 There is currently no registered manager, therefore senior staff are ensuring the smooth running of the home and safety of service users is maintained. EVIDENCE: There is currently no manager in the home but recruitment is currently taking place. Two managers from other homes in the group are currently overseeing the home and the regional operations manager is also in the home two days a week. The clinical manager was the senior member of staff on duty at the time of this inspection and a night member of staff, with previous management experience, is also assisting with the main duties around the home. Both are also undertaking staff supervision, appraisals and reviewing care plans. Woodlands Care Home DS0000065784.V273635.R01.S.doc Version 5.1 Page 18 Woodlands Care Home DS0000065784.V273635.R01.S.doc Version 5.1 Page 19 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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 X 28 X 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X 2 X x Woodlands Care Home DS0000065784.V273635.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? yes 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 OP 14 Requirement Care plans are to be reviewed on a monthly basis and staff must be familiar with all service user needs. Medication storage must continue to be maintained at an acceptable level, until this becomes common practice. That all areas of the home are clean at all times. Ensure there is regular and continued supervision of staff. All open doors are to be risk assessed and appropriate fire safety installations obtained. Timescale for action 06/03/06 2. OP9 OP 13 06/03/06 3. 4. 5. OP26 OP36 OP38 OP 16,23 OP 19 OP 12,13,16 & 23 06/03/06 30/04/06 30/04/06 Woodlands Care Home DS0000065784.V273635.R01.S.doc Version 5.1 Page 21 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 OP20 Good Practice Recommendations That the planned conservatory be added to the front of the home to provide adequate communal space for service users and support the provision of a selection of activities, to meet individual needs. That the refurbishment and redecoration programme continue until all areas meet an acceptable standard. 2 OP19 Woodlands Care Home DS0000065784.V273635.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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