Inspection on 30/10/07 for Woodlands Nursing Home

This inspection was carried out on 30th October 2007.

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 18/07/06

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 0ED Lead Inspector Mrs D Peel Unannounced Inspection 10:00 30 October 2007 th 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.V347658.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.V347658.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 0ED 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 01444 246342 blratnasinkam@btinternet.com 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.V347658.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th July 2006 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. The current fees are £531-£595 per week. Woodlands Nursing Home DS0000024241.V347658.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Mrs Diane Peel carried out this unannounced visit to Woodland Nursing Home on the 30th October 2007. During this visit the intended outcomes for 31 standards were assessed; these included the key standards for care homes providing a service to older people. Prior to the visit to the home previous inspection reports and information gathered about the home since it was last visited in July 2006 were reviewed. Have Your Say surveys were returned to CSCI by four relatives and three staff working at the home prior to the visit. This information was used to inform the inspection process. The Annual Quality Assurance Assessment (AQAA) was returned to The Commission for Social Care Inspection (CSCI) prior to this visit to the home and this was used to address areas of improvement and further improvements with the manager. During the course of the visit the inspector met many of residents and spoke with those who were able to converse with the inspector in either in the privacy of their bedrooms or in the communal areas. A case tracking exercise for three people living at the home was undertaken to look at how the assessed needs of this group of residents with diverse needs were being met. Staff were spoken with during the visit and observed during their interaction with people living at the home. What the service does well: The information available to people about the Woodlands Nursing Home is informative and ensures that people know what the service can offer. The home is comfortable and has a homely, clean, friendly environment and relatives say that the home is friendly and welcoming. Woodlands Nursing Home DS0000024241.V347658.R01.S.doc Version 5.2 Page 6 There is a low turnover of staff with some staff working for the provider for many years. A member of staff said, “ the owner/manager is kind and caring towards staff and residents. At least 50 of staff have an NVQ level 2 or above with further staff undertaking an NVQ qualification. No agency staff are used with any staff shortages being coffered by permanent staff or bank staff. 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. The summary of this inspection report can be made available in other formats on request. Woodlands Nursing Home DS0000024241.V347658.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.V347658.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4,5,6 People who use the service experience good outcomes in this area. People, who come to live at the home and their families, have information available to make an informed choice about where they want to live and people’s needs are assessed before they move to the home, so that they know that the home can meet those needs. EVIDENCE: The home has a statement of purpose and service users guide, which the manager reports is given to all people who come to live at the home. All people visited in their bedrooms were observed to have a service users guide on the wall with other information about the home and a questionnaire, which included a question about their first impressions of the home. Woodlands Nursing Home DS0000024241.V347658.R01.S.doc Version 5.2 Page 9 The manager commented that at an initial enquiry people are given a small brochure, are invited to visit the home and that the home has a website which people can access to find out more about what the service can offer. A visitor to the home spoke about the process of finding a care home for their relative living at the home. They had already known the manager and it had been a natural step for their relative to move to a home were they already knew the management. A person living at the home told the inspector “ We are terribly lucky to have such a nice home” and “ my daughter came to look at the home for me”. All four relatives returning Have Your Say surveys to CSCI felt that they had enough information about the care home to make a decision and three out of the four surveys reported that their relatives needs were usually met whilst one relative indicated that they were always met. Pre admission assessments are undertaken for all people considering moving into the home and records of these assessments were observed for the three residents whose care records were viewed at this visit to the home. It was observed that the assessments were not always signed and dated and the manager was reminded that they should be. People’s specific needs such as sensory impairment, physical disabilities, cultural and religious needs were observed to be identified in their care plans with details of how these needs were to be met. Information provided in the homes Annual Quality Assurance Assessment (AQAA) returned to CSCI prior to the visit to the home reported that there are both male and female care staff working at the home of various ages between eighteen years of age and sixty five years of age and who are from diverse social, cultural, and religious groups. Intermediate care is not provided at Woodlands Nursing Home. Woodlands Nursing Home DS0000024241.V347658.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 People who use the service experience good outcomes in this area. Care planning systems are in place and are regularly updated. They give clear information to assist with all aspects of health, personal and social care needs so that the changing needs of people living at the home can be monitored. EVIDENCE: The care records for three people were viewed during this visit to Woodlands to see how the assessed needs had been used to form a plan of care which staff could follow to make sure that people living at the home are having their needs met. Woodlands use a standard care planning and care record system, which was observed to have been regularly updated and reviewed. Where possible residents and their representatives had been involved had had signed the care plans and discussion with the nurse on duty at the time confirmed that the Woodlands Nursing Home DS0000024241.V347658.R01.S.doc Version 5.2 Page 11 initial care plan was always put together with relatives. Where people had no relatives to include in the care plan this was also recorded. Records showed support undertaken with personal care, medication, visits by other medical professionals such as Doctors and included particular nursing needs such as wound care. Pressure area risk assessments, handling assessments, nutritional assessments and dependency profiles were observed to be being used and daily records of individual’s well being were being kept. Minutes of a relatives meeting held on the 16th October 2007 reported that relatives present had said, “ that they felt the standard of care was high”. No issues were raised by anyone present. The nurse on duty said that there was no one currently living at the home who looks after their own medication needs. Medication was observed to be being stored in a locked medical cabinet with additional storage of medication in locked cupboards on the walls in a clinical storage room. A monitored dosage system is being used at Woodlands to administer medication. Medication records sheets were observed and were up to date and clearly recorded. On peoples medication records there was a photograph of them and the room number, which they occupied. Sample initials of qualified nurses able to administer medication were observed to be present at the front of the recording system. People living at the home who were able to speak with the inspector were asked about how they liked to be helped. One person said “ On a morning the girls get me out of bed with the hoist. I tell them what clothes I want to wear and they get them and help me get dressed.” The AQAA returned by the manager prior to the visit to the home stated “Service users privacy and dignity is respected at all times, and a policy of knocking before entering a room is in place and is continued at all levels as part of our on going training.” This was verified during the visit by observation of staff interaction with people living at the home and by relatives returning Have Your Say surveys to CSCI, who made comments such as “ they treat my mother with respect and dignity. Do everything possible to give a good quality of life.” Woodlands Nursing Home DS0000024241.V347658.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 People who use the service experience good outcomes in this area. People living at the home are encouraged to maintain contact with their family and friends. The home is friendly and staff respect the privacy and dignity of residents and the activity programme is flexible to cater for individual residents abilities so that they experience variation to daily living. EVIDENCE: The AQAA returned to CSCI prior to the visit to Woodlands states “Woodlands provides a varied and extensive range of activities, including employing an activities co-ordinator who visits all service users in the lounge, dining room or in their own rooms.” On the morning of the visit an activities person was in the lounge encouraging people to take part in singing. The activities programme observed advertised in the entrance hall included bingo, music and movement, games massage and there was also a poster advertising an Xmas afternoon tea for a Saturday in December. Woodlands Nursing Home DS0000024241.V347658.R01.S.doc Version 5.2 Page 13 Through talking to residents and a visitor to the home and feedback in surveys returned by relatives it was evident that the home is able to be flexible to individual peoples needs, helping people to live a life they have some control over and making visitors welcome with the open door policy. The main meal of the day was advertised in the small dining room as roast chicken, stuffing and roast potatoes, carrots and parsnips followed by sherry trifle. The cook told the inspector that she had worked at the home for a long time and for those residents who had been at the home for a long time knew their likes and dislikes of food. It was observed at lunch time that alternatives were available with one person having a pizza and another person who wanted to continue to eat as far as possible by themselves, they had chosen to have their chicken in sandwiches. Staff were available to assist and supervise people in the dining room whilst other people at in their bedrooms by choice or in the lounge area at small tables. The kitchen assistant bringing out the meal to people sitting in the dining room was observed to take the time to explain to a person having a softened diet what the meal actually consisted of. There was fresh fruit on the tables for people to help themselves to and the sherry trifle was very popular with people accepting second helpings. Woodlands Nursing Home DS0000024241.V347658.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 People who use the service experience good outcomes in this area. The complaints procedure enables those using the service to have the confidence that any complaints will be taken seriously and responded to. Arrangements are in place to protect people using the service from being place of harm or abuse. EVIDENCE: Woodlands has a complaints procedure, which was observed to be on display in the hallway and a copy is kept in each resident’s bedroom with the service users guide. The home has a complaints book but no complaints had been made to the home since the last visit by CSCI and no complaints had been received by CSCI directly about Woodlands. All relatives returning Have Your Say surveys to CSCI said that they knew out to make a complaint and for those who had raised concerns they said that they had usually been dealt with appropriately. Staff training records showed that the last safeguarding adults training in June of this year and the AQAA returned to CSCI stated that “All staff have had Woodlands Nursing Home DS0000024241.V347658.R01.S.doc Version 5.2 Page 15 training on protection of vulnerable adults.” The home has its own safeguarding adults procedure, which information in the AQAA reports was last reviewed in January 2007 and the manager confirmed that he had attended a seminar with the local authority about the revised West Sussex Multi Agency safeguarding adults procedures. Woodlands Nursing Home DS0000024241.V347658.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,2021,22,23,24,25,26 People who use the service experience adequate outcomes in this area. Wedged doors and fire doors that do not close properly could place people living and working at the home at risk. EVIDENCE: The AQAA returned to CSCI prior to the visit to the home reports improvements to the environment as “A redecoration of the lounge and dining room including all soft furnishings”. Overhead hoists have been installed in several rooms and bathrooms and the provider plans to extend overhead hoists to all bedrooms. The lift has been refurbished and a carpet shampooer purchased. Extra excel mattresses have been purchased. Woodlands Nursing Home DS0000024241.V347658.R01.S.doc Version 5.2 Page 17 Woodlands is a well maintained homely care home. People living there have been encouraged to make their bedrooms their own and for some people this has enabled them to have some of their own furniture in their bedrooms. On person spoken with in her own room comented about the furniture which they had brought with them and the lovely view to the garden which they had. A collection of animals was on display in the room and outside on the wall beyond the bedroom window. There were a number of bedroom doors which did not close properly and two doors were being wedged open even though they has self releasing mechanisms to close in the event of a fire. A requirement has been made that all fire doors are risk assessed and that risks are to eliminate or reduced the risk and advise must be obtained from the fire officer about the pratice of keeping these doors open. Woodlands Nursing Home DS0000024241.V347658.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 People who use the service experience good outcomes in this area. Recruitment procedures safeguard and protect residents at the home and staff receive training to support so that they can carry out their jobs efficiently. EVIDENCE: The staff on the day of the visit were well organised and observed to work well together as a team. Relatives returning surveys to CSCI made comments such as “ The staff are excellent, nothing is too much trouble for them.” But for one person “ there should be more of them.” Over 50 of staff have an NVQ at level two or above and the AQAA returned to CSCI prior to the visit to the home reports that a further four are undertaking an NVQ qualification. The records of three staff were observed during this visit to the home. They were observed to include evidence of Criminal Record Bureau (CRB) and Protection of Adults (POVA) checks. Woodlands Nursing Home DS0000024241.V347658.R01.S.doc Version 5.2 Page 19 A job application was on file, two written references (for those people employed after 2002), photograph, proof of the person’s identity and completed equal opportunity monitoring forms and health declaration forms. Surveys returned from three staff confirmed that their employer carried out checks such as CRB and references, before they started work. Staff records viewed also demonstrated a commitment to staff training within the home and staff returning surveys to CSCI confirmed regular training and all three reported that they felt that they are with training relevant to their role and have regular meetings with the manager to discuss how they are working. Woodlands Nursing Home DS0000024241.V347658.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 30,31,33,35,36,38 People who use the service experience good outcomes in this area. The manager wants to run the home in the best interests of the people that live there but to do so must take account of all risks. EVIDENCE: The manager, Mr Krishna Ratnasinkam has many years experience in the care of older people. He is a registered general nurse and registered mental nurse and has an NVQ Level 4 in Management. Staff are supervised though a line management system within the home, which is displayed on the notice board in the staff office. Records of staff Woodlands Nursing Home DS0000024241.V347658.R01.S.doc Version 5.2 Page 21 appraisals, supervisions and staff meeting were available during the visit to the home. A quality assurance system is in place, which includes the surveying of residents and their relatives twice a year, the presence of a suggestions book in each the residents bedrooms and a suggestions box in the hallway by the front door. Meetings are held for relatives twice a year and staff meeting are held. Minutes are kept for these meetings. The manager told the inspector that no changes had been made for the arrangements for handling service users monies. The home invoices relatives and representatives direct for any services and purchases not covered by the fees. Information provided by the manager in the AQAA confirms that annual safety inspections are undertaken on equipment and utility supplies. These were sampled at random and found to be correct. There were a number of bedroom doors which did not close properly and two doors were being wedged open even though they has self releasing mechanisms to close in the event of a fire. Woodlands Nursing Home DS0000024241.V347658.R01.S.doc Version 5.2 Page 22 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 3 X 3 3 3 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 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 2 Woodlands Nursing Home DS0000024241.V347658.R01.S.doc Version 5.2 Page 23 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 OP19 OP38 Regulation 13.4 (a) (c) Requirement All fir doors must be risk assessed and risks are eliminated or reduced. Advice must be sought from the fire officer with regard to keeping these doors open. Timescale for action 30/11/07 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.V347658.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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.V347658.R01.S.doc Version 5.2 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. 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