Inspection on 19/02/08 for Woodside

This inspection was carried out on 19th February 2008.

CSCI found this care home to be providing an Adequate service.

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

Woodside 08/01/09

Woodside 31/08/07

Woodside 25/07/06

Woodside 06/10/05

Woodside 23/05/05

Woodside 12/10/04

Woodside 06/07/04

Woodside 10/02/04

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

CARE HOMES FOR OLDER PEOPLE Woodside 40 Woodside Road Selly Park Birmingham B29 7QS Lead Inspector Kulwant Ghuman Key Unannounced Inspection 19th February 2008 11:45 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 Woodside DS0000033612.V360107.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. Woodside DS0000033612.V360107.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodside Address 40 Woodside Road Selly Park Birmingham B29 7QS 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) 0121 471 3700 0121 471 3411 Not known Birmingham City Council (S) Diane Blount Care Home 22 Category(ies) of Dementia - over 65 years of age (22) registration, with number of places Woodside DS0000033612.V360107.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the home be registered to provide care for up to 21 service users with dementia who are over the age of 65 years and one named service user with dementia under the age of 65 years. That minimum staffing levels are maintained at 4 care assistants plus a senior member of staff throughout a 14.5 hour waking day Additionally to the above minimum staffing levels, there are also 2 waking night care staff and a senior on sleeping-in duty. Care/shift manager hours and ancillary staff should be provided in addition to care staff 31st August 2007 2. 3. 4. Date of last inspection Brief Description of the Service: Woodside is a care home providing personal care and accommodation for 22 older people with dementia. The City of Birmingham, Social Care and Health department own Woodside. Woodside is a compact single-storey building, set well back on the corner of Woodside Road and Warwoods Lane, and ten minutes walk from Pershore Road, with its shops and frequent buses to and from the city centre. All bedroom accommodation and facilities are found on the ground floor, which is split up into two units known as Laurel and Willow units. The accommodation and facilities are of good quality with bathrooms that are well adapted, corridors that are wide and bedrooms that are of a good size. There is off road parking to the front of the building, and an enclosed garden to the rear. Some bedrooms have en-suite facilities. The home offers both long and short-term care including a respite service for carers. Fees at the home are dependant on the financial assessments carried out by the placing social workers. Woodside DS0000033612.V360107.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is a 1 star. This means the people who use this service experience adequate quality outcomes. We carried out this key, unannounced inspection over one day in February 2008. As part of the key inspection process we looked at the files of two people living in the home, talked with the manager, another member of staff and someone who was visiting the home. There had been no new staff employed in the home so the way people were employed in the home was not looked. The training that staff in the home got was looked at. There were not many people who lived in the home that could tell us about the home but two people were talked to. We had not received any complaints about the home since the last inspection and it had not been brought to our attention that anyone was not safe in the home. What the service does well: The home is very comfortable with nice chairs and carpets. The home is decorated well and kept clean so that there are no smells in it. The staff in the home have all worked there for quite a long time and know how to look after the people living there. Nearly everyone working there has had good training. People visiting the home were made welcome and we saw that they and the people living there were spoken to nicely. People who were thinking about moving into a home were able to have a look around before deciding if it was a good home for them. If they could not visit they could get someone close to them to have a look around instead. The manager made sure the home could look after the people that wanted to live in the home before they moved in. Woodside DS0000033612.V360107.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. The summary of this inspection report can be made available in other formats on request. Woodside DS0000033612.V360107.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 Woodside DS0000033612.V360107.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, 2, 3, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People moving into the home or their relatives are given written information about the home and encouraged to visit the home before deciding whether the home is suited to their needs. EVIDENCE: The relative of a person recently admitted to the home was spoken to briefly and confirmed that written information was given to them about the home and that they were able to visit the home before deciding whether their relative should move in. There was evidence to show that the home received an assessment from the placing authority and carried out their own assessment before the individual moved into the home. Woodside DS0000033612.V360107.R01.S.doc Version 5.2 Page 9 There was a contract on the individual’s file but it had not been signed by the relatives. This should be done at the point of moving into the home. Since the last inspection the home had converted one of its beds to be used as an interim bed for people being discharged from hospital. They were able to stay in the home for up to six weeks whilst alternative arrangements could be made. The service user guide and statement of purpose needed to be updated to include this change. Woodside DS0000033612.V360107.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. The personal and health care needs of the people living in the home were being met. EVIDENCE: The care for two people living in the home was looked at. One was for someone who had recently moved into the home and the other was for someone who had been in the home for a long time. Both the individuals had Individual Service Statements (ISS or care plan) in place. The ISS’s included many sections that covered different areas of need such as social interaction, personal care, religion, continence monitoring, mobility, mental health, managing noise levels, emotional care, laundry and so on. The ISS’s did not always include sufficient detail in areas such as personal care. In one instance the ISS in the mental health needs section indicated that Woodside DS0000033612.V360107.R01.S.doc Version 5.2 Page 11 behaviour and moods needed to be monitored but there was no detail in how the dementia manifested in the behaviour of the individual. The oral care stated ‘to encourage me to wash/clean my teeth and dentures’ but it did not state whether the individual had dentures or not, how the teeth or dentures were to be cleaned and it could not be determined from the daily records what assistance had been given in this area. The key worker review sheets indicated that the individual preferred a bath to a shower but this had not been recorded in the daily notes so that it was accessible to all staff and the ISS had not been updated with this information. It was important that the actual assistance given was recorded by care staff so that this information was available for when the ISS was updated. The ISS for one individual indicated that they were not to be assisted to their bedrooms until after 8.45pm however there was no reason identified. This could appear to be a restriction on the individuals liberty and access to private space. Bedrooms were generally kept locked to prevent individuals walking into other peoples bedrooms but the inspector was told that they are opened if individuals want to access their bedroom. The ISS’s were being reviewed but there was no record of what changes needed to be made to make them more effective or what had worked well. Following the inspection the manager and her staff had worked hard at improving the level of detail included in the ISS’s and updated them all. Copies provided to the inspector indicated that all the issues raised above had been addressed. Risk assessments were being carried out and management plans were in place where these were needed. Individual risk assessments covered areas such as going out of the home, medication, diet and fluid, falling/tripping/spillages and aggression. Some of these areas were generic, for example, medication and need not necessarily be recorded unless there was a specific issue that needed to be monitored. There were Waterlow and skin assessments in place however, there was no scoring system identified that would identify whether the individual was at high, medium or low risk of developing pressure ulcers and the management plan in place. There was evidence on the files looked at that GP, district nurses, chiropodists and so on, were involved as needed in the care of the people living in the home. Woodside DS0000033612.V360107.R01.S.doc Version 5.2 Page 12 The management of medicines in the home was good. At the time of this inspection daily audits were being undertaken of boxed medicines and the pharmacist had recently carried out an inspection and given a good report. The inspector carried out a limited audit of the controlled medicines and one boxed tablet and found them to be suitably recorded and stored. No one was able to administer their own medicines. A medicine fridge was in use. There were good interactions observed in the home between staff, relatives and the people living in the home. Woodside DS0000033612.V360107.R01.S.doc Version 5.2 Page 13 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 adequate. This judgement has been made using available evidence including a visit to this service. There were a good variety of activities available in the home and relatives were welcome in the home. Food was of a good quality and enjoyed by the people living there but the management of portion sizes needed to be better to ensure that people’s individual needs were catered for. EVIDENCE: There were activities ongoing in the home. Activities such as bingo, music to movement, playing of music, watching television, chatting to individuals, going to the local shops and dancing were arranged by the home. Since the last inspection the home had received some additional funding that had enabled the people living in the home to benefit from dance and drama therapy. The drama therapy had been used to carry out some reminiscence and life story work. One member of staff was starting to document events in the home on a video so that this could be used by the people in the home. Woodside DS0000033612.V360107.R01.S.doc Version 5.2 Page 14 There were regular trips to the theatre for people who wanted to go. There were televisions in the communal areas but the radio had been removed as it had been identified at the last inspection that both television and radio were being left on at the same time and this could be confusing for people. Issues such as whether individuals liked to be assisted by male or female staff were recorded as were their religious requirements. The home could meet the physical needs of an ageing population. Menus were not looked at during this inspection but choices are put up on a board in the dining room. Lunchtime was observed and people appeared to be enjoying their meal. The inspector noted that one individual’s meal had been set aside and it had been plated up on a small plate. The kitchen staff asked the care staff who it was for and the individual’s ISS did not identify a small diet was needed. Staff needed to be mindful that small portions were only served where this was identified as a requirement. The food records being completed at the time of the inspection were not being fully completed so that it was not possible to decide whether the individuals were eating adequate and nutritious meals throughout the day. These records are particularly important for people who may be losing or putting on too much weight to identify whether further action needed to be taken The food record was in the process of being revised to help the manager monitor the food and drink eaten by people living in the home as it was important to be aware that they were getting the right amounts. The record needed to be able to identify exactly what was being eaten, for example, it should state beef casserole instead of just beef and the fillings in the sandwiches should be identified so that the variety and nutrition of the meals could be monitored. Woodside DS0000033612.V360107.R01.S.doc Version 5.2 Page 15 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. The people living in the home were safeguarded by the home and issues raised with them were looked into although the recording of the outcomes could be improved. EVIDENCE: No complaints had been logged with the commission since the last inspection and one complaint was logged in the home. The manager had referred the complaint to the domestic supervisor but the resolution and investigation was not recorded in the complaints log. The issue of the protection of two of the people living in the home that had been raised at the last inspection had been resolved. Multi-disciplinary meetings had been held to ensure that both parties were safeguarded. The manager had also used the incident to develop her understanding of the process and to pass on information to other people who also held responsibility for safeguarding vulnerable adults. The training matrix (dated November 2007) indicated that some staff had undertaken training in adult protection. The inspector was told that others had been nominated for the training. This should be followed up by the manager Woodside DS0000033612.V360107.R01.S.doc Version 5.2 Page 16 to ensure that the staff are fully aware of their responsibilities in relation to raising issues of adult protection and identifying possible incidents. No other issues of adult protection had been identified. Woodside DS0000033612.V360107.R01.S.doc Version 5.2 Page 17 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 good. This judgement has been made using available evidence including a visit to this service. The home was well maintained, comfortable and homely and suitable for the people living there. EVIDENCE: As at the last inspection the home appeared to be well maintained and clean. The needs of people with dementia and physical disabilities could be met at the home. The central area of the home had had the seating removed as the manager found that arguments were occurring and people were becoming isolated. All the communal areas of the home were homely and well furnished with a variety of seating including easy chairs and small sofas enabling visitors to sit with the people living in the home in a way that maintained their relationships. Woodside DS0000033612.V360107.R01.S.doc Version 5.2 Page 18 There were suitable garden facilities available at the home and some improvements had been made including paving and fencing around the patio area. The decor of the home did take into account the needs of people with dementia including painting bedroom doors in different colours according to which corridor they were on and ensuring that appropriate signage was available on bathroom doors. The bedrooms varied in size and facilities provided in them. Some had ensuite shower facilities, others did not. Some were large and suitable for people who had increased physical disabilities. Bedrooms were maintained well and personalised. Bedrooms tended to be kept locked to prevent people walking into bedrooms other than their own and taking things that did not belong to them. Woodside DS0000033612.V360107.R01.S.doc Version 5.2 Page 19 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff were knowledgeable about the needs of the people living in the home and how to care for people with dementia. EVIDENCE: At the time of this inspection there were only 13 people living in the home and there were 3 care staff on duty in the home. This was in addition to the senior carers and manager. There were additional people in the home who were responsible for the cleaning and cooking. The manager will need to monitor the staffing levels as the numbers of people living in the home go up. It had been difficult to maintain staffing levels in the home during the past few days due to an illness in the home but they had been maintained a minimum levels and people living in the home were not at risk. There had been no new staff employed in the home and as a result the recruitment process was not assessed. The training matrix indicated that lots of training had been undertaken however there were no dates available on the matrix enabling the inspector or manager to be able to assess if the training was up to date or whether it Woodside DS0000033612.V360107.R01.S.doc Version 5.2 Page 20 needed to be refreshed. Nearly all staff had achieved NVQ level 2 in care. Some senior staff were undertaking dementia care mapping training. The inspector observed the staff to be respectful and helpful towards the people living in the home. The manager needed to ensure that the recording of food intake was better managed and the size of the portions of food served to individuals was in line with their requirements. This is particularly important in a home where the people living there are not able to clearly express if they are getting enough to eat and drink. Woodside DS0000033612.V360107.R01.S.doc Version 5.2 Page 21 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 adequate. This judgement has been made using available evidence including a visit to this service. The home is well managed and the needs of the people living there are met. EVIDENCE: The manager of the home has many years of experience of managing residential homes and along with the members of the management team continues to update her knowledge and skills in caring for people with dementia. The management of the home was generally good however, the management of nutrition and some records needed to be strengthened. Woodside DS0000033612.V360107.R01.S.doc Version 5.2 Page 22 Another home was carrying out audits against the National Minimum Standards and surveys had been sent out to relatives. These showed that people were very happy with the service. Any non-conformities identified led to remedial actions being identified and these were then followed up by the individuals carrying out the audits. The home managed small amounts of money kept for the people living in the home. There were facilities available in the home for small items of value be locked away in the safe. The records of monies spent on behalf of some of the people living the home and the comforts fund were checked and the records were found to be well managed with receipts and running balances available. Staff undertook daily handovers to check the amounts of money in the home. The management of health in the home was good with equipment being maintained and serviced on a regular basis. Woodside DS0000033612.V360107.R01.S.doc Version 5.2 Page 23 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 2 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Woodside DS0000033612.V360107.R01.S.doc Version 5.2 Page 24 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 OP8 Regulation 13(4)(c) Requirement Waterlow and skin assessments must have the scoring system attached to ensure that the level of risk can be assessed and the correct management plan put in place. Timescale for action 01/06/08 2. OP15 16(2)(j)1 2(1) This will ensure that the needs of the people living in the home are planned for appropriately. The manager must ensure meal 14/04/08 portions are suited to the individual needs of the people living in the home. Previous timescale of 01/11/07 not met. 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 Woodside DS0000033612.V360107.R01.S.doc Version 5.2 Page 25 1. 2. 3. OP1 OP2 OP7 The service user guide and statement of purpose should be updated to include the provision of an interim bed in the home. Contracts or terms and conditions of residence should be signed at the point of moving in the home. Monthly reviews of ISSs must include information indicating if the ISS has been successful in achieving the goals and if not the changes should be incorporated into the ISS. Daily recordings needed to include details of the assistance given so that this information can be used to update ISS’s. The registered manager must ensure that a record of complaints made by residents or their representatives is fully documented to show the outcome of any investigations undertaken. This will ensure that people are assured that their views are listened to and acted on. All staff should receive training in adult protection. The manager needed to review the need for resiting the emergency call system in shower/bathrooms. Not assessed. The manager needed to ensure that the training matrix included dates of when courses were undertaken and ensure that any gaps in the matrix are identified and addressed. This will ensure that all the staff looking after the people living in the home will have the appropriate skills and knowledge. 4. OP16 5. 6. 7. OP18 OP22 OP30 Woodside DS0000033612.V360107.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Woodside DS0000033612.V360107.R01.S.doc Version 5.2 Page 27 - 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!