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Inspection on 27/02/09 for Woodlands (Colchester) Ltd

Also see our care home review for Woodlands (Colchester) Ltd for more information

This inspection was carried out on 27th February 2009.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home environment is a comfortable and homely. It provides people who live there with suitable space and resources to meet their needs. The maintenance and decor of the building is to a good standard. People who live at the home and their relatives speak highly of the service. Surveys received by the Commission contained statement such as " they give the support and care that my relative needs and more", "as a family we are pleased that (our relative) was able to find a care home that looks after (them) so well" and "every care is taken at all times, no complaints, a happy environment for (my relative)". The provision of meals was felt to be very good, people living at the home told us that they felt that the menu was very good with sufficient choices for them to feel able to pick out what they liked. They appreciated that the staff took time to help them chose form the menu. People living at the home liked the atmosphere and their relationship with staff. During our inspection a good humored banter was in evidence, and people told us they appreciated that staff "treated us like human beings, they pull our legs and we pull theirs". The level of support was felt to be very good by visiting health professionals, we were told that "my patients are well looked after", and "they follow the instructions in maintaining people`s wellbeing well".

What has improved since the last inspection?

There were only two matters raised at the last inspection that required attention. The recruitment processes relating to people employed on a supported employment programme were in need of review. At this inspection the manager and a director were able to demonstrate that they had addressed this. The registered manager had not completed the NVQ 4 Registered Managers Award. Julie Wells has since achieved the completion of this qualification and a certificate is displayed in the home.

What the care home could do better:

there are not any significant areas of improvement required at this inspection.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Woodlands (Colchester) Ltd 76 Lexden Road Colchester Essex CO3 3SP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sara Naylor-Wild     Date: 0 2 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Woodlands (Colchester) Ltd 76 Lexden Road Colchester Essex CO3 3SP 01206571200 01206505450 sam@woodlandsrh.freeserve.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Woodlands (Colchester) Limited care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Twenty three female service users, aged 65 years and over, who require care by reason of old age only Date of last inspection Brief description of the care home Woodlands is located within the Lexden area of Colchester, an established residential area to the west of the town centre. There is approximately a ten-minute walk between the home and the town centre. Public transport, passing to the front of the home, is frequent. The nearest train station is Colchester Town, approximately half a mile distant. Hairdressing, chiropody, toiletries and newspapers and magazines are all charged at cost. 0 Over 65 23 Care Homes for Older People Page 4 of 28 Brief description of the care home The early 1900s property was a former large family dwelling and has been developed to present the current accommodation. The home is solely for women. The accommodation is arranged on two floors, the upper floor is accessed via a passenger lift. Single and shared bedrooms are available and there are various communal rooms including a lounge, dining room, small conservatory/hairdressing salon and a large conservatory. There is a rear garden incorporating a sun terrace and lawn. The front of the property, enclosed by trees and shrubs, includes parking and seating areas. The garden also extends along one side of the home. Mrs Julie Wells is the Registered Manager. Miss Samantha Racey, the Responsible Individual of the company and Mr Chris Graham director of the care home are also involved in the day to day running of the home. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last key inspection of this service took place on the 28th February 2007. This key inspection took place on the 27th February and 2nd March 2009. As part of the inspection we checked information received by the Commission for Social Care Inspection (CSCI) since the last inspection on the 27th February 2007, looking at records and documents at the care home and talking to the manager, Julie Wells, care staff and the people living at the home. In addition the Annual Quality Assurance Assessment (AQAA) completed in December 2008 was considered as part of the inspection process and a tour of the premises undertaken at the visit to the care home. Feedback was received from people who use the service, their relatives and staff who completed the surveys sent by the Commission. Care Homes for Older People Page 6 of 28 The service sent us their AQAA when we asked for it. this contained information about what they felt they did well and how they planned to improve the service. The manager and a director of the home assisted the inspector at the site visit. Feedback on the findings was given during the visit with the opportunity for discussion or clarification. We would like to thank the manager, the staff team and the people living at the service and their relatives for their help throughout the inspection process. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 Care Homes for Older People Page 8 of 28 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering moving to the home can be confident that the service will understand how they should best be supported and if the staff have the capability to meet their needs and expectations. Evidence: The service has an updated Statement of Purpose and Service users guide. This provides information to people considering moving into the home, including examples of contracts and their rights of tenancy. The files of three people living at the service were examined for evidence of the services admission processes. The services Annual Quality Assurance Assessment submitted to the Commission stated that all new service users, prior to admission, have a full assessment undertaken to ensure the home can meet their care needs. It also stated that Care Homes for Older People Page 11 of 28 Evidence: prospective service users and their relatives/advocates are invited to visit the home an stay for a morning or lunch prior to admission to determine the suitability of the home. The files seen all contained an assessment of the person, their strengths and needs. This provided a picture of their daily life and how they would require to be supported to continue to achieve independence in this. There was also opportunity for the person and their family members to contribute to the document with their views. People spoken with during the visit were clear that they had been provided with opportunity to visit the home and where possible this had been for longer periods. One person told us that I was able to chose because I came here for respite so I knew how it worked. People are provided with a copy of their contracts and the content of this sets out clearly the fees payable and what this payment is for. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the service are confident that the staff understand them and how best to support their assessed needs. Evidence: The care plans of the same three people were considered to understand how the service translates the information from initial assessments to provide support for individuals. The plans all contained descriptions of areas of support staff should consider in meeting peoples daily needs. Some issues were further considered under separate objectives. These highlighted areas where it was felt extra efforts could be made to achieve improved outcomes. Some examples included where someone had recently moved to the home and the objective was to provide additional support to assist them to settle into their new environment. Care plans were regularly reviewed with comments made to changes in the plans and instructions to staff. There was not any evidence of the person themselves or their Care Homes for Older People Page 13 of 28 Evidence: family members signing off the documents to indicate their agreement with the plan. The staff maintained daily records of each individuals experiences at the end of each shift. The information was informative and gave indications about how successfully the care plan was being addressed. However, it tended to focus on the physical needs of people rather than a more holistic view of their day. There were risk assessments present for some aspects of individuals activities. These included moving and handling assessments and in one case the use of locked facilities in their room. However there were other areas indicated in the care plans seen that warranted risk assessments to determine how the service should support the person. These included a person who had suffered falls, another with a recorded poor appetite and continence issues. Whilst there was support provided for these areas a comprehensive risk assessment would give a clearer indication of the best approach. Health care records were maintained and included details of visits by health professionals and their outcomes. These were transferred into the persons plan of care for implementation. Generally the care plans provided information about the person and how to meet their identified needs and wishes. The way in which these could be further developed was discussed with the manager and proprietor, during which they were able to indicate their own understanding of how they intended to develop the plans. Discussions with people living at the home and the staff as well as observation of staff interaction with people during the visit indicated a good understanding of people as individuals and how their support needs varied. One person told us I am independent and like to do things for myself, but i get as much help as I need. A staff member discussed how the knowledge of the way in which someone liked to go to sleep had enabled the staff to make sure their routine supported this. Medication management and recording was considered at this visit which included an observation of staff dispensing medication according to peoples prescriptions. The service uses an MDS system and from the observation of the lunchtime administration staff generally demonstrated a good understanding of the procedures for the safe administration of medicines. There were some issues with how staff dispensed and signed for medication for people who were not in the dining room. This was discussed with the manager at the time and corrections made to the practice. Overall the administration and management of medications was in line with the Care Homes for Older People Page 14 of 28 Evidence: recommended safe practice guidance of the Royal Pharmaceutical Society of Great Britain. A sharps box used by the district nurses was also left unsecured on top of cabinets in the dining room during the inspection visits. This is an unsafe location and this was pointed out to the manager during the inspection. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home can be confident that they will be provided with opportunities for stimulation and have the ability of making choices in how they spend their day. Evidence: Activities available in the home are displayed daily on a flip chart in the main lounge. The list of activities on offer included outside entertainment, musical bingo, excercises, dice and card games, skittles and quizzes. Efforts are made by staff to include everyone in some kind of social activity and on the day of inspection staff were observed supporting people to participate in the musical bingo session. The availability and accessibility of activities to people with cognitive impairments was an ongoing effort and the manager discussed ways in which the service were exploring this aspect of care support. People who we spoke with during the inspection told us that they enjoyed the activities on offer and that they had gone out on visits to the town center. They were aware of the service users meetings and said that they knew that developments such as the patio area and the plans for a slope with a gazebo were planned as a Care Homes for Older People Page 16 of 28 Evidence: result of their feedback. Some people told us that they did not like joining in activities and were grateful to staff for acknowledging this and allowing them to opt out. People told us that their visitors were always made welcome and staff readily offered them refreshments and privacy if they wished. Mealtimes were observed at both visits to the home. They were relaxed and unhurried. People told us they choose from a planned menu, but that they were offered alternatives if they did not like the choices on offer. During the visit staff were seen obtaining peoples choices for the next meals, and they spent time explaining what was on offer to people. The meals were presented well and people told us that they were tasty and appetising. Overall staff were observed to carry out their duties in a calm and relaxed manner. There was an obvious affection for the people living at the home and good humoured banter between staff and residents. One person told us that They treat you normally here, they joke with you and pull your leg, I like this very much. They were also observed to treat people with dignity and respect in the way the attended to their needs. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home can be confident that their views will be listened to and any complaints or concerns they may have will be acted upon. Evidence: The services complaints procedure is displayed in the foyer of the home, and also within the Service Users guide. The format of the procedure meets the expectations of the National Minimum Standards and includes a 28 day response timescale and explanation of the processes that the home undertakes in receiving a complaint. The safeguarding policy and procedure has a clear statements about what constitutes abuse and how the expectations of staff in reporting alleged abuse. It sets out the steps taken by the home when an allegation has been made and this includes referral to the local authoritys safeguarding unit. In discussion with the manager some minor issues in relation to the documents were raised such as the contact details of the Commission and clarity in the statements about the stage at which the homes manager would carry out an investigation of an allegation. There have not been any complaints made to the service in the previous 12 months Care Homes for Older People Page 18 of 28 Evidence: and the Commission is not aware of any complaints raised with them about the service. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home benefit from premises that meet their needs and expectations. Evidence: A tour of the premises were undertaken with the manager. The premises were clean and tidy with no apparent odours. Rooms were bright and well decorated, and peoples bedrooms had been personalised with their own belongings including some of their own furnishings. There are a selection of seating areas in the home including the main lounge, a sun lounge and a conservatory which were all seen in use during the inspection period. There is a central dining room with space for everyone to sit and eat meals. People moved around the building with ease and appeared comfortable in their surroundings. There is a passenger lift to access the upper floors. People spoken with during the visit were very happy with the accommodation provided by the home and the comfort that this provided. One person told us I was able to bring things to cheer up my room when I moved in. The laundry facilities are small and domestic in nature but meet the requirements of Care Homes for Older People Page 20 of 28 Evidence: the people living at the home. A cycle of moving dirty and clean clothing is maintained as part of the services infection control measures to reduce the likelihood of cross infection. The exterior of the home has gardens with seating areas and patios. The manager informed us that there are plans to add raised flower beds and a gazebo to the rear gardens to allow people to sit and plant at a comfortable level. This is in response to direct feedback from people living at the home. There is ongoing maintenance of the premises with much of the work being carried out by the proprietor themselves. This hands on approach means that work is readily addressed as required. Other works are carried out by contractors and examples of this were seen following a water leak across the rear of the building where substantial works and repairs had been carried out. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home can be assured that the staff are trained to provide support to meet their needs. Evidence: The files of three staff were considered at this inspection visit. They demonstrated the homes performance in recruitment, induction, supervision and training of staff working at the home. All the files contained documents relating to a robust system of recruitment. This included full application forms, two written references, checks made against the data held by the Criminal Records Bureau and the Department of Healths Protection of Vulnerable Adults list. These cross reference checks enable the service to be secure in understanding where prospective staff have been employed previously and if there have been any concerns about their actions that would make them unsuitable to work with vulnerable adults. Newly recruited staff undertake an induction period where they are taken through the Skills for Care common induction standards. This will ensure that as they commence their employment with the service they obtain a sound understanding of the basis on which the service operates and good practice standards that they should work to. Care Homes for Older People Page 22 of 28 Evidence: Ongoing staff training is provided annually. The details of training undertaken by the three staff whose records were seen included, moving and handling, health and safety, challenging behavior, first aid, palliative care, infection control and Safeguarding. Some additional training was provided to senior care staff such as medication administration, care planning, Mental Capacity Act 2006 and The deprivation of Liberty standards. The service makes efforts to tailor training to meet the needs and abilities of people working at the home. This had included arranging training to fit in with night staffs working arrangements and offering training in a variety of formats including DVD, external and internal courses and distance learning. There are over 50 of staff trained to level 2 National Vocational Qualification (NVQ) or above. The manager holds her NVQ level 4 managers award and 50 of the senior care staff have obtained NVQ level 3. Monthly staff meetings are held with the manager and proprietor and staff told us that they felt supported and able to approach the manager with any issues. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home can be confident that the service is lead in an effective and competent way. Evidence: The Manager Mrs Wells has completed both the NVQ 4 Registered Managers Award and the NVQ 4 in Care since the last inspection. She is more than adequately supported by the Responsible Individual Miss Samantha Racey and Company Director Mr. Chris Grahame, who have a very hands on presence in the home and both attended the home throughout the inspection visits. The service has a Quality Assurance system in place that is made up of questionnaires to people living at the home and their supporters, meetings with people living there and the staff group and a newsletter distributed to family and supporters. The results of surveys are collated and action taken to respond to the issues they identify as being important to people. In this past twelve months this has included Care Homes for Older People Page 24 of 28 Evidence: adding a ramp and seating area in the garden and this year the addition of raised flower beds and a gazebo. Other efforts include submitting a bid to an Essex County Council bid to buy IT equipment for people to use. People we spoke with during the inspection and through our own questionnaires told us they were consulted and able to see how their comments influenced the service. one person told us they (the managers) are always available to speak to, even just passing through they wills stop and speak to you if you need them. The service does not hold any monies on behalf of people living there, instead invoices for purchases above the fees are included in the monthly billing process sent to nominated bill payers. Staff Supervision is carried out for each staff member at least every 8 weeks. The records relating to their supervision sessions demonstrate discussions about policy and procedures and feedback on their performance and personal development identified as a result. This supports staff in understanding the aims and objectives of the service and in developing their practice to meet these. The certificates relating to the maintenance of equipment in the home were examined during the course of the inspection. These included Electrical certificates, Gas Safety Certificates, Fire Systems checks, Annual safety checks on the passenger lift and moving and handling equipment. These were all carried out within the specified timescales and evidence was seen of remedial work that had been attended to as a result of items identified during these checks. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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