CARE HOMES FOR OLDER PEOPLE
Woodlands Farmhouse Woodlands Farmhouse Wrantage Taunton Somerset TA3 6DF Lead Inspector
Ms Sue Hale Unannounced Inspection 23rd May 2006 08:50:0 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 Farmhouse DS0000016064.V293617.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 Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Woodlands Farmhouse Address Woodlands Farmhouse Wrantage Taunton Somerset TA3 6DF 01823 481036 01823 481125 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) Mrs Emma K Purvis Mrs Emma K Purvis Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The two rooms on the first floor to be used for low dependency service users, requiring minimal assistance with manual handling. 6th January 2006 Date of last inspection Brief Description of the Service: Woodlands Residential Care Home is located in the village of Wrantage. The Registered Provider / Manager is Mrs Emma Purvis. Woodlands Residential Care Home is registered with the Commission for Social Care Inspection to provide personal care for up to thirteen people over the age of 65 years. Residents’ accommodation is provided over two floors. Each service user bedroom has en-suite toilet facilities and there are three assisted bathrooms within the home. There is a pleasantly furnished lounge and dining room on the ground floor, and a further small lounge situated on the first floor. All areas of the home have been decorated and furnished to a high standard. Woodlands Residential Care Home provides day care for one or two resident users each day. The current fee levels at the home are between £395 and £595. Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over the course of one day in May 2006. The inspection lasted 7.5 hours. The inspection involved discussions with the people who live and work at the home, and the registered manager/provider. Selected residents and staff files were looked at and documents relevant to the running of the home were examined. As part of the inspection process, the Inspector used case tracking as a means of assessing some of the Care Homes for Older People national minimum standards, this process allowed the Inspector to focus on a small group of people living at the home. All records relating to those residents were checked in with the rooms they occupied in the home. Comment cards for relatives/visitors to the home were left on the day of the inspection. The registered manager/provider and care manager have made significant efforts to address the requirements and recommendations made in the last inspection report and this has worked well to improve the standards within the home. What the service does well:
Prospective residents are given the opportunity to spend time in the home before they make a decision about residency. A full assessment of health, care and social needs is made to ensure that that the home is the right place for the prospective resident and can meet all their needs. The staff team are skilled and experienced to work with and meet the needs of residents. Utilising a new member of staff’s language skills has greatly benefited a resident’s well being and enabled their cultural heritage to be acknowledged. Each resident has a plan of care and appropriate risk assessments, all records were up-to-date, contained good detail and gave clear instructions for staff. Residents have right of access to health and remedial services, and the homes policies, procedures and practice guidance strongly support this. Medication procedures in the home are safe. Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 6 The aims and objectives of the home reinforce the importance of treating residents with respect and dignity and these are fundamental to the homes philosophy of care. Staff listen to residents and make considerable effort to provide a flexible service, which enables the residents to enjoy a better quality of life. Residents are encouraged to maintain their independence and supported to make their own decisions about daily life. One resident is supported by staff to attend a local luncheon club and also to attend outings with them to maintain their links with the local community. All the residents spoken to during the inspection were very positive about the high standard of care and environment provided by Woodlands Farmhouse and comments included ‘Im very well looked after’ and that the ‘staff are very kind and sympathetic’. The food and mealtimes are looked forward to by residents and are of a good standard. Staff provide assistance and support at mealtimes if necessary. All residents spoken to said that they enjoyed the food offered in the home and that it was varied and of good quality. The home provides opportunities for stimulation and social activities that are linked to individuals’ interests and abilities. Residents’ civil and legal rights are protected by the homes policies, procedures and care practice. The complaints policy was clear and available for all to see and residents spoken to were confident that any concerns or complaints would be taken seriously and sorted out by the registered manager/provider. The home offers residents information and telephone numbers for contacting independent people who will act as advocates. The home provides a good, homely environment for residents that is kept clean and tidy. All residents have a single room with en suite facilities. The standard of furnishing and fittings in both communal and private rooms is high. There is a choice of bathing facilities and the home provides any necessary aids, adaptations and equipment required to meet residents’ needs. The laundry facilities and arrangements in the home work well and are of a high standard. Health and safety is taken seriously to ensure the well being of residents and staff. The registered manager/ provider works continuously to improve services and provide an increased quality of life for residents. There is an ethos of being open and transparent in all areas of running of the home. Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 7 If they wish and are able to, residents are helped to take responsibility for managing their own money. What has improved since the last inspection?
It is recommended that the pre admission assessment covers all topics detailed in standard 3.3 of the national minimum standards. All residents had a risk assessment in relation to falls undertaken on admission and as necessary thereafter as required in the last inspection report. Pre admission assessments are now undertaken prior to admission for all prospective residents and the assessment tool now covers all the recommended topics to ensure that all aspects of residents’ social, health and care needs are assessed. Photographs of residents are now kept on their file. Pressure sore risk assessments are undertaken on admission and regularly thereafter. All residents are weighed regularly and weights recorded on their personal files. The advocacy policy has been revised to include the details of local advocacy services. The gift policy now makes it clear that staff are precluded from assisting with or benefiting from residents wills. A copy of the Department of Health guidance No Secrets and also a copy of Adult protection in Somerset, multi agency policy and practice guidance has been obtained and the adult abuse policy revised to correspond with good practice advice and guidance. Two new carpets have been fitted in communal areas and redecoration continues. The wet room had been completed and is in use giving residents a choice of bathing facilities. All staff have now been given a job description, contract of employment and their own copy of the General Social Care Council code of conduct. Recruitment practices at the home have improved significantly. The policies and procedures have been reviewed and updated to reflect current good practice advice. The home has complied with the requirements issued by the Fire Service in August 2005. All staff have undertaken training in moving and handling, first aid, food hygiene, fire safety and health and safety.
Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 8 All staff are now receiving formal supervision at least six times a year, and annual appraisals have been undertaken. The management structure of the home has changed and a care manager and senior carer appointed providing career development opportunities for the staff team. The registered manager/provider and the care manager are currently undertaking the NVQ 4 registered managers award. The introduction of staff uniforms and name badges has been very successful and staff feel very positive about their professional identity. 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 Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 10 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 4. Standard 6 is not applicable to this service. The quality of this outcome group is good. Prospective residents are given the opportunity to spend time in the home. Admissions to the home are not made until a full needs assessment has been undertaken. The staff team are skilled and experienced and able to meet residents’ needs. EVIDENCE: The files of two residents, who have recently arrived at the home, were checked. The assessment document had been revised to include all the topics recommended in the national minimum standards and the forms had been completed prior to admission, with good detail and signed and dated. Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 11 Residents spoken to confirmed that they were supported and encouraged to visit the home and spend time there before they made a decision on residency. All staff are supported and encouraged to attend appropriate training courses by the registered manager/provider. The service is committed to increasing the number of qualified staff that the home employs. The staff were observed during the inspection to respond appropriately and professionally towards residents, both socially and during care interventions. Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 12 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. The quality of this outcome group is good. Each resident has a plan of care and appropriate risk assessments, all records for up-to-date and contained good detail and clear instructions for staff. Residents have right of access to health and remedial services, and the homes policies, procedures and practice guidance strongly support this. Medication procedures in the home are safe. The aims and objectives of the home reinforce the importance of treating residents with respect and dignity and these are fundamental to the homes philosophy of care. EVIDENCE: The care plans have improved significantly since the last inspection; they contain more detail, cover a wider range of topics and included instructions for
Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 13 staff on how to meet residents’ individual needs. Individual residents files contained risk assessments covering falls, the use of wheelchairs, smoking, bathing and the use the stairs on the stair lift. Specific health problems such as diabetes were also risk assessed to ensure that individual needs could be met appropriately. Entries are made daily on individual record sheets and used by staff to keep a check of residents’ progress. There was some evidence that residents who are able to had participated in the care planning and review process to ensure that they were in agreement with the care provided by the home. One residents first language is not English, a new member of staff, who is multilingual, has been asked to work specifically with this resident, and they are able to converse in two languages other than English. This has brought great pleasure to the resident and the inspector noted that their mood had improved and that they (the resident) were more settled living at the home. It was evidenced on records that residents have access to appropriate medical and health care professionals, including dentists, opticians, dieticians and community psychiatric nurses, if necessary. Pressure relieving equipment is provided, if necessary following assessments undertaken by the district nurse. The home has a nutrition policy to ensure that risks were minimised and appropriate steps taken but had not been able to obtain a nutritional risk assessment tool. Staff spoken to were familiar with individuals dietary needs and preferences and was seen given appropriate support and encouragement to eat and drink where necessary. The Inspector observed staff treating residents with courtesy and kindness and residents privacy and dignity were respected at all times including during care interventions seen on the day of the inspection. Residents spoken to confirm that this was normal practice. Residents preferred names were recorded on their personal files and observed to be used by staff. Residents confirmed that their own clothes were returned from the laundry, and that if they needed to see a healthcare professional that this happens in their own private room. Medication procedures were observed and examination of records and prescribed items were checked and found to be correct. Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 14 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. The quality of this outcome group is good. Staff listen to residents and make considerable effort to provide a flexible service, which enables the residents to enjoy a better quality of life. Residents are encouraged to maintain their independence and supported to make their own decisions about daily life. The food and mealtimes are looked forward to by residents and are of a good standard. The home offers residents information and telephone numbers for contacting independent people who will act as advocates. The home provides opportunities for stimulation and social activities. EVIDENCE: The routines of the home of as flexible as possible to meet the individual choices and preferences of people living at the home. The registered
Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 15 manager/provider promotes a homely atmosphere, which residents confirmed that they enjoy. The home has an activities programme, which is on display for residents to see, this included information about the forthcoming summer fayre in June 2006, future plans include a visit from a local donkey sanctuary. There is a programme of outings booked throughout the summer months. The hairdresser visits the home on a regular basis. Residents’ interests and hobbies are recorded on their personal file. One resident is supported by staff to go to a local luncheon club once a fortnight and also to go on outings with the luncheon club. Residents are able to bring their own possessions, and some items of furniture on admission following discussion and agreement with the registered manager/provider. Residents spoken to confirmed that they are supported and encouraged to personalise their private room according to their own choices and preferences. The home provides a television and radio if the resident needs one and doesnt have their own appliances. The staff, registered manager/provider and the policies of the home support and encourage residents to maintain contact with family, friends and members of the community. The homes policies and procedures are clear about residents’ rights to see their care records. The advocacy policy has been revised and updated and now includes information on how residents can access local advocacy services if they should wish to. The home offers a varied and healthy menu and caters for specialist diets such as diabetes, as necessary. The menu was recently changed to include lighter meals for summer. Two choices are offered at lunch, on the day of the inspection residents could choose from beef stroganoff or cod in cheese sauce. There were also two choices of pudding. The registered manager/provider said that there were plans to display the menu, but that currently staff see each resident individually to find out what they would like for their forthcoming meal. Records are kept in the kitchen of individuals choices and preferences, and it was observed that staff were familiar with these and that these preferences were taken into account, for example, when drinks were given. Mealtimes were observed to be on unhurried, and as an opportunity for residents to socialise, with sufficient staff available to assist if necessary. Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 16 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18. The quality of this outcome group is good. Residents legal and civil rights are protected. The complaints policy was clear and available for all to see and residents were confident that any concerns would be taken seriously. Residents are protected from abuse by policies, procedures and care practices within the home. EVIDENCE: The home has not received any complaints since the last inspection. The home has a complaints policy and procedure that was readily available for residents, visitors and staff. The complaint log was kept in the home and available for staff for recording purposes should a complaint be received. Residents spoken to were confident that they could raise any concerns and that staff or the registered person would deal them with. Residents are supported to vote, either by postal ballot or in person, with staff assistance. As stated previously, the advocacy policy has been updated and gives residents information on how to get contact independent persons for support if they so wish. The homes policies and procedures reflect the rights of the individual and are central to the aims and objectives of the service.
Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 17 The homes gift policy had been revised to make clear that staff are unable to assist with or benefit from residents wills, to provide safeguards for staff and residents. The protection of vulnerable adult policy had been revised and makes clear that it should be read in conjunction with Safeguarding Vulnerable Adults Adult Protection in Somerset – multi agency policy and practice guidance. Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 18 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26. The quality of this outcome group is good. The home provides a good, homely environment for residents that is well maintained and kept clean and tidy. All residents have a single room with en suite facilities. The standard of furnishing and fittings in both communal and private rooms is high. There is a choice of bathing facilities and the home provides any necessary aids, adaptations and equipment required to meet residents’ needs. The laundry facilities and arrangements at the home work well and are of a high standard. EVIDENCE: Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 19 All areas of the home were clean, tidy and free from odours on the day of the inspection. The home is well maintained and the standard of furnishings and fittings in both communal and private areas is of a high standard. The inspectors saw that all the residents had chosen to personalise their rooms according to their individual choices and preferences. All residents spoken to are very satisfied with their private rooms and the standard of the homes environment. The majority of the private rooms within the home are able to accommodate all the furniture recommended in the national minimum standards. The furniture in each room, and the layout are discussed with residents on admission, and at any time should they wish to do so. All the residents’ private rooms are single with ensuite facilities provided. Two new carpets been fitted since the last inspection in the lounge and entrance hall. One empty private room is currently being redecorated. The home provides all aids, adaptations and any necessary equipment to meet individuals’ needs and to support their independence. There are sufficient bathing and toilet facilities within the home, which has been enhanced by the new shower wet room. The laundry meets all the national minimum standards and was well organised, clean and tidy on the day of the inspection. An outside contractor now launders all bedding and towels, and this has worked well in freeing up staff time and providing residents with a high-quality laundry service. Residents’ spoken to confirmed that their clothes are laundered to a high standard and returned to them promptly. Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 20 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. The quality of this outcome group is good. Residents have confidence in the staff that care for them. The number of staff completing the necessary basic training has improved but continued efforts need to be made to increase the number of qualified staff and provide foundation training. The staff files have improved but recruitment practices need to be further tightened to ensure that vulnerable adults are protected. EVIDENCE: The Inspector checked the files of three new members of staff. There was evidence that the Protection of Vulnerable Adults (POVA) register had been checked before they had started work and the Criminal Records Bureau application for an enhanced disclosure had been made. Copies of qualifications has been obtained and retained on individuals’ files. The registered manager/provider informed the inspector that all staff had been given job descriptions, terms and conditions of employment and an individual copy of the General Social Care Council code of conduct. Not all files contained photographic identity of staff or of proof of identity, although the registered manager/provider stated that this had been seen at the point of applying for the CRB disclosure. Two members of staff have been recruited from overseas
Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 21 and appropriate measures were in place to support them, particularly in improving their understanding of and spoken English. There was sufficient staff on duty on the day of the inspection to meet the needs of the residents in a professional and unhurried manner. All residents spoken to were very satisfied with the care they receive from staff and comments included that staff were ‘very nice’ and ‘very good’. The home employs 11 carers, three of whom are qualified to NVQ level 2 and one is currently registered on an NVQ 2 course. The registered manager/provider informed the inspector, that they were concentrating on ensuring that all staff had completed mandatory training and a formal induction process and that once this was complete a foundation training programme would be set up. Whilst the efforts made to increase the amount of training available is acknowledged further efforts are needed to increase the numbers of qualified staff and to provide a variety of foundation training to ensure that residents’ needs are met. There is no limit on the number of days training that staff are able to access and the home pays the course fees. All residents spoken to were very satisfied with the standard of care they receive from staff and the registered manager/provider. Comments included positive mention of individual staff and included that staff were ‘very helpful’, ‘lovely’ and ‘jolly good’. Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 22 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. The quality of this outcome group is good. The registered manager/ provider works continuously to improve services and provide an increased quality of life for residents. There is an ethos of being open and transparent in all areas of running of the home. If they wish and are able to, residents are helped to take responsibility for managing their own money. The home has up-to-date policies and procedures that staff are familiar with and take seriously. Health and safety are taken seriously to ensure the well-being of residents and staff. EVIDENCE:
Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 23 The registered person (Mrs Emma Purvis) has several years experience of running the care home and is committed to providing a high standard of care in the home. Mrs Purvis is currently undertaking the registered managers award. Staff spoken to were very clear about the role of the registered person/manager and said that they felt well supported and able to ask for advice and support as necessary. The registered manager/provider has introduced staff uniforms and name badges with photographs and job title on. Staff spoken to were very positive about this change and said that they have been fully consulted and that they felt that the increased their professionalism and their pride in their work. Since the last inspection one member of staff has been designated as home care manager and is supernumerary to the staff rota. Their duties are gradually increasing to include care planning and review and supervision of staff and they are currently undertaking NVQ for registered managers award. A carer has been promoted to senior carer and the registered manager stated that the promotion had been part of their career development and was working well. The registered manager/provider has positive working relationships with local health, social care and medical professionals. A staff meeting was held on the 28th February 2006 and staff were invited to fully participate in the discussion about the changes occurring in the home including the introduction of uniforms and badges. All staff are encouraged to attend and are paid for doing so. The registered manager/provider and the care manager have been working closely together to review and improve the care planning system and to address the requirements recommendations made in the last CSCI inspection report. The home has a written survey form to gather residents and relatives/visitors views of the home these are giving out randomly and always available although the results were not collated or published. The home does not have formal written development plan although there is evidence of ongoing investment and forward planning by the registered manager/provider. The homes policies and procedures had been revised and updated to reflect current good practice and give up-to-date information for staff. Records seen were well kept, dated and signed. One service user is supported by staff to be able to visit their bank and look after their own finances. The home does not hold personal allowance for any residents. All sundries are paid for by the home and invoiced to the residents/relatives on the monthly accounts. No valuables were currently held by the home, appropriate records would be kept and these would be stored in a safe place should this be necessary. A formal supervision programme has started and the care manager is aiming to ensure that these take place at least six times a year. A format has been
Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 24 developed to give staff the opportunity to plan for supervision and to bring their own topics for discussion. All staff have recently had their yearly staff appraisal, this was recorded and a copy kept in their personal file. All staff have either undertaken mandatory training or this is due to take place in June 2006. Records were seen in relation to the servicing and safety of equipment used throughout the home. A fire risk assessment dated February 2006 was in place. This included the stair lift, PAT testing, fire extinguishers and bathing equipment. Records were kept in a fridge and freezer temperatures and checks were made and recorded in relation to food. The accident book was examined and entries relating to residents case tracked were checked against their care planning records and all were found to be correct. Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 25 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 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 4 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 3 Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 26 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 OP29 Regulation Sch2(1-3) Sch6(b) Requirement The registered person must ensure that proof of identity is obtained for all new staff. This must include a recent photograph. The registered person must ensure that staff are given access to appropriate training to enable them to further develop their existing knowledge and skills to care for older people. The registered person must ensure that at least fifty per cent of staff is qualified to NVQ level 2 as soon as practicable The registered person must ensure that at least fifty per cent of staff is qualified to NVQ level 2 as soon as practicable Timescale for action 31/07/06 2 OP30 18(1)(c) 31/08/06 3 OP28 18(1)(c) 30/09/06 4 OP30 18(1)(c) 30/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 27 No. 1 2 Refer to Standard OP8 OP33 Good Practice Recommendations It is recommended that a nutritional risk assessment tool is obtained and undertaken on admission and regularly thereafter for all residents. The results of surveys should be collated and made available to residents, their representatives and other interested parties. Woodlands Farmhouse DS0000016064.V293617.R01.S.doc Version 5.1 Page 28 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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