Inspection on 20/08/08 for Woodside Home for the Elderly

This inspection was carried out on 20th August 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Woodside Home for the Elderly 05/09/07

Woodside Home for the Elderly 30/05/06

Woodside Home for the Elderly 14/02/06

Woodside Home for the Elderly 21/06/05

Woodside Home for the Elderly 11/12/04

Woodside Home for the Elderly 15/08/04

Similar services:

Chirnside House

Keer Sands Residential Home

Sunny Bank (P.R.S.) Ltd

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Clover House

Langrigg House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/11/2008.

CARE HOMES FOR OLDER PEOPLE Woodside Home for the Elderly Burnley Road Padiham Burnley Lancashire BB12 8SD Lead Inspector Mrs Julie Playfer Unannounced Inspection 20th August 2008 09:00 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 for the Elderly DS0000035069.V366244.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 Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodside Home for the Elderly Address Burnley Road Padiham Burnley Lancashire BB12 8SD 01282 774457 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) Lancashire County Care Services Miss Pauline O`Neill Care Home 44 Category(ies) of Dementia - over 65 years of age (10), Learning registration, with number disability over 65 years of age (1), Mental of places Disorder, excluding learning disability or dementia - over 65 years of age (3), Old age, not falling within any other category (30) Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to take people in the following categories: OP- Older age not falling within any other category - 30 DE(E) Dementia over 65 years of age - 10 MD(E) Mental disorder, excluding learning disability or dementia over 65 years of age - 3 LD(E) Learning Disability over 65 years of age - 1 5th September 2007 Date of last inspection Brief Description of the Service: Woodside is registered to provide personal care and accommodation for a total of 43 people. The home is owned and operated by Lancashire County Care Services and was extensively refurbished in 2005. Woodside stands in its own grounds close to Padiham town centre. Public transport is accessible from Burnley Road. There are car-parking facilities at the front of the building. Accommodation is provided in 42 single rooms and 1 double room. 19 of the single rooms have an ensuite facility. The home comprises of four units, Alder, Beech, Cedar and Damson. Each unit is self-contained with lounges, dining rooms, bedrooms and bathroom facilities. There is a large conservatory on the ground floor and a designated smoking room. Beech unit provides care for older people with a dementia. The home has been decorated and furnished to a good standard throughout. At the time of the inspection the scale of charges was as follows: standard rate £366.00, higher rate £412.00, self-funding residents and residents with a dementia £433.00. Additional charges were made for hairdressing, toiletries, magazines and newspapers. The registered manager made information available to prospective residents by means of a statement of purpose and service users guide. These documents were usually given to relatives and/or prospective residents on viewing the home or at the point of assessment. In addition, all residents accommodated in the home had been issued with a personal copy of the service users guide. Woodside Home for the Elderly DS0000035069.V366244.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 1 star. This means the people who use this service experience Adequate quality outcomes. A key unannounced inspection, which included a visit to the home, was conducted at Woodside on 20th August 2008. At the time of the inspection there were 42 people accommodated in the home. The inspection comprised of spending time with the residents, looking round the home, reading some of the residents’ care records and other documents and discussion with the staff and the registered manager. As part of the inspection process we (the commission) used “case tracking” as a means of gathering information. This process allows us to focus on a small group of people living at the home, to assess the quality of the service provided. Prior to the inspection, the registered manager completed an Annual Quality Assurance Assessment known as AQAA, which is a detailed self assessment questionnaire covering all aspects of the management of the home. This provided useful information and evidence for the inspection. Satisfaction questionnaires were sent to the home for some of the staff and the residents. Nine questionnaires were returned from people living in the home and five questionnaires were received from staff. It was noted that many of the residents’ relatives had assisted their family member to complete a questionnaire and some had added their own comments about the home. The responses from the questionnaires were collated and used throughout the inspection process. What the service does well: Current and prospective residents were provided with appropriate written information. This ensured the residents were aware of the services and facilities available in the home. The admission procedure involved an assessment of people’s needs. This enabled the registered manager and prospective residents to determine whether or not their needs could be met within the home. Each resident had a care plan, which provided clear guidance for staff on how best to meet the residents’ personal and social needs. The daily routines were flexible and designed to meet the wishes of the residents, many of the residents chose to have a lie in and breakfast was served throughout the morning to suit their preferences. The residents spoken to felt they were well cared for and the staff respected their rights to privacy and dignity. One resident wrote in a questionnaire, “The staff are always ready to help and are patient and caring”. Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 6 The staff planned and implemented a range of activities in line with the needs and choices of the residents. The activities were arranged on different units to encourage the residents to meet people in different areas of the home. Varied and well-presented meals were served. All residents spoken to described the meals as “very good” and “lovely”. Visitors were welcome in the home at any time and residents were supported to maintain good contact with their family and friends. The relatives who made comments on the questionnaires were satisfied with the quality of care provided. The residents were aware of the complaints procedure and knew who to talk to in the event of a concern. Residents’ meetings were held on a regular basis, which gave the residents the opportunity to discuss all aspects of life in the home. The residents were provided with clean comfortable bedrooms. The residents could personalise their rooms, with their own belongings. The sitting and dining areas were decorated in a homely fashion, with a variety of armchairs, footstools, side tables, ornaments and pictures. All care staff had achieved NVQ level 2 or above. This qualification provided the staff with the necessary knowledge to carry out their role effectively. The registered manager had developed a quality assurance system, which was based on the outcomes for the people living in the home. This meant the residents and their relatives were able to have some input into the future development of the service. What has improved since the last inspection? Since the last inspection a new brochure had been produced about the services and facilities available in the home. The brochure was easy to understand and provided useful information for current and prospective residents. The staff had become familiar with the new care planning systems and found the care plans easy to use. As such the care plans were used and updated by the staff on a daily basis. The registered manager had ensured the staff had signed the medication administration records contemporaneously to avoid any omissions on the records. Additional procedures had been drawn up for the administration of covert medication, which were used when specific instructions had been given by the prescriber. The registered manager had introduced a new “Getting to Know You” document, which was completed by the staff alongside the resident. This document provided the staff with each resident’s activity preferences and Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 7 details about their past life experiences. This meant that activities could be arranged in line with people’s choices and interests. A PAT (Pets are Therapy) dog had been introduced to the home, which allowed the residents to spend time with a dog. An awning had been fitted outside Beech unit, a raised flowerbed had been added to the garden and four tele-care sensor mats connected to the call system had been purchased. The latter was designed to alert staff if residents who were at high risk of falling, got out of bed during the night. 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 Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 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 for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 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. 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 living in the home had their needs properly assessed and they were provided with appropriate written information to enable them to make an informed choice about where to live. EVIDENCE: Written information was available for the residents in the form of a statement of purpose and service users guide. The guide had been distributed to each resident and was available for reference in the entrance hall. Two people spoken to confirmed they had received a copy of the service users guide and both said that it was easy to read and understand. A new brochure had also been produced which offered current and prospective residents with a useful overview of the services and facilities available in the home. The brochure included photographs of the home and a section on frequently asked questions. All the residents who completed a questionnaire indicated they had Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 10 received enough information prior to moving into the home. Copies of the last inspection report were available for reference in the entrance hall. From the personal files seen it was evident that the residents had been issued with a contract/terms and conditions of residence. The contracts had been signed by the residents and/or their representative and included information about the level and payment of fees and the rights of the residents. The contract was easy to read and was presented in a clear format. This meant the residents were aware of their terms and conditions and what they could expect from the service. The ‘case tracking’ process demonstrated that the residents had their needs assessed prior to admission by a social worker and/or manager. Copies of the preadmission assessments were seen on the residents’ files in the office. The assessments covered a range of individual needs. The registered manager confirmed that admissions were not made to the home in the absence of a full needs assessment. This meant the registered manager was confident that the staff had the necessary skills and knowledge to meet the assessed needs of the prospective resident. Copies of letters were seen of the residents’ files to indicate the registered manager had informed the prospective residents in writing, that having considered the assessment, their needs could be met in the home. The registered manager said that prospective residents were encouraged to spend time in the home prior to making the decision to move in. This enabled the resident to meet other residents and staff and experience life in the home. One person was observed viewing the home on the day of inspection. Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 11 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): 6, 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care practice took full account of the residents’ privacy and dignity and the personal care received by the residents was based on their individual assessed needs. However, the care planning system did not fully address the residents’ healthcare needs. EVIDENCE: Three people’s files were looked at in detail as part of the case tracking process. All three people’s files contained a care plan based on their assessment of needs. The three plans had been developed using a computerised care planning system known as “Saturn”. The Saturn plans covered people’s physical, personal and social needs and were supported by risk assessments. Personal profiles had been incorporated into the care plan documentation and provided details about past life experience, important events and likes and dislikes. This information was useful for staff to stimulate meaningful conversations with each resident. The plans were supported by Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 12 daily records of personal care, which provided information on changing needs and any recurring difficulties. These records were detailed and the residents’ needs were described in respectful and sensitive terms. The care plans and other associated paperwork were collated in individual files and were available on each unit to facilitate ease of reference. Since the last inspection, the staff had become much more familiar with the format of the Saturn plans and all the staff spoken to said the plans were easy to use and understand. Further to this, one member of staff commented on a questionnaire, “We are now working with the new Saturn care plans, which are easy to use and contain all relevant information regarding the residents we care for”. The residents confirmed they were involved in the care planning process and recalled discussing their care needs with a member of staff. The residents had also signed their care plans wherever possible to indicate their agreement and participation. This gave the residents the opportunity to have an active input into the delivery of the care. Written evidence seen in the residents’ files demonstrated that the care plans were reviewed each month and the care plans had been updated in line with changing needs. Healthcare needs were appropriately assessed, however, there was no designated section within the care plans, which provided information on healthcare needs and staff therefore had limited guidance on how best to meet and respond to these needs. There was evidence within the records of personal care to indicate the residents had access to NHS services and advice from specialist services had been sought as necessary, for instance the District Nursing Team. Risk assessments in respect to moving and handling, pressure sores, falls and nutrition had been incorporated into the care plan records. The risk assessments were supported with risk management strategies, to provide staff with guidance on how to manage and reduce any identified risks. However, it was noted that management strategies had not always been drawn up following the assessment of the risk of pressure sores. The residents spoken to felt the staff respected their rights to privacy and dignity and all made complimentary remarks about the staff, for instance one person said, “All the staff are smashing, they are very caring and will do anything for you”. The residents, who completed a questionnaire, indicated that they received the care and support they needed. One person commented, “I’m very happy with the care and support provided”. The staff were observed to interact with the residents in a positive manner and they referred to the residents in their preferred term of address. Discussions with staff Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 13 demonstrated an awareness of treating people with respect and considering their dignity when providing personal care. Policies and procedures were in place to cover all aspects of the management of medicines. The home operated a monitored dosage system of medication, which was dispensed into blister by the local pharmacist. Staff designated to administer medication had completed accredited medication training. Appropriate records were maintained in respect to the receipt, administration and disposal of medication and charts had been placed in residents’ bedrooms to record the administration of prescribed creams. Suitable arrangements were in place for the storage and administration of controlled drugs. Since the last inspection additional procedures had been drawn up for the administration of covert medication, which were used when specific instructions had been given by the prescriber. The registered manager had also ensured the staff had signed the medication administration records (MARs) contemporaneously to avoid any omissions on the records. However, it was noted that the MARs did not always accurately reflect the details/instructions included on the prescription labels. Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 14 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 were able to exercise choice and control over their lives and maintained good contact with their family and friends. The residents were provided with a nutritious and varied diet. EVIDENCE: The residents’ preferences in respect of social activities were recorded and considered as part of the assessment process. Since the last inspection, the registered manager had introduced a “Getting to Know You” document, which was completed by the keyworker alongside the resident. This document provided information about the residents’ activity preferences and past life experiences. A range of activities was planned and implemented by the manager and staff, which included dominoes, bingo, ball games, word puzzles, discussion and singing and dancing. The activities were arranged on different units to encourage the residents to meet people in different areas of the home. The number of activities offered depended on the staffing levels of the home. One Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 15 member of staff commented on a questionnaire, “We pride ourselves on giving the residents stimulating daily activities which they enjoy and have input in choosing, but due to staffing levels often we cannot undertake these activities or have to cut activities short which leaves the residents frustrated”. The residents spoken to during the visit said there were activities available if they wished to join in. The residents on Beech Unit said they particularly enjoyed playing musical instruments. Since the last inspection, a PAT (Pets are Therapy) dog had been introduced and some of the residents had been on several trips out of the home. The residents were consulted at regular residents’ meetings about what activities they wished to pursue. Information about forthcoming activities was displayed on notice boards in the main hall way and around the home. On the day of the inspection the residents were observed to be watching television, listening to music and chatting to staff. The residents were supported to follow their chosen religion and representatives from the local church visited the residents for communion and prayers and an ecumenical service was held every Sunday. The routines were flexible and were primarily designed to meet the needs of the residents. The residents spoken to said they had a choice in the times they got up and went to bed. One person said, “It’s free and easy and I can decide what I want to do myself”. The staff were observed to seek the residents’ views throughout the inspection and the residents spoken to said they felt comfortable to comment on life in the home. The residents had the opportunity to develop and maintain important personal and family relationships. There were no restrictions placed on visiting times and residents were able to receive their guests in the privacy of their own rooms, should they wish to do so. The relatives who commented on the questionnaires were satisfied with the overall standard of care, one person wrote, “I find all the staff respond to any requests and try to cheer up any of the residents who may not be feeling happy”. Similar comments were received from relatives during the inspection, one person said, “They have been so good, I have no concerns at all”. All the residents spoken to said they liked the food provided. There was a choice of food and residents were asked the day before what choice they wished to make. Breakfast was served throughout the morning to suit the preferences of residents, who wished to have a lie in. The menu was displayed on the wall in the dining areas. Menu planning was discussed with the residents at the residents’ meetings and all residents were able to make suggestions for forthcoming meals. The meal served on the day inspection looked appetising and was well presented. Residents were given sensitive and appropriate support to eat their Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 16 meals. Drinks and snacks were served throughout the day and at other times on request. Residents were observed asking for drinks during the inspection and were promptly served by staff. Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 17 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. Residents were able to express their views and had access to a clear complaints procedure. Policies and procedures were in place to respond effectively to any allegations or suspicions of abuse. EVIDENCE: Both informal and formal arrangements were in place to ensure the registered manager and staff listened to and acted on the views and concerns of residents. This was achieved during daily conversation, one to one discussion, satisfaction questionnaires and residents’ meetings. The residents spoken to said they felt comfortable expressing their views and were aware of whom to speak to in the event of a concern. One resident wrote on a questionnaire, “I would speak to all members of staff who deal with me” and another person commented, “Complaints are always listened to”. A copy of the complaints procedure was included in the service users guide, which was available in each of the bedrooms and on display in each unit and in the reception. The procedure contained the necessary information should a resident or their representative wish to raise a complaint with the home or direct to the Commission. Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 18 According to records seen during the inspection, the registered manager had not received any complaints about the service. Arrangements were in place to record and investigate any concerns raised by the residents, for instance issues relating to personal relationships. The registered manager had access to a copy of “No Secrets in Lancashire” (The Joint Strategy for the Safeguarding of Vulnerable Adults), along with a specific procedure setting out the required response in the event of any allegation, suspicion or evidence of abuse. These issues were incorporated into the induction training and staff received specific training as part of their mandatory training programme. Staff spoken to were aware of the procedure and whom to refer any incident to as well as the various agencies involved. Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 19 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, 20, 21, 22, 23, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents were provided with a clean, pleasant and well-maintained environment, which promoted their comfort and independence. EVIDENCE: Woodside is a purpose built two storey building, which was extensively refurbished and extended in 2005. The accommodation within the home is split into four separate units. Each unit is self-contained and provides lounges and dining areas along with bedrooms and bathrooms. The home has been refurbished and decorated to a high standard throughout. Integration between the units was actively encouraged and residents enjoyed free movement around the home. The residents living on Beech unit were supported by staff, when they wished to visit other areas of the home. Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 20 The grounds were extensive and there were several sitting areas for the use of the residents in fine weather. Garden furniture was available on the patio outside the main conservatory. Beech unit had a large enclosed garden, which residents were able freely access at any time. In additional to the communal space provided on each unit the residents had access to conservatories attached to Alder and Beech units. There was an assisted bath and shower on each unit and nineteen of the single rooms had an ensuite facility. Since the last inspection, an awning had been fitted outside Beech unit, a raised flowerbed had been added to the garden and four tele-care sensor mats connected to the call system had been purchased. Residents were provided with appropriate aids and adaptations to assist their mobility and independence, these included Oxford hoists, a stand aid hoist, grab rails in toilets and bathrooms and raised toilet seats. There was a call facility in every room. The doors to residents’ bedrooms had been fitted with appropriate locks and residents had been issued with keys. One resident spoken to said she liked to keep her room locked at all times. It was evident from a partial tour of the premises that residents had brought in their own belongings and had personalised their room in accordance with their own tastes and preferences. All residents spoken to were pleased with the size and standard of furnishing and décor in their bedrooms. Radiators had guaranteed low temperature surfaces or had been fitted with guards. However, one relative spoken to said the home was often uncomfortably warm and the radiator guards did not allow for individual adjustments of the thermostats. Wherever possible the manager was managing this situation with the use of fans. The home was clean and odour free at the time of the inspection. The residents spoken to said that a good level of hygiene was maintained at all times. Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 21 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents’ benefited from well-trained and competent staff. However, the level of staffing did not always meet with people’s expectations. EVIDENCE: The registered manager maintained a staff rota, which indicated, which staff were on duty and how many hours they had worked. All staff providing personal care were aged over 18 and all staff left in charge of the building were aged over 21. Whilst all the residents who completed a questionnaire indicated that they received the care and support they needed and staff listened and acted upon what they said, the level of staffing was a concern for many of the staff and relatives who completed a questionnaire. One member of staff wrote, “I have noticed that when working shifts where the hours have been deducted we do not spend as much individual time with the residents leaving them more vulnerable than before”. A resident spoken to during the inspection was also concerned and said, “The staff work very hard – always dashing, they could do with more carers on duty”, the person added “It’s difficult when staff are working on their own, I don’t like to ask for anything they are so busy”. Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 22 The organisation had recently made proposals to reduce the number of night staff and had carried out a full consultation with all interested parties. The proposals had provoked widespread concerns for the health and safety of the residents. One relative wrote on a questionnaire, “I think the proposal to reduce night staff cover is ridiculous. These vulnerable people need 24 hour care. The caring staff are already stretched and do not need a reduction in numbers during the night when people become ill or need assistance, whether medical or otherwise”. The outcome of the consultation was not available at the time of the inspection; however, should the organisation make changes to the staffing levels the health and safety of the residents must be safeguarded. Lancashire County Care Services operated a recruitment and selection procedure, which was underpinned by an Equal Opportunities Policy. The files of three members of staff, who had recently commenced working in the home, were seen during the inspection. It was evident from viewing these files that not all documentation collated, as part of the recruitment process was available for inspection purposes. Both the manager and area manager confirmed that such documentation had been received prior to the staff commencing work in the home. Arrangements were in place for all new employees to undertake an in house induction programme and complete the Lancashire County Care Services induction. The latter provided underpinning knowledge for NVQ level 2. According to information supplied by the registered manager, all members of staff had achieved NVQ level 2 or above. All the staff who completed a questionnaire confirmed they received training relevant to their role and all commented that they were well supported by the management team with any training needs. One member of staff wrote on a questionnaire, “Ongoing training has enhanced my ability to do my job. Our training is always up to date”. Staff attended both internal and external training courses and had at least three paid days training a year. The manager was able to track staff training by the means of a central database, which highlighted the staff’s future training needs. Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 23 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, 32, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Management and administration practices were effective in ensuring the home was run in the best interests of the residents. EVIDENCE: The registered manager held the Registered Manager’s Award as well as other relevant qualifications such as NVQ level 4 in Management and an HNC in Social Care. The registered manager had also undertaken periodic training to update her knowledge and skills, which included business training. The registered manager had a sound understanding and knowledge about the best ways to care for older people and this was communicated to the management and staff team by means of daily interactions, formal supervisions and Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 24 meetings within the home. Further to this, one member of staff who completed a questionnaire commented, “The manager is always available for support advice, guidance and supervision”. The manager operated an “open door” policy and staff, residents and visitors were encouraged and welcomed into the office should they have a query. This was observed throughout the day of the inspection. The management approach was consultative and there were established ways of working to consult the staff and residents on an ongoing basis. Relationships within the home were positive and staff spoke to and about the residents with respect. One member of staff wrote on a questionnaire, “The home provides individual care for each person respecting their rights, beliefs and dignity”. There was a programme in place for staff supervision and the topics discussed during supervision were recorded on a suitable format. The registered manager had delegated the responsibilities for supervision to senior staff, who had been assigned specific groups of staff. In addition to supervision, staff were given the opportunity to attend regular staff meetings. The service had been awarded an Investors in People Award. Residents’ and staff meetings were held on a regular basis and from the minutes seen it was evident both the staff and residents were encouraged to express their views about life in the home. A consultation week was also arranged for a group of residents every quarter. Five topics were chosen for discussion during the consultation, with three questions on each topic. The topics included activities and mealtimes. The results of the consultation week had been collated and summary of the results had been displayed for the residents. The registered manager had developed a business plan for the home, which highlighted the planned developments for the forthcoming year. This document linked with the AQAA questionnaire submitted to the Commission. All sections of the AQAA were fully completed and the information provided gave a clear picture of the current situation within the service and the planned areas for development. Satisfaction questionnaires had been distributed to the residents in June 2008. The forms had been sent to a central office and the registered manager reported the collated results were not yet available. Care audits were carried out by the Area Manager and the registered manager monitored the management of medication and all aspects of health and safety. Such systems ensured that the quality of the service was continually checked. Appropriate arrangements were in place for handling money, which had been deposited with the home by or on behalf of a resident. A random check of monies was found to be correct. Records were maintained centrally, in respect to the amount of fees charged and received. There was a set of health and safety procedures available, which included the safe storage of hazardous substances. Staff received health and safety Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 25 training, which included moving and handling, food hygiene, first aid and fire safety. Information supplied by the registered manager indicated the electrical, gas and fire systems were serviced at regular intervals. The fire log demonstrated the staff had received instruction about the fire procedures during their induction. Risk assessments had been completed in respect to safe working practice topics. Arrangements were in place to record accidents and incidents in the home and the Commission had been notified as appropriate of any significant event in the home. Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 26 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 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 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 2 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP8 Regulation 15 (1) Requirement Timescale for action 01/09/08 2. OP9 13 (2) 3 OP27 18 (1) (a) 4 OP29 17 (2) (3) The care plans must include a section to cover the residents’ healthcare needs in order to provide clear guidance for staff on how best to meet these needs. The medication administration 20/08/08 record must accurately reflect the prescription label instructions. This is to ensure staff can easily cross check information and the records are an accurate representation of the medication administered to the residents. A review of staffing levels must 01/10/08 undertaken and completed to ensure the number of staff is appropriate to protect the health and welfare of the residents. All regulatory documentation 20/08/08 collated during the recruitment of new staff must be available for inspection purposes. This is to ensure the home can clearly demonstrate that the correct checks have been obtained, prior to a person commencing work. Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 28 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 OP8 Good Practice Recommendations Risk management strategies should be drawn up following the assessment of the risk of pressure sores, to ensure staff have guidance on how to manage any identified risks in a safe and consistent manner. The residents should be able to control the heating in their own room so that they can regulate the temperature. 2 OP25 Woodside Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Home for the Elderly DS0000035069.V366244.R01.S.doc Version 5.2 Page 30 - 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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