Inspection on 10/03/06 for Woodside Home

This inspection was carried out on 10th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Woodside Home 13/06/06

Woodside Home 06/07/05

Woodside Home 26/10/04

Woodside Home 08/06/04

Woodside Home 29/04/03

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Woodside Home Woodside Home Baxendale Whetstone London N20 0EH Lead Inspector Tom McKervey Unannounced Inspection 09:45 10 March 2006 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 Woodside Home DS0000010528.V271128.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 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 Home DS0000010528.V271128.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Woodside Home Address Woodside Home Baxendale Whetstone London N20 0EH 020 8445 1127 020 8343 8324 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) The Trustees of The Woodside Home Miriam Kajencki Care Home 49 Category(ies) of Old age, not falling within any other category registration, with number (49) of places Woodside Home DS0000010528.V271128.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th July 2005 Brief Description of the Service: Woodside Home is a care home registered to provide care and support for up to 49 older people, all of whom are female. The home is run by a charitable trust and is managed through a board of trustees. A House Committee oversees the general running of the home. The home, which is purposed-built, has 49 single bedrooms, located on the ground, first and second floor. None of the bedrooms have en-suite facilities. There is a passenger lift, which serves all three floors. There is a large communal lounge area and dining room on the ground floor. Additional lounge space is provided elsewhere in the building, as well as a large conservatory. There is an attractive garden and lake within the grounds. Woodside Home is close to the shops, services and transport links of Whetstone, and is easily accessible by public transport. Woodside Home DS0000010528.V271128.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was completed in seven hours, forty-five minutes. Two members of the Trust board were present at the inspection, and the deputy manager was present throughout the process. The inspection consisted of a tour of the premises, speaking to residents and visitors to the home, and interviewing staff. All interviews were conducted independently. The inspector also read residents’ case files and staff records. In addition, several documents pertaining to the running of the home were also examined. At the time of the inspection, the manager who had been appointed on a fixedterm contract had left. A new manager had been appointed and was due to take up post in April 2006. Before the inspection, concerns had been received from some members of staff anonymously. They alleged that they felt intimidated by the more experienced staff and that favouritism was being practiced. This inspection therefore, was mainly focused on investigating these matters. What the service does well: All of the residents who were spoken to, said that the quality of the care was very good, and they were very complimentary about the staff. The home has particularly attractive grounds, where residents and visitors can enjoy lakes and well maintained gardens. The catering, cleaning and general housekeeping duties are well organised and managed. There is a good programme of training and development of staff to equip them to meet service users’ needs. Woodside Home DS0000010528.V271128.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: A requirement made at the last inspection to review care plans, has not been met and has been restated in this report, with a new timescale for compliance. In the “Timescale for Action” column, the date in ordinary type relates to the timescale given at the last inspection. The date in bold type relates to the new timescale. Further information about unmet requirements can be found in the relevant standard. Unmet requirements can impact upon the welfare and safety of service users. Failure to comply by the revised timescale may lead to the Commission for Social Care Inspection considering action to secure compliance. There are serious issues about morale and inter-relationships among some staff to be dealt with, especially as some residents are aware of these issues. Members of the Trust Board should have discussions with residents and staff individually when visiting the home, and individual supervision of staff and staff meetings must be held regularly. All of these measures could enable staffs’ and residents’ concerns to be raised and dealt with promptly. Residents’ contracts of the terms and conditions of the service need to be signed by all parties and their care plans must be reviewed at least monthly to ensure that any changes in their needs are highlighted and addressed. Staffing levels should also be kept under review as the residents’ needs change. Woodside Home DS0000010528.V271128.R01.S.doc Version 5.0 Page 7 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. Woodside Home DS0000010528.V271128.R01.S.doc Version 5.0 Page 8 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 Home DS0000010528.V271128.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 5. Standard 6 does not apply. Potential service users are encouraged to visit the home to test out the service before moving in. The residents’ contracts must include the fees charged so that they are aware about what is and is not covered in their terms and conditions of service. EVIDENCE: The Statement of Purpose and Service User Guide will need to be amended to include the new management structure when the new manager takes up post. The case files of four new residents were examined. Although they contained contracts of terms and conditions of service, they did not stipulate the fees charged and not all were signed. A requirement is made to address this. There was evidence in the case files, of trial visits being available for service users before moving to the home. During the inspection, a potential resident was spending the day at the home to try it out. Woodside Home DS0000010528.V271128.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 The residents have a full range of healthcare and are well supported by staff in their personal care. Residents’ needs, as set out in their care plans, are not being regularly monitored on a monthly basis. EVIDENCE: Four care plans were sampled. New, comprehensive care plans had been introduced in the home, including short-term and long-term goals. The care plans covered all aspects of the residents’ care. However, the rhetoric in both plans was repetitive and a recommendation is made to adopt one care plan. It was noted that some care plans were not being monitored monthly, and a requirement is made to address this. It was noted that the concept of key working had been introduced. Staff were knowledgeable about the key worker’s responsibilities, including writing the care plans. One care plan seen, had been signed by the resident, which is good practice and indicates their involvement in their care plan. The case records showed that all service users were registered with the GP, and health care appointments were recorded. These ranged from chiropody to dentists, opticians etc. Woodside Home DS0000010528.V271128.R01.S.doc Version 5.0 Page 11 Residents said that the staff were very caring and they were supported in their personal care with dignity and respect. There were records to show that medicines were being administered safely and stored securely. Woodside Home DS0000010528.V271128.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 & 15 The residents have a good quality of life and they are happy with the food provided. There is an appropriate range of stimulating activities that they can choose to participate in. EVIDENCE: There has been a great improvement in the scope of activities provided for residents, with individual care staff taking a lead in developing stimulating topics. The activity programme also includes musical movement, art classes, sing-along sessions and outside entertainers monthly. A hairdresser also attends weekly. The visitors’ book showed that there were regular visits to the home by family and friends, and the inspector spoke to relatives during the inspection. Woodside Home DS0000010528.V271128.R01.S.doc Version 5.0 Page 13 The inspector observed residents eating the lunchtime meal, which is the main meal of the day. The food was well cooked and attractively presented. The inspector also observed some service users being helped by staff to eat in an unhurried and sensitive manner. Residents said that they could choose to dine in their rooms if they wished. The menus showed a choice of main meals. Special diets, including different cultural dishes were provided as appropriate. An inspection of the kitchen, confirmed that food was stored safely. Woodside Home DS0000010528.V271128.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Staff are inappropriately discussing their grievances about their managers in the presence of residents. This could undermine residents’ feeling of security and compromise their best interests. EVIDENCE: Some residents who were spoken to, said that some staff discussed serious concerns about their working conditions and their managers in their presence; (see commentary under Management and Administration Standards). A requirement is made to address this matter. There is a complaints procedure in place and there were records to show that staff had attended training in adult protection and abuse awareness. Woodside Home DS0000010528.V271128.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24 & 26 Residents live in a home that is very clean, comfortable, safe and well maintained. EVIDENCE: A tour of the premises was carried out. The building was generally well maintained and the standard of décor was very good. The gardens were very attractive for the time of year. There are plans for major building works to provide new accommodation on the third floor of the home, which it is hoped will start later in the year. There are also plans to totally refurbish the kitchen, which is looking its age. Five bedrooms were visited and they were all very comfortably furnished and attractively decorated. Since the last inspection, disposable hand towel holders had been installed in the toilets and bathrooms. The home was very clean and tidy throughout, and there were no unpleasant odours. Woodside Home DS0000010528.V271128.R01.S.doc Version 5.0 Page 16 Woodside Home DS0000010528.V271128.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 29 There are good procedures in place for recruiting staff. Staffing levels need to be kept under review to ensure that they reflect the fluctuating dependency of residents. EVIDENCE: At the time of the inspection, there were forty-two residents and seven vacancies. The staff rotas showed that there were regularly, seven care staff on duty in the morning, five in the afternoon/evening, and four on night duty. This meets the minimum staffing levels. However, some staff said that they felt that only one care staff in the morning, was insufficient on a corridor where the dependency level was high. A recommendation is made for this to be reviewed and the level of staff adjusted if necessary. Care staff are supported by a team of catering and domestic staff. The home also employs its own maintenance staff. The records of the seven most recently recruited staff were examined. They included references and proof of identity, and they had been cleared by the Criminal Records Bureau. Woodside Home DS0000010528.V271128.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32 & 36 There is poor morale among some care staff who feel aggrieved about how they are managed by senior staff. This could have a detrimental effect on the recruitment and retention of staff and the general ethos of the home. Staff are not receiving supervision consistently and meetings with the care staff , where these matters might be discussed openly, are not being held regularly. EVIDENCE: The manager, who had been appointed on a fixed-term contract, left the home in December 2005 and a new manager is due to take up post in April 2006. In the interim, the deputy manager is in charge of the home, supported by four team leaders. Woodside Home DS0000010528.V271128.R01.S.doc Version 5.0 Page 19 Before this inspection, two approaches were made to the inspector from staff members who alleged that they felt intimidated and bullied by some senior staff and other carers who had worked at the home for many years. It was alleged that the deputy manager exercised favouritism in the allocation of shifts and that some senior carers favoured staff, particularly regarding meal breaks. In the report of the last inspection, the inspector stated that there was serious discontent among some staff, including the senior carers, about the changes that the then manager had embarked upon. Most of these changes were about introducing good practice. There had been resistance to some of these initiatives, including the pace of change and how this was communicated to staff. During that inspection, it was evident that residents were aware of staffs’ discontent. It was also evident during this inspection that there is still discontent among some care staff, but it is focused more on the current management team, which includes the deputy manager and senior carers. Some care staff spoke in support of the previous manager. For example, this comment was made; “The previous manager was firm, but fair”. Some staff also spoke well of the deputy manager. During this inspection, the inspector informed the deputy manager and three members of the committee about these allegations, at which they expressed surprise and concern. The staff said that they were unable to air their grievances in the normal way, because they felt intimidated and said that, although senior team meetings had been held, meetings for the “care staff” had not been held since the last manager left. It was also alleged that the members of the committee did not speak to junior staff when they visited the home, but only spoke to “the management”. These allegations were made anonymously. An inspection of the staff rota did not show any evidence of discrimination in the shift allocation, and the deputy manager said that she was very flexible in responding to staffs’ requests. The majority of staff on duty during the inspection were spoken to, either individually or in pairs, and independently of senior staff. Several staff confirmed that there was some substance in the allegations. It was evident that some staff were discussing grievances in the presence of some residents; (see commentary under Standard 18). Individual staff supervision had been initiated by the previous manager, however, since she left, supervision was not taking place consistently, according to the records and discussions with staff. Woodside Home DS0000010528.V271128.R01.S.doc Version 5.0 Page 20 Supervision, along with staff meetings, provides a forum for staff to discuss their concerns and might enable the above issues to be resolved at an early stage. Requirements are made to ensure that all care staff receive at least six supervisions a year, and for regular staff meetings to be held. A requirement is also made that committee members talk to staff and residents individually about any concerns they have, when they carry out Regulation 26 visits. Woodside Home DS0000010528.V271128.R01.S.doc Version 5.0 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 2 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 X X X 2 X X Woodside Home DS0000010528.V271128.R01.S.doc Version 5.0 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 OP2 Regulation 5(1)(b) Requirement The registered person must ensure that residents’ contracts are signed by the service users’ or their representatives, and by the managers of the home. The registered person must ensure that service users care plans are reviewed each month to reflect residents changing needs. This requirement is restated from the last inspection. The previous timescale was 30/09/05 The registered person must ensure that staff do not discuss their grievances with, or in the presence of, residents and visitors. The registered person must ensure that regular meetings are held with all staff to seek their views about the management of the home. The registered person must talk to residents and staff individually to elicit any concerns they have, when they carry out Regulation 26 visits. DS0000010528.V271128.R01.S.doc Timescale for action 30/04/06 2. OP7 15(2)(a) 30/04/06 3. OP18 21(1) 30/04/06 4. OP33 21(2) 30/04/06 5. OP33 26 30/04/06 Woodside Home Version 5.0 Page 23 6. OP36 18(2) The registered person must ensure that all care staff receive at least six supervisions a year. 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP27 Good Practice Recommendations The registered person should keep staffing levels and staff breaks under review and adjust them if necessary as residents’ needs change. Woodside Home DS0000010528.V271128.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Woodside Home DS0000010528.V271128.R01.S.doc Version 5.0 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. 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. 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