Inspection on 08/02/07 for Woodside Resource Centre

This inspection was carried out on 8th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 Resource Centre 27/01/09

Woodside Resource Centre 14/02/06

Woodside Resource Centre 01/09/05

Woodside Resource Centre 03/11/04

Woodside Resource Centre 13/08/04

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

CARE HOMES FOR OLDER PEOPLE Woodside Resource Centre Cavendish Road Middlesbrough TS4 3DJ Lead Inspector Jackie Herring Key Unannounced Inspection 09:30 8th February 2007 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 Resource Centre DS0000033593.V328250.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 Resource Centre DS0000033593.V328250.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodside Resource Centre Address Cavendish Road Middlesbrough TS4 3DJ 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) 01642 828146 01642 827418 manager.woodside@careuk.com manager.burroughs@careuk.com Care UK Community Partnerships Limited Mrs Karen Morrison Care Home 60 Category(ies) of Dementia - over 65 years of age (60) registration, with number of places Woodside Resource Centre DS0000033593.V328250.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home provides accommodation for people, 60 years and over, who have been diagnosed as suffering from a Dementia. The home provides 40 places, providing care with nursing and 20 places personal care, a total of 60 places. Two named individuals who are under the age category are allowed to reside in the home. 14th February 2006 Date of last inspection Brief Description of the Service: The Willows is a 60 bedded purpose built home, which was registered in November 2002. It comprises of two distinct units; a 40 bedded nursing unit for individuals over the age of 60 who have dementia and a 20-bedded unit for personal care the same category of care. Within the 20-bedded unit, 5 of the beds provide a dedicated respite service. A number of the nursing beds are also dedicated for continuing health care. All of the 60 rooms are single with ensuite facilities and meet the room requirements. The home is situated in an urban setting within ready access to local transport, the local hospital a public house and a church. The weekly fees range from £338 for residential care to £512 for nursing (this included the free nursing care component). Woodside Resource Centre DS0000033593.V328250.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was a key unannounced inspection and was completed by one inspector over two inspection days, twelve inspection hours in total. As a key inspection, all of the key standards were examined. This was to check that the home meets the standards that the Commission for Social Care Inspection say are the most important for the people who use services, and that it does what the Care Standards regulations say it must. Residents and relatives were spoken to during the inspection to seek their views, as were staff members and the home manager. A number of records were looked at including resident’s assessments and plans of care, staff recruitment records, complaints and maintenance records along with the pre inspection questionnaire. Indirect observations also took place, as due to health needs, a large number of residents were not able to be involved in informed discussion about their care at The Willows. What the service does well: The Willows is an extremely well managed care home offering a high standard of care to the residents and is a very supportive and enabling environment for the staff to work. There is very strong leadership and extremely sound management systems in place. The staff are well trained, very knowledgeable and can competently meet the needs of the residents and clearly have a great understanding of the individual residents they care for. One relative said, “I visit every day and everyone is really friendly”. Another relative said, “My loved ones general health is much better since being admitted, the care for them has lived up to expectations and they are well cared for by the staff, they are friendly, helpful and respectful in their approach” The Willows provides a pleasing and comfortable environment for the residents to live, in which there is a good sense of space. Staff said of what The Willows did well, “The best is the care given to the residents in a wonderful way, their needs are met in every way, the main priority is the resident, whatever they need they get”. Another staff member said, “It is important to be flexible, choice for each resident is encouraged and when assisting with dressing you always ask and observe for facial expressions particularly if there is difficulty with verbal communication”, “You have to get to know the residents own little ways and patience is very important”. Woodside Resource Centre DS0000033593.V328250.R01.S.doc Version 5.2 Page 6 The staff clearly demonstrate the core values of care ensuring rights, privacy and dignity. 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 Resource Centre DS0000033593.V328250.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 Resource Centre DS0000033593.V328250.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): 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are assessed prior to the moving into The Willows, ensuring that individual care needs can be met. EVIDENCE: During discussion with staff, it was confirmed that pre admission assessments were completed by key staff of the home prior to planned admission to The Willows. Details of these assessments are kept within the residents file and were made available during the inspection. It was also confirmed that a copy of the care management assessment was also obtained. A small number of files were looked at and contained copies of the assessment documentation. The Willows does not provide intermediate care. Woodside Resource Centre DS0000033593.V328250.R01.S.doc Version 5.2 Page 9 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, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home plans well for and is good at meeting the health, personal and social care needs of the people who live there. EVIDENCE: During discussion with staff, it was confirmed that pre-admission assessments are completed for all planned admission to the home and these assessments form the basis for individual plans of care. The residents’ records continued to be a computerised record with some paper files also kept which contained supporting information. A selected sample of resident’s records were examined and found to be very personal and individualised with a good level of detail. Very good care interventions are described in the individual care plans, which were very specific to individual needs. The evaluations of care are very good within the nursing unit. Some additional detail would improve the records within the residential unit and the training should continue to ensure that all assessment records and care records are cross-referenced. A relative also confirmed that they were involved in bi-monthly reviews of care and confirmed they had seen a copy of the assessment and care plan, which had been signed. Woodside Resource Centre DS0000033593.V328250.R01.S.doc Version 5.2 Page 10 Care staff said that they look at the care plans particularly when there were new admission and they also confirmed that they wrote in the daily progress notes. During discussion with staff it was clear that they were very knowledgeable about individual residents and they spoke with great understanding. One care worker said, “It is important to be flexible, choice for each resident is encouraged and when assisting with dressing you always ask and observe for facial expressions particularly if there is difficulty with verbal communication”, “You have to get to know the residents own little ways and patience is very important”. There was clear evidence of GP, Consultant Psychiatrist or other health care professionals involvement when required. Examples of this included the monthly involvement of the dietician, which was detailed in two of the records examined and the involvement of the physiotherapist. Through indirect observation, residents were relaxed and comfortable in the lounge, they were all appropriately and nicely dressed and a number of residents were smiling on interaction with staff. A small activity was taking place with residents and the staff interaction was observed to be respectful and friendly. Another observation was during one of the visits to the nursing unit after lunch, a resident was resting on their bed, they had gentle music playing through the TV, they were clearly comfortable and relaxed and there was a lovely smell in their bedroom. A relative said, “My loved ones general health is much better since being admitted, they care for them has lived up to expectations and they are well cared for by the staff, they are friendly, helpful and respectful in their approach” The medication systems were examined in both of the units and found to be very good, with additional information in place, addition checks in place for certain medication and very sound procedures. Storage in both units was excellent and staff clearly knew the procedures and systems for the safe storage, ordering and handling of medication. Confirmation and evidence was also available to demonstrate that non-qualified nursing staff had received appropriate training. Woodside Resource Centre DS0000033593.V328250.R01.S.doc Version 5.2 Page 11 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, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ daily lives are flexible and very much determined by individual needs and choices. A range of activities do take place, these are changeable and kept under review. Open visiting is encouraged and residents are able to maintain contact with family and friends. EVIDENCE: During discussion with staff they spoke very clearly about their role in providing residents with a full a life as possible and whilst they said there were individuals responsible for coordinating activities, the care staff also recognised they too had a role in this area. One staff member said, “It is important to spend time with residents, talking to them, involving them in activities and listening to music. Dedicated staff are employed to co-ordinate and deliver activities and it was confirmed through discussion with one of the coordinators that they have undertaken specific training for this function, such as chair based activities and communication activities for families to be involved in. Activities were also being included within the day-to-day role of care assistants and this was observed during the inspection. Woodside Resource Centre DS0000033593.V328250.R01.S.doc Version 5.2 Page 12 One of the activity coordinators was also in the process of developing life storybooks for individual residents with the involvement of the relatives and loved ones. There was quite some discussion about activities and people’s perceptions of activities. Two of the relative surveys commented that there could be more stimulation for the residents. Currently there are planned times for activities to take place, however these are flexible depending upon the needs of residents and may be time spent with a resident on a one to one basis rather than large group activities. Relatives spoke very highly about the welcome they received when visiting and there were clearly very good staff/relative relationships. They said, “I visit every day and everyone is really friendly”. Informal discussion took place with other relatives who said, “It’s very good, she is well cared for and they always check on her”. A discussion took place with the head chef and the menus were also looked at. The chef talked in detail about the dietary needs of the residents and how the menu was constantly reviewed and amended depending on what residents were enjoying. The menu is also changed seasonally. Although there is no actual choice for the main lunchtime meal, it was confirmed that alternatives are available should they be required. In the past choice has been offered, however they current system is said to be more effective. The chef also confirmed the arrangements when new residents were admitted to the home and showed the inspector a copy of the information he receives about dietary needs, likes, dislikes and preferences. Woodside Resource Centre DS0000033593.V328250.R01.S.doc Version 5.2 Page 13 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, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A clear complaints procedure is in place and complaints are handled objectively; procedures are in place to protect residents from abuse. EVIDENCE: Relatives said they were aware of the complaints procedure and said they would speak to the key staff in the first instance and had every confidence that any concerns would be appropriately addressed. One relative said that on admission of their loved one they were talked through the welcome pack, which also contained the complaints procedure. The complaint procedure was observed to be on display throughout the home and contained the required information. During discussion with the manager, it was confirmed that complaints were managed in a thorough way and detailed complaints records were made available for examination, and they contained detailed information, both computerised and paper records detailing complaints were maintained. One staff member said, “I would not hesitate to raise any concerns and have done so which has effected change for the better, the manager has most definitely addressed any issues raised”. Staff were aware of abuse and what constitutes abuse and they had received training on this topic as well as Protection of Vulnerable Adults. Care staff, catering staff and the maintenance staff, also confirmed this. Woodside Resource Centre DS0000033593.V328250.R01.S.doc Version 5.2 Page 14 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, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a homely, well-maintained environment to suit their needs and lifestyles, which is clean and well maintained. EVIDENCE: Both the residential unit and nursing unit were visited during the inspection. The residential unit continues to be homely, well maintained and well decorated. Improvements had been made to the nursing unit with the partitioning of the dining room and the creation of two separate units. Ongoing redecoration and refurbishment is taking place and there was evidence of redecoration during the inspection. A number of chairs and tables had been renewed since the last inspection and the manager confirmed that further furniture was on order. Woodside Resource Centre DS0000033593.V328250.R01.S.doc Version 5.2 Page 15 The dining areas within the nursing units do not on first appearance seem to be the most conducive environments. This to a large part is as a result of the needs of the residents, the specialist equipment needed due to their more complex and dependency needs. It is acknowledged that the use of these rooms is continually kept under review and staff continuously look at ways to improve the dining experience for residents. A further improvement is that of a small sensory room within the nursing unit, which staff were very pleased with. A large range of specialist equipment was observed such as airwave mattresses, different hoists, different types of beds and specialist chairs. One of the qualified nurses also confirmed the involvement of the Occupational Therapist. During a visit to the nursing unit, one of the shower rooms was in need of attention, due to a very damp smell and damage to the door. The remainder of the bathrooms and shower rooms visited were in good order. Work has commenced to improve the residential unit garden and plans are also underway to improve the centre courtyard garden, which is accessed via the nursing unit. This will be a real improvement and will benefit all. Woodside Resource Centre DS0000033593.V328250.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Very good procedures are in place for the recruitment and selection of staff and care is provided to the residents by a very well trained, competent and dedicated team of staff. EVIDENCE: Staff records of three new staff were looked at during the inspection and contained all of the required information such as application form, references, job description and Criminal Record checks and showed that good recruitment procedures were in place. The pre inspection questionnaire detailed that 70 of care staff are trained to NVQ Level 2 or above, however at the time inspection, this had increased to 75 . The manager described a new e-learning training programme, which was demonstrated during the inspection and looked very good. Training was also detailed within the pre inspection questionnaire and described by the manager and staff. Included in this is the mandatory training such as fire and first aid as well as more client specific training including, dementia awareness; safe handling of medicines and falls awareness. It was also evident that developing the staff team was very important and staff undertake specific roles within the home such as health and safety and back care. Woodside Resource Centre DS0000033593.V328250.R01.S.doc Version 5.2 Page 17 During discussion with staff they spoke very highly of the training opportunities made available to them, one staff said, “You are forever training and you can request more and it will be arranged”. During interviews with staff and informal discussions, very strong values were expressed in regard to residents rights and independence. All staff spoken to were very positive and enthusiastic about the training provided. The manager also confirmed that a training matrix, which detailed all of the training and who had attended what training is kept updated as a management tool and a copy of this was also included within the pre inspection questionnaire. Staff members said that they each have a training file where they keep their training certificates. Staff were very clear about their job roles and said when asked about the role of a keyworker, “It is to ensure that personal needs such as bathing is carried out as well as being there to listen to any concerns and worries”. Staff believed there was a really good staff team at The Willows and talked about the support, both peer support and support from the manager. Woodside Resource Centre DS0000033593.V328250.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manager provides extremely good leadership to the staff team and continuously strives to improve standards within the home ensuring that resident’s needs are well met. Good systems are in place for the handling of resident’s personal allowances and there is also a good range of quality assurance systems. Service and maintenance arrangements are in place and in order. EVIDENCE: The manager has the required qualification, skill and experience, is highly competent to manage The Willows. She is extremely enthusiastic about her role and her commitment to The Willows was very obvious on the day of the inspection. This commitment and enthusiasm was evident throughout the staff team who were very positive about the work they did. Woodside Resource Centre DS0000033593.V328250.R01.S.doc Version 5.2 Page 19 Staff said, “There is good leadership”, “The manager values you as a staff member, the home is run well and staff are always consulted”, “Excellent Management, really good communication and extremely supportive”. A relative said, “We are very satisfied with the care, communication is good, they let you know about any changes and keep you informed”. All of the management systems looked at during this inspection were thorough, with supporting information and evidence. Some roles and responsibilities have been cascaded through the staff team, allowing for increased responsibility and development. The management of resident’s personal allowances was discussed with the administrator. The system was good and contained the required information such as two signatures and receipts. A selected sample of records and balances were checked and all found to be correct and in order with supporting information. Quality Assurance was discussed with the manager who said regular audits are in place for care plans, supervision records, medication and the environment. In addition, regulation 26 visits take place as well as in house quality assurance and relative/resident satisfaction surveys. A copy of the last report was made available; it was well written with a good level of detail and also included information from the last CSCI inspection report. A random sample of maintenance records were examined during the inspection such as fire alarm system, passenger lift and gas landlord certificate and all found to be in order. They were also detailed within the pre inspection documents. The maintenance person discussed the regular environmental checks that are undertaken to ensure that the Willows remains safe and well maintained. Woodside Resource Centre DS0000033593.V328250.R01.S.doc Version 5.2 Page 20 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Woodside Resource Centre DS0000033593.V328250.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP7 OP19 OP21 Good Practice Recommendations Further training should be delivered to the residential staff in respect of the assessment and care records. Consideration should be given to replacing the corridor carpet in the nursing unit. One of the shower rooms on the nursing unit must be attended to as there was the smell of damp and the door was damaged. Woodside Resource Centre DS0000033593.V328250.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 Resource Centre DS0000033593.V328250.R01.S.doc Version 5.2 Page 23 - 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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