Inspection on 28/09/05 for Woodlands Farmhouse

This inspection was carried out on 28th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Woodlands Farmhouse 23/05/06

Woodlands Farmhouse 06/01/06

Woodlands Farmhouse 13/01/05

Woodlands Farmhouse 27/05/04

Woodlands Farmhouse 11/03/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Woodlands Farmhouse Woodlands Farmhouse Wrantage Taunton Somerset TA3 6DF Lead Inspector Ms Sue Hale Unannounced Inspection 28th September 2005 8.20 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.V250799.R01.S.doc Version 5.0 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.V250799.R01.S.doc Version 5.0 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.V250799.R01.S.doc Version 5.0 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. 13th January 2005 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. Woodlands Farmhouse DS0000016064.V250799.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out as part of the planned annual programme of inspections. It was unannounced and took place over the course of one day in September 2005. Thirteen people were living at the home and six staff on duty throughout the inspection. The inspector spoke to four members of staff and seven residents. The inspection involved discussions with the people who live and work at the home, examination of records and a tour of the premises. Some records and policies and procedures were not available as the manager was not on duty. As part of the inspection process the inspector used ‘case tracking ‘as a means of assessing some of the National Minimum Standards. This process allowed the inspector to focus on a small group of people living at the home. All available records relating to these people were inspected, along with the rooms they occupied in the home. An immediate requirement was issued on the day of inspection, because one resident’s file did not contain a care plan detailing the action staff needed to take to look after that person. One resident was staying overnight in the registered manager’s private home on the day of the inspection. This was dealt with separately to this report. What the service does well: What has improved since the last inspection? Woodlands Farmhouse DS0000016064.V250799.R01.S.doc Version 5.0 Page 6 A bathroom was being altered to provide a wet room to meet the needs of a resident unable to use the existing facilities. The home has purchased a new standing hoist. A pressure area risk assessment tool has been obtained and was in place on all files checked. This had been recommended in the previous report. 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.V250799.R01.S.doc Version 5.0 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 Farmhouse DS0000016064.V250799.R01.S.doc Version 5.0 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 (standard 6 does not apply). Admission procedures need to improve to ensure that the home is confident it can meet the needs of prospective residents. EVIDENCE: The records of two residents recently admitted were examined. One file did not contain a pre admission assessment so it was unclear prior to admission if the resident’s needs could be met at the home. The assessment that had been undertaken had limited information; as all the recommended topics had not been considered to ensure that all the resident’s health, social and care needs could be met at the home. The deputy manager was unaware of the funding arrangements of the residents’ files checked, there was no evidence of assessment or care plans from funding authorities on files to suggest that residents were funded via care management arrangements. These records were kept in the managers office so were not available for inspection. Woodlands Farmhouse DS0000016064.V250799.R01.S.doc Version 5.0 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, 10. There is no clear and consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet service users’ needs. Care staff work hard to provide a good standard of care that meets residents’ expectations that their physical and health needs would be met by the home. EVIDENCE: Three resident’s personal files were checked. One resident did not have a care plan. None of the files contained all the information that staff should have available to provide the care that residents required to meet there needs. None of the care plans indicated that they had been drawn up or reviewed with residents or their representatives. Risk assessments lacked detail and were not in place on individual files when a risk was evident such as a resident who had fallen out of a wheelchair on several occasions and a resident who had exhibited aggressive behaviour towards staff. Risk assessments in relation to falls and nutrition had not been undertaken. Woodlands Farmhouse DS0000016064.V250799.R01.S.doc Version 5.0 Page 10 Service users have a choice of GP. The deputy manager said that residents were supported to access appropriate health care professionals. However, written evidence of this was contained in a communication book kept in the managers’ office, which was not available on the day of inspection, and made access to information difficult for the staff. Such information should be kept on individual resident’s files to ensure staff have access to information they need to carry out their tasks. Woodlands Farmhouse DS0000016064.V250799.R01.S.doc Version 5.0 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): 12, 13, 15. The range of social activities available was limited, so that the expectations of people living at the home were not fully satisfied. Residents are encouraged to maintain contact with family and friends and are enabled to exercise as much control as possible over their lives. The meals served at the home were of a high standard and provided a healthy, nutritious diet for residents. EVIDENCE: A member of staff had recently been appointed to undertake the role of activities organiser for five to six hours a week as part of her role as a carer. This had been recommended in the previous report. They told the inspector that they planned to arrange a structured programme of activities. Residents spoken to said that they have opportunities to go out in the home’s own transport, and that such outings were ‘very good’. However, the range of activities within the home was very limited and not on display for residents to see. Woodlands Farmhouse DS0000016064.V250799.R01.S.doc Version 5.0 Page 12 The routines of the home were as flexible as possible to allow residents some choice and control over their lives. Residents’ interests and hobbies prior to moving into the home were recorded on some files checked. Spiritual support to people living at Woodlands Farmhouse was available if they wanted it. Residents said that visitors were made welcome and that visits took place in private. Meals were seen to provide a wholesome balanced diet. The food served was fresh, of good quality and homemade. Mealtimes were seen to be unhurried, and support was given to residents requiring assistance. Menus changed regularly and the cook was familiar with the likes and dislikes of the residents. Special diets were provided in an appropriate manner. Residents spoken to were very satisfied with the food and commented that it was ‘very good’ and ‘really marvellous’. The dishwasher was noted to be in a poor condition and needed to be replaced. Woodlands Farmhouse DS0000016064.V250799.R01.S.doc Version 5.0 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. Residents felt able to raise any concerns or complaints that they had but the complaints policy and procedure was not available for inspection. EVIDENCE: Complaints received by the home were not examined as the manager was not present and records were unavailable. It was noted that the complaints procedure was not displayed for residents or visitors to the home to see. Woodlands Farmhouse DS0000016064.V250799.R01.S.doc Version 5.0 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, 20, 23, 24, 26. The home provides a good, homely environment for residents that is kept clean and tidy. All residents have a single en suite room. The standard of furnishing and fittings are high. EVIDENCE: The home was clean, tidy and pleasantly decorated. The furnishings were of a high standard and gave residents a good standard of living in their private rooms and communal areas. Residents were able to bring personal possessions with them into the home including furniture by prior arrangement. A record should be kept of such items. Residents are able to have telephones in their private room at their own expense if they wished to be able to accept and make calls in private. They are also able to use the home’s telephone in private. All private rooms are single with en suite facilities. Residents spoken to were pleased with the environment in which they lived. Woodlands Farmhouse DS0000016064.V250799.R01.S.doc Version 5.0 Page 15 The home has two lounges and a dining room on the ground floor and another small lounge on the first floor which residents could use to see their visitors in private. Lighting and furnishings are domestic in style to give a homely atmosphere. Residents are able to sit outside and a resident used this area on the day of the inspection. Carpets are of a good quality. However, some needed cleaning and the lounge carpet required replacement due to separation in one area that could present a hazard to residents if it worsens. Laundry facilities are adequate for the size of the home and infection control measures in place that were understood and adhered to by staff. People living at the home said that their clothes were always clean and returned from the laundry. The laundry was clean and tidy, both the washer and dryer were awaiting repair on the day of the inspection, temporary arrangements were in place. An outside contractor laundered the bedding and towels. Woodlands Farmhouse DS0000016064.V250799.R01.S.doc Version 5.0 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): 27, 28, 30. The skill mix and number of staff on duty was sufficient to meet the needs of residents. Progress in giving care staff access to obtaining a qualification is poor. EVIDENCE: The staff rota was checked; two carers were available throughout the day and one member of staff was on duty and awake at night. One cook is employed to work three days a week and care staff are on the rota as a cook when she is not on duty. The home employs nine care staff, only two of which are qualified to NVQ level 2. Both are currently working towards obtaining level 3. Staff spoken with stated that access to training is limited. The registered person should ensure that at least fifty per cent of care staff are qualified to NVQ level 2 by 31st December 2005 to ensure that the workforce of the home has the skills and experience to provide a good level of care. The training programme was not available for inspection. However, one new member of staff had not undertaken an induction and another member of staff had not completed their induction after being employed for six months. The expectation is that care staff will undertake a programme of training based on national standards, over 6 weeks, to assess their competency. Woodlands Farmhouse DS0000016064.V250799.R01.S.doc Version 5.0 Page 17 Whilst staff had completed mandatory training foundation training, except NVQ level three for two members of staff, did not appear to be available. Woodlands Farmhouse DS0000016064.V250799.R01.S.doc Version 5.0 Page 18 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): 36, 37. Formal supervision of care staff did not take place. Some records were not kept appropriately to comply with the requirements of the Data Protection Act 1998, or to be accessible to staff. EVIDENCE: Staff spoken to said that they did not receive formal supervision to ensure that they were providing the level of care required by the home. They were unaware if the home had a supervision policy. Staff spoken to said they were given good support by the manager, deputy manager and colleagues and that advice and guidance was available, as required. Woodlands Farmhouse DS0000016064.V250799.R01.S.doc Version 5.0 Page 19 Some information about residents was recorded communally such as contact with healthcare professionals. This was kept by the manager and was not available to the inspector or staff on the day of the inspection. Such information should be kept on residents’ individual files in a manner that complies with the Data Protection Act 1998. Woodlands Farmhouse DS0000016064.V250799.R01.S.doc Version 5.0 Page 20 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X 2 3 X X 3 3 X 3 STAFFING Standard No Score 27 2 28 2 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 2 2 X Woodlands Farmhouse DS0000016064.V250799.R01.S.doc Version 5.0 Page 21 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 OP3 Regulation 14 Requirement The registered person must ensure that a pre admission assessment is undertaken prior to admission for all prospective residents. The registered person must ensure that all residents have a care plan and that they are involved as far as practicable when it is drawn up. Care plans should be agreed with and signed by the resident whenever capable or if not by their relative/representative. The care plan should set out in detail the action needed to be taken by staff to ensure all aspects of residents care are met. All residents must have a risk assessment in relation to falls undertaken on admission and as necessary thereafter. Sit on scales must be purchased to enable all residents’ weights to be monitored. An opening and discard date must be recorded on creams DS0000016064.V250799.R01.S.doc Timescale for action 31/10/05 2 OP7 15 Schedule 3 (1)(b) 31/10/05 3 OP7 15 Schedule 3 (1)(b) 15 Schedule 3 (1)(b) 13 (4)(b)(c) 14 (1)(a)(2) 13 (2) 31/10/05 4 OP7 31/10/05 5 6 OP8 OP9 31/12/05 31/10/05 Woodlands Farmhouse Version 5.0 Page 22 7 8 OP15 OP16 23 (2)(c) Schedule 4 (11) 23 (2)(b)(d) Schedule 4 (10) 18 (1)(c) 18 (2) 17 (3)(b) 9 10 11 12 13 OP19 OP24 OP30 OP36 OP37 (timescale of 24/1/05 not met). The dishwasher must be replaced and one suitable for commercial premises obtained. The complaints log must be kept in the home and be accessible to staff. The complaints procedure must be displayed. The lounge carpet must be replaced due to separation and wear and tear. A record of any property brought into the home by residents must be kept. The registered person must ensure that staff are given access to appropriate training. The registered person must ensure that all staff are appropriately supervised. Information relating to individual residents must be kept in their care file, not communally, in line with the Data Protection Act 1998. 30/11/05 31/10/05 31/12/05 31/10/05 31/12/05 30/11/05 31/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP3 Good Practice Recommendations It is recommended that the pre admission assessment covers all topics detailed in standard 3.3 of the national minimum standards. It is recommended that a nutritional risk assessment tool is obtained and undertaken on admission and regularly thereafter for all residents. It is strongly recommended that a structured activities programme is drawn up and displayed for residents to see. The registered person should ensure that at least fifty per DS0000016064.V250799.R01.S.doc Version 5.0 Page 23 2 OP8 3 4 OP12 OP28 Woodlands Farmhouse 5 6 OP36 OP3 cent of staff are qualified to NVQ level 2 or above by 31/12/05. It is strongly recommended that formal staff supervision take place at least six times a year. It is recommended that a supervision policy that complies with this standard be developed. Woodlands Farmhouse DS0000016064.V250799.R01.S.doc Version 5.0 Page 24 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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