Inspection on 25/08/05 for Woodlands (Horley)

This inspection was carried out on 25th August 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Woodlands (Horley) 06/02/07

Woodlands (Horley) 19/12/05

Woodlands (Horley) 25/11/04

Woodlands (Horley) 06/07/04

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

CARE HOME ADULTS 18-65 Woodlands 42 Massetts Road Horley Surrey RH6 7DS Lead Inspector Helen Dickens Unannounced 25 August 2005 12:00 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Woodlands Address 42 Massetts Road Horley Surrey RH6 7DS 01293 784235 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) SeeAbility Seeability House, Hook Road, Epsom, Surrey, KT19 8SQ Heather Salisbury Care Home (CRH) 7 Category(ies) of Learning disability (LD) 7 registration, with number Sensory impairment (SI) 7 of places Mental disorder, excluding learning disability or dementia (MD) 7 Woodlands H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 Of the 7 residents accommodated within categories SI, up to 7 may also fall within categories LD or MD 2 Age range: 40 - 60 Date of last inspection 25 November 2004 Brief Description of the Service: Woodlands is a large detached house situated in a pleasant residential area of Horley, Surrey. It is owned and managed by the registered charity, SeeAbility. It is close to local facilities and amenities. The service provides personal care and accommodation for seven adults with learning and sensory disabilities (visual impairment). All residents have single bedrooms, some with ensuite facilities. The home is on two floors. There is no lift but none of the current residents requires that form of assistance at present. The home has a large garden area with a newly built art and crafts studio at the far end. There are plenty of car parking spaces to the front and rear of the property. Woodlands H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over four and a half hours and was the first inspection to be undertaken in the Commission for Social Care Inspection year April 2005 to March 2006. This inspection was carried out by Helen Dickens, Lead Inspector for the service. Heather Salisbury, Registered Manager, represented the establishment. A full tour of the premises took place. Three residents were spoken to at length and the inspector met the other residents who were at home on that day. One member of staff was interviewed and the inspector examined a number of files and documents during the course of the inspection. All direct quotes in this report are included with the express permission of those quoted. This was an extremely positive inspection. The inspector would like to thank the residents and staff of Woodlands for their time, assistance and hospitality. What the service does well: Woodlands offers a very homely environment, a relaxed atmosphere and an ethos centred around encouraging and enabling residents to be independent. SeeAbility has in-house rehabilitation workers to support residents in this respect. There is a Code of Conduct for Visitors displayed in the entrance to the home which sets out that visitors must behave in a respectful way towards residents. Residents were happy and spoke well of the home to the inspector. They told the inspector of the many interesting events in their lives and at least two were making plans to move to ‘supported living’ – a more independent type of accommodation. The staff were respectful to residents at all times and enthusiastic in their own areas of focus. One staff member was particularly interested in rehabilitation. The benefits to residents from her attendance on a social inclusion training course are documented later in this report. Another, with a background in nutrition, was enabling residents to prepare and enjoy much healthier meals. The Registered Manager is well respected by both residents and staff. She demonstrated excellent leadership skills and has a very positive attitude to the inspection process. She is leaving the home in the near future as she has been promoted within SeeAbility. She will leave behind a well-organised and extremely resident-focused service, with a very committed staff team. Woodlands H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Woodlands H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Woodlands H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3, and 5. Residents at Woodlands can be confident that their needs have been properly identified and will be met. EVIDENCE: Resident’s assessments were examined at the inspection and found to provide a good overview of residents needs. Special attention was given to therapeutic needs and consideration given to a programme of rehabilitation for each resident. Aids and adaptations to promote the independence of this client group had been identified and provided within the home. Specialist services are available to residents at Woodlands and the staff were observed to communicate effectively with residents. Contracts and up-to-date information regarding the change in fees each year was documented on each residents file. Woodlands H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8 and 9 Arrangements for promoting independence in this home are outstanding and resident’s benefit from this approach. EVIDENCE: Individual plans were informative, up-to-date and contained plenty of evidence that residents had been involved in drawing these up. Health and social needs were very well documented. The inspector observed that they were reviewed regularly. The residents at Woodlands are supported to make decisions, with assistance when needed. Both individual plans, and other evidence such as notes from residents meetings, show examples of this. Residents participate in all aspects of life in the home. Residents help with domestic chores, including cooking, and do their own laundry; they answer the door and the telephone and take responsibility for a variety of communal tasks. Risk assessments were appropriate and regularly reviewed. Residents are actively encouraged to try new things and staff supported them to take part in Woodlands H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 10 activities. One resident who had joined the gym is only given minimal assistance form staff. It should also be noted that often residents need assistance not because of their lack of ability to learn new things, but because services and activities in the wider community are often not user-friendly for this group. For example, residents cannot program the machines at the gym independently, because they are on a flat pad, no Braille or alternative format is available. The home highlights such discriminatory practice and works with external agencies to promote the rights of residents. Woodlands H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15,16 and17. Residents at Woodlands have many opportunities for personal development, fulfilling activities and community involvement. This home actively promotes independence for residents. EVIDENCE: Resident’s individual plans identified the range of social, emotional, communication and independent living skills. Life skills training is recorded in resident’s files and their certificates are displayed in their rooms. All residents have a sensory impairment and are continually assessed, guided and reviewed by the See Ability rehabilitation team. By this method opportunities for further education and fulfilling activities are identified for individual residents. Woodlands has two kitchens; one is the house kitchen and where most communal food is prepared; the other is the ‘training’ kitchen where residents can learn about independent living skills in food preparation and hygiene. There was evidence on each of the files sampled that staff had assisted residents to claim all of the benefits to which they were entitled. Woodlands H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 12 Residents were very well integrated into the local community, used community facilities such as the gym, and had made friends with their neighbours. Information was available within the home about community activities. In addition to the home’s own transport, residents are encouraged to use public transport facilities in the area. Staff spending time with residents outside the home is a high priority at Woodlands, and the staff rota takes this into account. The residents are also encouraged to be part of the wider learning disability community and copies of the Learning Disability Partnership Board Bulletin were with the resident’s meeting notes. Residents also receive the Surrey Association for the Visually Impaired Newsletter. The number and variety of activities are too numerous to mention but include the usual in-house parties, a brick-built outdoor barbecue set, and outings to community facilities etc. The staff are encouraging residents to have coffee in the lounge after meals, particularly on Sunday after lunch. This creates an additional opportunity for residents to spend some time together. Some more unusual ‘treats’ were noted by the inspector including the visiting farm (the last visit bringing a donkey and a pot bellied pig to Woodlands) and the garden. Local businesses (Barclays/Unum-Provident/Pfizer) had contributed financially and practically to the making of a ‘sensory’ garden for residents to enjoy. A small allotment area afforded residents opportunities to be involved in gardening and growing their own vegetables – residents were harvesting their runner beans on the afternoon of the inspection. The home supported residents to maintain links with family and friends and staff spoken to were knowledgeable about the family and social contacts enjoyed by each resident. During the inspection there were no instances of staff interacting with each other to the exclusion of residents. Staff were observed to be respectful to residents at all times and residents spoken to by the inspector raised no issues in this regard. All residents took part in household activities including setting the table, cooking, and their own laundry. During the inspection residents were observed to be accessing the kitchen and making their own drinks and snacks as they wished. The home should be commended for their attention to promoting resident’s health and wellbeing by their diet. Residents are encouraged to choose healthier options and given information about the merits of particular food groups. A staff member with a background in nutrition is educating both staff and residents to be aware of the benefits of a healthier diet. Two of the three residents interviewed highlighted this in a positive way. Woodlands H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 19. Residents at Woodlands can be confident that their health and personal care needs will be met. EVIDENCE: Staff at Woodlands were observed to be providing support in ways which supported independence, for example how residents wished to be guided (or not) when moving around. Staff respected privacy and dignity and personal care was provided in a sensitive way. Examples of resident’s most recently acquired independent living skills were highlighted to the inspector both by staff and residents themselves. The service caters well for the needs of residents with sight impairment and a number of ‘gadgets’ around the home supported residents in their daily lives. In the kitchen, talking can covers, with the message recorded by residents themselves, was not only fun to record, but then assisted residents to identify whether a can contained beans, or spaghetti, or something entirely different. In the ‘training kitchen’ there is also a talking microwave. In the hallway there was a talking staff rota, recorded daily so that residents could press a pad and find out who was on duty that day. And there was a speaking clock near the front door which residents were observed to use several times during the afternoon. Woodlands H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 14 Residents were encouraged to be involved in their own healthcare and manage their own medical conditions. One resident told the inspector about her recent health history and a therapeutic programme centred around attention to a healthier diet. She was pleased with her own progress and staff reinforced the efforts made in a positive and supportive way. Specialist assistance was available to residents and well documented on their care plans. Woodlands H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Resident’s at Woodlands are protected from abuse and neglect by the systems in place within the home. EVIDENCE: The home uses the SeeAbility adult protection procedure which dovetails in with the Surrey Multi-Agency Procedures for the Protection of Vulnerable Adults. The latest February 2005 version of this policy was available within the home and staff spoken to knew what actions to take in the event of suspected abuse. Woodlands H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,28,29 and 30 Woodlands provides a homely and inviting environment for its residents. The premises are clean and hygienic and aim to maximise residents independence. EVIDENCE: Woodlands is safe, accessible and well maintained. It is bright, cheerful and airy. It is clean, hygienic and free from offensive odours. The outside of the building is maintained in a way which is in keeping with the local area. The inspector viewed the ‘premises’ file, which documents all the necessary safety and maintenance issues and a timetable for carrying out the necessary work and inspections. The latest environmental health inspection showed satisfactory ratings (the highest attainable) for the majority of items, and only two minor issues were raised. These have since been dealt with. All residents have single rooms and most have en-suite facilities. Bedrooms are well furnished and are set out in a way which promotes the independence of residents. Shared spaces are also comfortable, safe and fully accessible for residents. Kitchen and laundry facilities are domestic in nature and there are quiet areas within the home for the use of residents. The large sensory garden and the new craft studio provide alternative space to the main house. The Woodlands H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 17 Registered Manager said that when the art and craft materials have been transferred to the new studio, an additional ‘chill-out’ area will be identified for residents. Specialist aids and equipment are provided at Woodlands and many of these are described elsewhere in this report. Woodlands H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,35 and 36 Resident’s at Woodlands are well supported by the current staff team. EVIDENCE: Staff understood their own roles and responsibilities and all supported the main aims of the home. They had good relationships with residents. Staff competencies and qualities met resident’s needs and the inspector observed many instances of positive communication between residents and staff. All staff at Woodlands have already got at least NVQ level 2, including the housekeeper. Staff were complimentary about the amount and level of training available from SeeAbility. An effective staff team supported residents and external specialists were used when necessary. Regular staff meetings take place; in addition there are some joint meetings with residents and staff. Regular and recorded staff supervision meetings take place and advance dates for these are displayed in the office. Woodlands H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39 and42. The conduct and management of Woodlands means that resident’s benefit from a well-run home. EVIDENCE: The Registered Manager is qualified and competent. She and her team have created an open, positive and inclusive atmosphere and processes for managing the home are open and transparent. Quality assurance systems include resident involvement for example with regular resident’s meetings. Feedback is actively sought from residents both in daily activities, and in their care plans. All residents have year on year development plans and at least two residents are working towards moving out of Woodlands to more independent living. Progress can be followed on care plans and in reviews. Health and safety at Woodlands is taken seriously and the inspector saw evidence of this both in their record keeping (on maintenance and safety issues) and in their risk assessments. On the day of the inspection the Woodlands H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 20 hazardous substances cupboard was locked. Electrical systems which needed up dating had been rectified but an up-to-date safety certificate had yet to be issued. Some minor items needed attention including a freezer which needed defrosting and a toilet which needed de-scaling. A kitchen cupboard door needed replacing and the Registered Manager said this was ordered and due to be fitted the following week. The inspector asked for the laundry area risk assessment to cover the hot water at the sink which was in excess of 43C. The fridge temperatures need to be reviewed in line with current good practice as one was often recording temperatures at between 8C-9C which the inspector felt was too warm. The Registered Manager immediately adjusted the temperature and will seek advice on this issue. Woodlands H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 x 3 Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 4 4 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 x 3 3 3 Standard No 11 12 13 14 15 16 17 4 4 4 3 3 3 4 Standard No 31 32 33 34 35 36 Score x 4 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Woodlands Score 4 3 x x Standard No 37 38 39 40 41 42 43 Score 3 4 3 x x 2 x H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 22 No Are there any outstanding requirements from the last inspection? 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 24.1 Regulation 23(2)(b) Requirement Timescale for action 01.9.05 2. 42.2iv 13(4)(c 3. 42.3 13(4)(c The broken kitchen cupboard door must be replaced as soon as possible as this detracts from the otherwise homely and wellmaintained appearance of the kitchen. Fridge temperatures must be 30.8.05 reviewed in line with current best practice, to ensure that food is stored safely. A risk assessment must be 26.8.05 carried out on the temperature of water accessible to residents in the laundry room. 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. 2. 3. Refer to Standard 30.1 42.2 42.3 Good Practice Recommendations On the day of the inspection, one of the toilets was heavily limescaled. It is recommended that a proprietry toilet descaler be used to rectify this problem. One freezer needed defrosting and the regular rota for the frequency of defrosting needs to be reviewed to take into account the age and useage of the appliance. The work recommended by the previous electrical H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 23 Woodlands inspection has been carried out but no up-to-date safety certificate has yet been issued. The home needs to be able to produce definitive written evidence that electrical systems are now safe. Woodlands H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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. Extracts may not be used or reproduced without the express permission of CSCI Woodlands H58 S13840 Woodlands V239102 250805 Stage 4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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