CARE HOME ADULTS 18-65
Woodlands Residential Care Home Woodlands Residential Care Home 147 Kedleston Road Derby DE22 1FT Lead Inspector
Vanessa Davies Unannounced Inspection 27th September 2005 2.30pm Woodlands Residential Care Home DS0000002012.V257422.R01.S.doc Version 5.0 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 Residential Care Home DS0000002012.V257422.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 Adults 18-65. 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 Residential Care Home DS0000002012.V257422.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Woodlands Residential Care Home Address Woodlands Residential Care Home 147 Kedleston Road Derby DE22 1FT 01332 349625 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) Community Care Solutions Limited Nicola Taylor Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Woodlands Residential Care Home DS0000002012.V257422.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 8th February 2005 Brief Description of the Service: Woodlands is situated on the outskirts of Derby City and is on a regular bus route into the city. The smaller shopping area of Allestree is also only a short bus ride from the home. It is close to two popular large parkland areas (Markeaton Park, and Darley Park). Woodlands is a home registered for 6 adults with a learning disability. The Registered Provider is Community Care Solutions. The head office for the Registered Provider is in Bedfordshire.The home provides personal care only. The home receives all medical services via agreement with its local community medical practices. Service users receive 24-hour care. The home provides 4 single occupancy bedrooms and 1-shared bedroom. The home has a private enclosed garden and parking to the side and front. Woodlands Residential Care Home DS0000002012.V257422.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and the manager was not on duty. Information for this report was gathered by speaking with staff and service users and reading documentation kept by the home. What the service does well: What has improved since the last inspection?
At the previous inspection a number of requirements were left relating to medication, the manager has addressed all of the requirements left. Woodlands Residential Care Home DS0000002012.V257422.R01.S.doc Version 5.0 Page 6 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 Residential Care Home DS0000002012.V257422.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Woodlands Residential Care Home DS0000002012.V257422.R01.S.doc Version 5.0 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 the following standard(s): 1, 2,5 Detailed assessments of need and easy to read contracts of terms and conditions ensure that the home is able to meet the needs of the service users and service users are aware of this. EVIDENCE: The member of staff on duty was aware of the Statement of Purpose and produced a copy from the staff handbook, however this copy was the company statement of purpose and not individual to the home. The manager should ensure that a copy of the Statement of Purpose is readily available for all service users and staff. The service users guide is detailed and available in symbol form, however the name of the manager is incorrect and it refers to NCSC. Each of the service users had a very detailed contract of terms and conditions, both written and in symbol form. All had been given to the service users and were available in their files. Contracts had been signed by staff on behalf of the service user, rather than an independent person. Each file examined had a detailed plan of care in place to highlight the needs of the service users. Assessed needs are reviewed as necessary. Each file had evidence of an annual review with social services. Woodlands Residential Care Home DS0000002012.V257422.R01.S.doc Version 5.0 Page 9 Woodlands Residential Care Home DS0000002012.V257422.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 6, 7, 8, 9, 10 Detailed care plans and risk assessments enable service users to lead a fulfilling life, meeting their needs and ensuring choices are offered. EVIDENCE: The files examined had detailed care plans in place. The plan was not available in a symbol format, however it was written in clear simple English. There was evidence of input from a variety of other professionals to assist with meeting needs highlighted. It was evident on the day of inspection that service users are supported to make decisions. Service users spoken with discussed holidays, 1 service user had planned to have his haircut on the day of inspection and monthly service user meetings are held to encourage participation in all aspects of the home. There was no evidence within the files of service users, relatives or advocates being involved with the writing or reviewing of their care plans. Each file had evidence of detailed risk assessments enabling service users to take necessary risks with a management strategy. All records are kept securely in the office.
Woodlands Residential Care Home DS0000002012.V257422.R01.S.doc Version 5.0 Page 11 Woodlands Residential Care Home DS0000002012.V257422.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 17 A varied and healthy diet with choices ensures service users enjoy and value mealtimes. EVIDENCE: The home offers a varied, healthy diet and a record of menus are kept. Service users are offered a choice and have access to the kitchen to assist with the preparation of meals. Woodlands Residential Care Home DS0000002012.V257422.R01.S.doc Version 5.0 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 the following standard(s): 19,20 Holistic care ensures all needs of service users are met, however lack of input from service users could potentially mean wishes are not met. EVIDENCE: Each file examined had detailed information relating to the needs of the service users and how to address the needs. There was evidence of input from a variety of professionals; GP, chiropodist, opticians and the Derbyshire Learning Disability Team, to ensure needs are met. A service user spoken with stated that he was supported to attend any appointments made with professionals. There was evidence of care plans for PRN (as necessary) medication, however there was evidence of input from the service users or any agreement for staff to administer medication. Woodlands Residential Care Home DS0000002012.V257422.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 22,23 Policies, procedures and training provided ensure the safety of the service users. EVIDENCE: The home keeps a clear complaints record and no complaints have been documented since the last inspection. One service user spoken with, clearly new who to complain to if necessary. The home has a complaints procedure, which is available and easy to understand. The organisation offers a variety of training to staff to ensure the safety of the service users; Managing Challenging Behaviour, Understanding Challenging Behaviour, None Aggressive Psychological and Physical Intervention and Care Principles. All service users monies are stored securely and clear financial records are kept. One file examined had a care plan detailing management of finances and 2 staff signatures are needed, however the financial records examined only had one staff signature. Woodlands Residential Care Home DS0000002012.V257422.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 24, 25, 26, 28, 30 A clean, homely environment helps to promote a positive image for the service users and enables them to take pride in their home. EVIDENCE: Woodlands is a large property situated on a busy main road. It is pleasantly decorated with a homely atmosphere. Each of the bedrooms are personalised and meet the needs of the service users. The home has one double room although at present there is only one service user in there and he will be consulted before moving someone in. The home has enough communal space to accommodate all of the people living there. The kitchen is large with a sitting area and there are 2 lounge areas. The home was clean and free from any malodours on the day of inspection. Staff stated that they try to encourage the service users to become involved with the cleaning. Woodlands Residential Care Home DS0000002012.V257422.R01.S.doc Version 5.0 Page 16 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,35,36 Training and support has enabled staff to provide a positive environment promoting independence. EVIDENCE: It was clear that the staff were aware of their roles and the service users were aware of the roles of the staff. The organisation provides a range of training to ensure the needs of the service users are met and staff development needs are met. In addition to the training discussed in standard 23, the organisation provide Manual Handling, Food Hygiene, Dementia, Autism, key-working, Health & Safety, epilepsy and Shift Leading. On the day of inspection the staff on duty had an excellent relationship with the service users and each other. As the manager was not available the inspector was unable to examine staff records, including supervision records, however the staff spoken with stated that they received supervision on a bi-monthly basis. Woodlands Residential Care Home DS0000002012.V257422.R01.S.doc Version 5.0 Page 17 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Standards within this area were not examined on this occasion as the manager was off duty. These will be examined during the next inspection. Woodlands Residential Care Home DS0000002012.V257422.R01.S.doc Version 5.0 Page 18 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 2 3 X X 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 2 3 3 Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 X 3 X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 3 X X 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Woodlands Residential Care Home Score X 3 2 X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000002012.V257422.R01.S.doc Version 5.0 Page 19 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. Standard Regulation Requirement Timescale for action 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 4 Refer to Standard 1 2 8 20 Good Practice Recommendations The Statement of Purpose for the home should be readily available for staff, service users and potential service users The Statement of Purpose and service user guide should reflect the change from NCSC to CSCI. Service users, relatives and advocates should be involved with writing and reviewing care plans. Service users/relatives/advocates should be consulted and agree to the administration of medication. Woodlands Residential Care Home DS0000002012.V257422.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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