Inspection on 18/07/06 for Woodlands Nursing Home

This inspection was carried out on 18th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 Nursing Home 30/10/07

Woodlands Nursing Home 29/11/05

Woodlands Nursing Home 26/07/05

Woodlands Nursing Home 12/10/04

Woodlands Nursing Home 03/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Woodlands Nursing Home 23 Silverdale Road Burgess Hill West Sussex RH15 OED Lead Inspector Mrs J Hough Key Unannounced Inspection 18th July 2006 09:10 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 Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 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 Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodlands Nursing Home Address 23 Silverdale Road Burgess Hill West Sussex RH15 OED 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) 01444 243579 Mr Sri Krishna Ratnasinkam Mr Sri Krishna Ratnasinkam Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Woodlands Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th November 2005 Brief Description of the Service: Woodlands is a care home registered to accommodate 23 service users, both male and female, in the category Old age with nursing care. The provider/ manager is Mr S R Ratnasinkam who is in charge of the day- to -day running of the home. The home is a large Victorian property situated in a residential area of Burgess Hill, West Sussex. The accommodation is laid out over 3 floors, ground, first and second floor. There are 19 single rooms and 2 doubles. The home has large grounds with a patio area to the rear and a decking area at the front of the house. There is a vertical lift to access all floors. Woodlands Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over 6 hours. The Registered Provider/Manager Mr Ratnasinkam was present at the inspection and provided the information required. Evidence was gathered from the pre-inspection questionnaire completed by Mr Ratnasinkam and relatives and resident’s comment cards. Records were examined in relation to resident’s care notes, medication, accidents, maintenance, and recruitment procedures. A tour of the premises took place and residents and staff were spoken with to find out what it was like living and working in the home. This was a key inspection and all the key standards were assessed. Ranges of fees are from £503.00 to £560.00 per week. What the service does well: Woodlands offers residents a homely and clean environment surrounded by well-maintained gardens. The gardens on the day of inspection were full of colour and two patio areas were accessible to residents to sit and enjoy the view. On speaking with some members of staff it was clear that they were provided with a wide selection of training related to their work. Regular staff meetings enabled them to participate in the decision making within the home and all felt the staff team worked well together with the aim of giving the residents the best of care. On touring the premises many of the resident’s rooms were furnished with their own possessions and small items of furniture. The menus showed that a good variety of home cooked food is on offer and fresh fruit was available in the dining area. Residents comments included it was a nice home and the staff looked after them very well. Woodlands Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 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 Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 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 Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 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): 3,6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All residents have a thorough pre-admission assessment carried out prior to moving into the home. The home does not provide intermediate care. EVIDENCE: A selection of the resident’s files that were read showed that all residents had a pre-admission assessment carried out prior to any agreement being made for admission to the home. The process involves the registered manager or a senior nurse to carry out the assessments and refer to current care plans if available, and input of other health professionals and relatives where appropriate. The home does not provide intermediate care. Woodlands Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans seen gave a detailed account of resident’s individual needs. Medication procedures within the home ensure safe practice. Residents felt the staff treated them with respect and dignity. EVIDENCE: Three of the resident’s care plans and assessments were read and gave a detailed account of the resident’s current needs and the support and assistance needed by staff. Risk assessments were completed in relation to nutrition, moving and handling, and pressure sores. Daily records were maintained and care plans and assessments updated monthly by the registered nurse and keyworker. Woodlands Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 Page 10 Pressure relieving equipment was seen in use and the home had two electric portable hoists and two standing aids. Bathrooms were well equipped with two Parker baths and one overhead ceiling hoist. Medication administration records were examined and well maintained with no errors or gaps noted in documentation. Controlled drugs were recorded in a separate register and safely stored. Disposal of medication was carried out in line with the clinical waste company procedures and all medication disposed of was documented in a book and signed for on collection. Residents generally spoke highly of the staff saying they were kind and caring and provided all personal care in a sensitive manner. Woodlands Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 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): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are offered a range of activities and outings to suit their needs. Resident’s family and friends are encouraged to visit the home and maintain contact. The home offers the residents a choice of well-balanced food. EVIDENCE: On speaking with residents it showed they are happy with the level of activities provided in the home. The home has two activity organisers who between them cover five days per week. An activity programme displayed showed an example of activities that take place regularly, and on occasions some extra outings and events were planned. The Bluebird bus is hired for trips out to garden centres, beauty spots and the coast etc. An old time music hall is arranged once a month. On the day of inspection the activities organiser was chatting to residents and a game of bingo was held in the lounge. A summer fete is planned for September 2006. Woodlands Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 Page 12 On checking resident’s notes and activity plans it was seen that some plans were not completed to reflect individuals participation in activities. The statement of purpose for the home states that visitors will be welcomed at all reasonable times and resident’s family and friends are encouraged to visit and maintain contact. Residents spoken with said their visitors were always made welcome and could spend time with them either in the lounge or in their own rooms. The kitchen was clean and tidy and fridge and freezer temperatures recorded on most days. An alternative to the main meal is offered for those residents who may not like the main meal on offer. Fresh fruit was seen available in the dining area. The dining area was small and many of the residents ate in the lounge on portable tables or in their rooms. Lunchtime was relaxed with staff offering assistance with eating and drinking where needed. The lunch on offer was steak and kidney pie, carrots, peas and broccoli followed by orange and chocolate mousse. Special diets were catered for, and an observation made at lunchtime of a pureed diet being given to a resident was poorly presented and looked unappetising as the meat and vegetables were not separated. Nutritional assessments monitored those residents who had a poor appetite or were underweight and supplement drinks were given where necessary. Woodlands Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s complaint procedures ensure residents that the home will take all complaints and concerns seriously. The policies and procedures in the home protect the residents from harm. EVIDENCE: The complaints log was checked and there were no recorded complaints since the last inspection. All residents have a copy of the complaints procedure in their room for reference. Residents spoken with said they would not hesitate to speak with the manager if they had any concerns or complaints. Staff had attended training on adult abuse and the staff spoken with had a good understanding of their responsibilities in reporting any incidents or allegations of abuse within the home. At the last inspection a recommendation was made to review the home’s adult protection policy to a working policy. However as the West Sussex County Council Adult Protection procedures are in the process of being updated so the home will wait for this to be completed before they carry out their own review. Woodlands Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 Page 14 Woodlands Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a homely, pleasant and clean environment. EVIDENCE: A tour of the premises took place and the home was fresh and clean in all areas. Minor maintenance work identified at the last inspection had been carried out. Some new furniture such as chest of drawers, wardrobes and armchairs had been purchased. General maintenance is carried out as and when needed or when resident’s rooms become vacant. One resident who shared a double bedroom expressed a wish to move into a single room, and the registered manager was aware of this request and said he would make arrangements for the resident to move when a single room became available. Woodlands Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 Page 16 Records seen gave evidence that regular maintenance checks for equipment and systems takes place. Three bedrooms were fitted with automatic door guards. While touring the premises concerns were raised with regard to some bedroom doors being wedged open due to the hot weather. This was discussed with the registered manager who confirmed that the fire safety officer voiced no concerns with this arrangement. A telephone call on 31/7/06 to the local fire service explained that doors wedged open in extreme weather conditions would be accepted as a temporary arrangement where ventilation was poor, within a risk assessment framework. Recommendations to have automatic door guards fitted would be made for long-term use. The fire safety assessment carried out in November 2005 listed some requirements that the registered manager confirmed these had all been addressed. The gardens were a very attractive feature of the home both at the back and front of the establishment with a colourful display of flowers and hanging baskets. A decking and patio area with tables and chairs provided an area for residents to sit. Woodlands Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 Page 17 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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Resident’s needs are being met by the numbers and skill mix of staff. Evidence that all the necessary checks were carried out on new members of staff was not available on some files to ensure the protection of residents. EVIDENCE: Staffing levels on the day of the inspection appeared appropriate to care for the residents accommodated. None of the residents or staff indicated that there was a problem with the numbers of staff. Residents spoken with generally felt staff responded appropriately to their calls for assistance except for one resident who felt staff took too long to respond. Staff training records showed that staff were offered a varied programme of training in line with their work and responsibilities. Staff morale appeared high and all the staff spoken with felt the team of nurses and care assistants worked well as a team and all supported one another. The home had no staff vacancies and many of the staff had worked in the home for many years. Woodlands Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 Page 18 Four staff files were examined to check recruitment procedures. Evidence was lacking in two files with regard to satisfactory references and one file lacked evidence of obtaining a satisfactory Criminal Records Bureau (CRB) check. The registered manager confirmed that no staff would be employed without having the necessary checks carried out but agreed that evidence was lacking on files and he would rectify the situation. Woodlands Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 Page 19 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. Quality in this outcome area is good. This judgement was made using available evidence including a visit to this service. The health and safety of residents and staff is protected as far as practicable. The home is well run by an experienced manager. EVIDENCE: The registered manager/proprietor is a very experienced qualified nurse who is committed to the home. Staff spoken with said he was very approachable and made himself available to residents and staff. Woodlands Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 Page 20 Residents meetings are held to enable residents to discuss any matters and regular contact is maintained with residents as the manager is at the home on a daily basis. Relatives meetings are held twice a year and the minutes of the meetings are sent to all relatives. The maintenance man and registered manager carry out in-house maintenance checks. Fire doors and alarms were tested weekly, fire escapes monthly, fire risk assessment completed quarterly. Emergency lighting, lift, hoists and other equipment is serviced and maintained within the appropriate timescales. The home has two portable hoists, two standing aids, and two Parker baths. The home has a policy not to get involved with the finances of residents. Relatives/representatives are invoiced by the home for any expenses incurred by residents. The environmental health inspection carried out in May 2006 made recommendations that the fridge and freezer seals needed cleaning, food temperatures needed recording and cleaning charts be put in place. All these had been met. Resident questionnaires were sent out in April 2006 and the feedback summary shows that 24 questionnaires were sent out and 10 responses were received, Feedback was generally positive with only minor issues raised. The accident book showed that there had been 12 minor accidents since January 06. All accidents, injuries and incidents were recorded and reported to the appropriate authorities. Woodlands Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 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 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Woodlands Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 19(1)(a) (b)(i) Requirement The registered person shall not employ a person to work in the care home until all the information and documents specified in Schedule 2 have been obtained. Timescale for action 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. No. Refer to Standard Good Practice Recommendations Woodlands Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Nursing Home DS0000024241.V298425.R01.S.doc Version 5.2 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!