Inspection on 12/06/07 for Woodley Hall

This inspection was carried out on 12th June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Woodley Hall 30/08/06

Woodley Hall 30/01/06

Woodley Hall 12/09/05

Woodley Hall 01/02/05

Woodley Hall 02/09/04

Similar services:

Ashlea Mews Residential Home

Eastwood

West Lodge

Arran House

Avenue Community Nursing Home

Cosin Lodge

Farmborough Court

Cragston Court

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

CARE HOMES FOR OLDER PEOPLE Woodley Hall 1 Gill Court Brunswick Village Wideopen Newcastle Upon Tyne NE13 7DU Lead Inspector Aileen Beatty Key Unannounced Inspection 12th June 2007 09:30 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 Woodley Hall DS0000000492.V338244.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. Woodley Hall DS0000000492.V338244.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodley Hall Address 1 Gill Court Brunswick Village Wideopen Newcastle Upon Tyne NE13 7DU 0191 217 1749 0191 236 7495 manager.woodleyhall@careuk.com 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) Care UK Mental Health Partnership Limited (Arc Healthcare Limited) Vacant Care Home 20 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (20) of places Woodley Hall DS0000000492.V338244.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Registered Mental Nurse staffing coverage. All detained patients will have a Responsible Medical Officer. All detained patients will have a current Section 17 (Leave of Absence). Forms 38/39 (Consent to Treatment) will be in place. Detained patients will be regularly informed of their rights of Appeal (Sec.132). 30th August 2006 Date of last inspection Brief Description of the Service: Woodley Hall is a 20-bed Care Home, which provides nursing care for people with enduring mental illness. The residents are former patients of St Nicholas Hospital, no longer felt to be in need of acute care and able to be cared for in a community setting. Located in Brunswick Village to the north of Newcastle upon Tyne, the home is ideally situated for shops, pubs, a wildfowl park and other local amenities which include churches and a major national racecourse. The home is staffed by Registered Mental Nurses at all times. The fees per week are £616.66 Woodley Hall DS0000000492.V338244.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was carried out on one day over five hours by one inspector Aileen Beatty. The manager was on duty during the visit and assisted the inspector with the process. Eight residents were spoken to individually. Questionnaires were received from xx residents. Records looked at included, three care plans, training records and the records for complaints as well as the health and safety, accident and maintenance records. Staff records and some policies and procedures were also read. Requirements set at the last inspection have been fully or partially met. What the service does well: What has improved since the last inspection? Staffing has been reviewed and there are now opportunities for qualified nurses to work together during overlapping shifts. This has improved communication and has contributed to staff working well together. Some staff vacancies have been filled. Training has been brought up to date and is planned more effectively. Woodley Hall DS0000000492.V338244.R01.S.doc Version 5.2 Page 6 The manager carries out regular spot checks and audits, which helps to maintain high standards in the home. The complaints procedure has been updated and residents are regularly reminded how to complain. Care records now address end of life wishes of residents where it has been possible to discuss this with them or their family. 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. Woodley Hall DS0000000492.V338244.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 Woodley Hall DS0000000492.V338244.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, and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a detailed statement of purpose and service user guide. Residents and their representatives are given good information on which to base the decision to move into the home. There is a comprehensive assessment undertaken by the staff prior to admission, which forms the basis for the development of the care plan. The home does not offer intermediate care. Woodley Hall DS0000000492.V338244.R01.S.doc Version 5.2 Page 9 EVIDENCE: The service user guide is comprehensive and contains all of the information identified in Schedule 1 of the Care Standards Regulations. It includes a large amount of information about the services offered by the home including information about staffing, who the home can care for, social activities, arrangements for religious observance as appropriate, fire safety, complaints, care planning, and the homes environment. This is provided to residents as a residents information pack. A copy is held in reception area for access at all times. A service user charter is also available and outlines rights and advocacy services. Residents and their representatives are encouraged to visit the home and spend time, this results in them having good information on which to base their decision to move into the home. Records examined show that residents have their individual needs assessed before moving into the home. If the needs of residents change during their stay in the home the close working relationship with St Nicholas hospital allows them to be readmitted to the hospital for a period of reassessment. Woodley Hall DS0000000492.V338244.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is good individual care planning and the care is being delivered in line with these plans. The residents have their healthcare needs met effectively. Staff treat residents with respect and maintain their privacy. The residents receive their prescribed medication in line with safe working practices. The medicines in the home are generally well managed and safely disposed of as necessary. EVIDENCE: Care plans for three residents were read. Each resident has an individual plan of care, which is based on the admission assessment and is then added to during the placement. Care records contain information about the residents Woodley Hall DS0000000492.V338244.R01.S.doc Version 5.2 Page 11 past psychiatric, medical and family history and mental health assessments. Physical assessments are in place including dependency levels, pressure area needs (Waterlow assessment), weights, nutrition assessment and moving and handling requirements. An assessment of the activities of daily living is carried out as the home has a role in rehabilitation and preserving skills. These include assessing how well a person is able to care for their clothes, cooking and domestic skills, work skills, social activities, cognitive ability and behaviour. The standard of care plans has improved. They previously lacked detail but more detail has now been added to plans. For example, one care plan describes that staff should encourage a resident to be involved in social activities. This now includes a list of suggestions of the types of activity she has previously enjoyed. In a minority of cases, some care assessments had not been evaluated monthly as it stated they should be in the plan. This had not compromised the care of the resident concerned and the types of assessment involved and the relative stability of the resident meant that they could have been legitimately reviewed less frequently. It is recommended that nurses consider carefully the review date for such assessments so that they are realistic and vary in frequency depending on the individual needs of the resident. Procedures for the ordering storage and disposal of medication are generally good. These procedures are regularly monitored by the hospital pharmacy service. A random check of controlled drugs found the correct quantity in stock. Some out of date eye drops were found in the fridge and there was an occasional gap in medicine records. The manager has already identified that he should be more involved in the routine auditing of medication procedures instead of leaving it all to the hospital pharmacy. It is recommended that this audit is carried out soon and on a regular ongoing basis. The dignity of residents is preserved by staff who address them as they wish to be addressed and are courteous when entering rooms. Residents are assisted to be appropriately dressed and presented in a way that reflects their individual style and preference but does not compromise their dignity. Woodley Hall DS0000000492.V338244.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,and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are satisfied with the flexibility of their routines and social activities, which adequately meet their cultural, social, religious and recreational interests and needs. There are satisfactory arrangements for residents to maintain contact with their family and friends and the local community. Residents have a generally well-balanced nutritious diet, not always popular with all residents. EVIDENCE: There are various social activities that the residents may wish to be involved in. These include trips to the nearby Bradbury centre trips further afield to the coast using the St Nicholas transport. Two residents had just returned from a short break to Blackpool, which they said they enjoyed and were escorted by Woodley Hall DS0000000492.V338244.R01.S.doc Version 5.2 Page 13 two staff. Another trip is planned for some resident’s caravanning in Berwick. The home holds a key for disabled toilets in Newcastle. There are TV’s in communal lounges and most residents have their own TV and audio equipment in their rooms. Bedrooms are nicely personalised and reflect the individual interests of the occupants. There were no visitors in the home during the inspection but staff confirmed that visitors are able to visit in private at any reasonable time. Residents are also taken to visit family and friends by staff. There is a private enclosed garden area that residents may use to socialise and during the better weather they may have barbeque. The kitchen was inspected and the chef spoken to. Since the last inspection, the manager and chef have been considering how to deal with some complaints about the food at Woodley Hall. Residents have been consulted about the types of food they want to have and if possible these choices will be incorporated into the menus. The manager is aware of the potential for good nutrition to affect mental health, so this must also be considered during the planning of the meals. On the day of the inspection, residents were given a choice of sausage rolls and beans with potato croquettes or fish fingers and mashed potato for lunch. The tea -time choice was cauliflower cheese or chicken pie. Breakfasts are cooked to order in the morning as people get up at different times. The kitchen was clean and very tidy. The chef confirmed that the manager carries out regular spot checks on cleanliness and records. A new system is in place for maintaining kitchen records. There are adequate supplies of food and an order of fresh fruit and vegetables was due that day so stocks were understandably low. Woodley Hall DS0000000492.V338244.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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A good complaints procedure is in place and this is reinforced to residents on a regular basis. Service users are protected from abuse by the home’s clear procedures and appropriately trained staff. EVIDENCE: There has been one complaint since the last inspection and it was from a student nurse. This was regarding teaching style and not concerning standards of care in the home at all. The complaints procedure has been updated and has been placed in the room pf each resident. They are also reminded of it at three weekly residents meetings. There are regular service user satisfaction surveys and it is planned that these will also be introduced to relatives and visitors to the home to monitor how satisfied they are too. There have been no adult protection issues since the last inspection. Most staff completed training in adult protection via distance learning over a number of weeks. The remainder of staff are currently doing the training. It was recommended that the manager seek out training that is now available locally from Newcastle social services safeguarding adults team. Woodley Hall DS0000000492.V338244.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of cleanliness in most areas of the home is good and the building is generally well maintained. EVIDENCE: The home was purpose built as a care home and residents are accommodated over two floors. There is an enclosed rear garden and car parking to the front of the building. All bedrooms are en suite, and are nicely personalised. To the front of the building there are some weeds to the borders and pathway. This gives a poor first impression of the home. The back garden is better but does require regular weeding. Woodley Hall DS0000000492.V338244.R01.S.doc Version 5.2 Page 16 The home is well decorated and some furniture and furnishings have been replaced since the last inspection. Some areas of the home require redecoration, and these areas have been identified. An estates audit was carried out earlier in the year. One problem in the home is a lack of space. There are two office areas, one small office and another very narrow area housing some files used by the administrator. This causes some problems when meeting with residents, relatives and medical professionals in privacy and comfort. The manager is considering using one of the ground floor toilet areas as all bedrooms have en suite facilities and moving the office and staff room around to make another meeting room. The home is generally kept clean and tidy. There was minimal malodour detected during the inspection. Some soiled flooring has been replaced and there is another area identified for replacement. Cleaning schedules are kept up to date and the home is consistently kept to an acceptably clean standard. The small kitchens in the dining areas in the home remain grubby upon inspection. Cupboards need to be wiped regularly and the cutlery drawer cleaned on a regular basis. The main kitchen is clean and tidy and all paperwork regarding food temperatures, fridge and freezer temperatures and cleaning schedules have been completed. All opened food is covered and dated and stored in the fridge. Cooker filters are clean and replaced on a regular basis. The laundry was found to be clean and tidy and well organised. A new tumble direr has been purchased. The linoleum in the upstairs bathroom is bubbled and needs to be replaced or repaired. The underneath of the bath hoist chair needs to be cleaned on a regular basis. Un named sponges found in the bathroom must be discarded. Creams that are open with no name on must also be discarded. The treatment room is clean and tidy. It is recommended that as much as possible is removed from worktops in this room to enable effective cleaning. The chair in the bedroom of an identified resident has a cigarette burn and must be replaced. It is not her own chair and she is a non- smoker. Some bedroom walls are marked and need of re painting. Woodley Hall DS0000000492.V338244.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff are recruited and selected using a robust system, which ensures that they do not present a risk to the residents and have the necessary skills and qualifications to care for them. All staff receive a comprehensive induction. All staff receive regular training which means residents are cared for by staff who are competent. EVIDENCE: Staffing has improved in the home. New staff have been recruited since the last inspection including support staff and qualified nurses. There is still a requirement for some agency staff but the regular agency staff are used who know the residents. The records of the two most recently employed staff were checked. These contained all of the necessary information and checks including two references health and criminal records checks. Woodley Hall DS0000000492.V338244.R01.S.doc Version 5.2 Page 18 On the day of the inspection, an agency support worker was on duty. She confirmed that she had received an induction into the home including awareness of fire procedure and emergency procedures. A comprehensive training plan is available. At the last inspection, training was found to be out of date. The manager has now caught up with statutory training and a plan is available outlining training that has been delivered and training planned. The manager is developing a system to prevent such a situation arising again. Staff are well organised. Rotas have been amended to enable RMN’s to overlap with one another, which is good practice. A shift de brief continues at the end of every shift, which encourages staff to reflect how things have gone. These reflections are then recorded in a book. Weekly staff meetings take place. Woodley Hall DS0000000492.V338244.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and deputy ensure that there are systems in place to make sure that the home is managed effectively taking into account the needs and wishes of the residents. Personal allowance management is good and the systems and records are in place to allow audit to be effective. The home has good safety procedures in place to protect residents. Woodley Hall DS0000000492.V338244.R01.S.doc Version 5.2 Page 20 EVIDENCE: A manager is in post and has yet to be assessed as fit by CSCI. Since their employment this manager has, with the deputy, made a number of improvements in the home. This has been particularly evident in the area of building staff morale and motivation and promoting a strong sense of teamwork. This has improved the atmosphere in the home and it is expected that this will continue. The home was without a manager for a long period of time. This led to some areas slipping, such as training and development and supervision. The manager and deputy have worked cooperatively and have succeeded in improving these areas. There has been a good response to requirements and recommendations from the last inspection with most requirements being met or in the process of being met. During the inspection it was obvious that the residents come first. Staff respond very promptly to requests for help or money etc. and at no time were residents seen to be kept waiting. Staff are friendly and approachable and there were no negative remarks from residents. Staff supervision is now up to date and staff appraisals are being arranged. Personal allowances continue to be managed by St Nicholas Hospital and there are strict procedures to follow. A number of residents were seen gaining speedy access to their funds and signing for this. There have been no changes to these procedures. Safety has improved in the home. At previous inspections there was some carelessness with leaving some doors unlocked including the sluices and shed. All of these areas were secure during this inspection and there were no hazards identified. The home is currently working on an emergency evacuation plan and demonstrate that they plan ahead and make contingency arrangements where required. A planned cut in the power supply in a few days time had been planned for in terms of meals and contingency arrangements in case the power was off for longer than anticipated. Regular maintenance checks are carried out. These include fire alarms and equipment, drills, water temperatures, hoists and lift. The moving and handling trainer is employed as a support worker in the home and explained to the inspector how they select slings for hoists and appeared knowledgeable and confident. Woodley Hall DS0000000492.V338244.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 3 X 3 X 3 X 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 X X X X X X 2 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 X X 3 x Woodley Hall DS0000000492.V338244.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP19 Regulation 23 (2) (b) Requirement Formally request change of use for ground floor toilet from CSCI Replace chair in identified bedroom. Advise CSCI of rooms to be redecorated and timescale for this. Remove weeds at entrance to home. All areas of the home must be kept satisfactorily clean, especially remote kitchen areas. Timescale for action 12/08/07 2. OP26 16 (2) (k) 12/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP9 OP8 Good Practice Recommendations Implement manager audit of medication in addition to pharmacist audit. Review realistic frequency of evaluations of assessments DS0000000492.V338244.R01.S.doc Version 5.2 Page 23 Woodley Hall 3. OP18 with nurses. Access Newcastle Social Services safeguarding adults training. Woodley Hall DS0000000492.V338244.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Woodley Hall DS0000000492.V338244.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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