Inspection on 22/03/06 for Woodstock Nursing Home

This inspection was carried out on 22nd March 2006.

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

Woodstock Nursing Home 27/03/07

Woodstock Nursing Home 30/09/05

Woodstock Nursing Home 14/03/05

Woodstock Nursing Home 07/10/04

Woodstock Nursing Home 16/03/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Woodstock Nursing Home 35 North Upton Lane Barnwood Gloucester Glos GL4 3TD Lead Inspector Pat Edwards-Jackson Unannounced Inspection 22nd March 2006 08:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Woodstock Nursing Home DS0000016655.V286852.R01.S.doc Version 5.1 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. Woodstock Nursing Home DS0000016655.V286852.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Woodstock Nursing Home Address 35 North Upton Lane Barnwood Gloucester Glos GL4 3TD 01452 616291 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) Mrs Millie Rosaleen Barnes Mr John Barnes Mrs Millie Rosaleen Barnes Care Home 29 Category(ies) of Dementia (2), Old age, not falling within any registration, with number other category (29), Physical disability (3) of places Woodstock Nursing Home DS0000016655.V286852.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th September 2005 Brief Description of the Service: Woodstock Nursing Home is situated in a residential area of Barnwood, on the outskirts of Gloucester. The providers Mr & Mrs Barnes are involved on a dayto-day basis in supporting the management of the home. The home is registered for 29 older people. The accommodation is located on three floors with bedrooms on each floor. All bedrooms have en suite facilities and twenty-one of these have their own shower facility. There is one assisted bathroom in the home and a large assisted toilet facility on the ground floor as well as several other toilets. Also on the ground floor is a spacious dining room adjacent to the kitchen, with a serving area; three lounges and staff office accommodation. Group social activities are usually held in the large lounge. The second lounge has a television. The third lounge is available for those who prefer a quiet room for reading. The home stands in its own grounds and the enclosed gardens at the rear are accessible to those with mobility needs. The home is close to local shops and services. Woodstock Nursing Home DS0000016655.V286852.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced, inspection was conducted by one inspector. Annie Tidy the Patient Care Manager was in charge of the home she was supported by a team of 13 staff at the time of the inspection. A tour of the premises took place. A sample of bedrooms and all communal areas were seen. A sample of records relating to care and medication were viewed. The home had 28 residents on the day of inspection. The home had no vacancies. The 29th place is in a double room, which continues to be used for sole occupancy. 1:1 discussions took place with a number of service users. The majority of standards were assessed during the inspection. For standards not assessed the reader is advised to see the previous inspection report 30th September 2005*. What the service does well: This aspect of the service remains unchanged as previously reported in September 2005*, • The staff work hard to ensure a clean and pleasant environment is maintained. • There are clear systems for monitoring care and support needs. • The providers are keen to work with the staff to provide a flexible level of support for the people living at the home. • Service users, who were able to express a view, said they liked living at the home. • The management approach encourages residents and relatives to comment on the service provided. • There is good communication between the staff team. In addition, Furnishings are replaced on a regular basis to ensure the fabric of the home is maintained. Woodstock Nursing Home DS0000016655.V286852.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Woodstock Nursing Home DS0000016655.V286852.R01.S.doc Version 5.1 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 Woodstock Nursing Home DS0000016655.V286852.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1; 2; 3; 4; 5. Prospective service users needs are assessed prior to moving into the home – further assessment takes place following admission. Prospective service users and their relatives/supporters are able to visit the home prior to making a decision about admission. The service user guide clearly sets out the terms and conditions of service. EVIDENCE: Discussions took place with a number of individual service users. There have been a number of admissions to the home since the previous inspection. A sample of the care and support plans relating to these recently admitted resident service users were seen. An assessment of needs was clearly set out and identified global needs including physical and mental health needs. The revised Service Users Guide clearly sets out the terms and conditions of the service to be provided. A copy of the guide was provided for the inspector to keep. Information provided during discussions with individual service users, about their care and support needs was accurately reflected in their care and support Woodstock Nursing Home DS0000016655.V286852.R01.S.doc Version 5.1 Page 9 plans seen. Observations during the inspection of service user/staff interactions further confirmed this. Woodstock Nursing Home DS0000016655.V286852.R01.S.doc Version 5.1 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; 11 Individual care plans detail health and social care needs and how these will be met. Service users health care needs are met by the home with the support of multi-disciplinary professionals. Service users are treated with respect and their need for privacy is upheld. The staff are sensitive to the needs of service users whose needs increase, and ensure they are treated with respect. EVIDENCE: These standards have been maintained as previously evidenced (30 September 2005). A sample of individual care and support plans were seen – these contained detailed information setting out how health care needs are met both within the home on a day to day basis and via support from multi-disciplinary health care professionals. The sample of care plans seen recorded visits involving GPs, community nurses, community psychiatric nurses and other health professionals. The homes long standing relationship with one GP practice is about to change, with the retirement of the GP. The Patient care manager was Woodstock Nursing Home DS0000016655.V286852.R01.S.doc Version 5.1 Page 11 confident that arrangements have been made to ensure a consistent service to those living in the home will be maintained. It was evident (from the care plans seen and observations during the inspection) that the staff ensure residents right to refuse treatment is respected e.g. when residents are unable to comply with medical interventions, due to mental deterioration. Care plans contained evidence of ‘in-house’ preventative support e.g. nutritional monitoring, skincare mobility needs. Risk Assessments were also in place and were up to date. The medication disposal system has recently been changed. The new disposal arrangements and the homes revised policy were seen. The patient care manager will be keeping the new arrangement under review as discussed during the inspection. She has previously sought advice from the CSCI Pharmacy inspector regarding this issue, to ensure the system meets the required standards. Changing care needs are kept under review and it was evident that the manager and staff team are sensitive to the needs of those whose condition deteriorates. They are also aware of the emotional needs of resident’s relatives when such changes occur (See Stds 27 – 30 re: Staff training). Woodstock Nursing Home DS0000016655.V286852.R01.S.doc Version 5.1 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; 14; 15 As previously found (30 September 2005*), The home caters for a group of people who have a range of needs, expectations and interests. Contact with friends, family and the local community is promoted and supported. Resident service users are encouraged and supported to maintain choice and control over their lives. A wholesome and appetising diet is provided and main meals are taken communally whilst breakfast is taken to individuals in their rooms. EVIDENCE: A sample of Care plans, were seen and conversations took place with a number of service users. As previously found*, social care needs including previous hobbies and interests were clearly identified in the individual care plans seen. A record is kept of resident’s level of engagement in social activities. A designated member of staff is responsible for organising social activities (which tend to have an important therapeutic purpose i.e. engaging people in group activity, maintaining manual dexterity, mental alertness etc). 1:1 conversations with service users confirmed that they enjoy a range of experiences within the Woodstock Nursing Home DS0000016655.V286852.R01.S.doc Version 5.1 Page 13 home. Some of those spoken with had been able to continue with hobbies and interests, which they enjoyed prior to admission. During the inspection a group of service users went out to a local church social event, it was clear from their comments that they enjoyed attending. The regular, in- house activities were planned to take place in the home during the afternoon. It was evident from the care and support plans seen and discussions with service users and the patient care manager that a wide range of family involvement is supported. With some relatives, visiting on a daily basis whilst others who lived overseas were able to keep in contact by telephone and letter. There was also evidence of family involvement in case conferences when changes in care were being decided. Woodstock Nursing Home DS0000016655.V286852.R01.S.doc Version 5.1 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): 17 Systems are in place to ensure service users legal rights are protected. EVIDENCE: A sample of Care and support plans were seen, these contained evidence of legal arrangements to ensure the protection of individual service users. The reader is referred to the previous inspection report 30 September 2005, for standards not assessed at the current inspection. Woodstock Nursing Home DS0000016655.V286852.R01.S.doc Version 5.1 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; 21; 22; 23; 24; 25; 26. The home is well maintained, clean (with no persistent odours), safe and comfortable. Specialist equipment is available to maximise independence. Individual bedrooms are arranged to suit individual resident needs. EVIDENCE: A tour of the premises took place and a sample of service user bedrooms were seen. As previously found, a programme of regular maintenance work and refurbishment, takes place – this ensures that repairs are made within a reasonable timescale. The home was clean and no persistent odours were noted during the inspection. Two cleaners were on duty and were busily engaged in working throughout the home. They were Spring-cleaning a bedroom and described how they undertook a rolling programme of Springcleaning individual bedrooms. As previously observed, given the high level of needs amongst the people living in the home the level of cleanliness was pleasing to see. Discussions with individual service users and observations confirmed that the arrangement Woodstock Nursing Home DS0000016655.V286852.R01.S.doc Version 5.1 Page 16 of furniture and personalisation of bedrooms very much reflected individual needs and preferences. Some replacement of furniture, bedding and floor coverings had taken place since the inspection in September 2005. Woodstock Nursing Home DS0000016655.V286852.R01.S.doc Version 5.1 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; 28; 30 The skills mix and number of staff meets the needs of the current resident group. Systems are in place to ensure the people living at Woodstock are in safe hands. The staff are trained and the level of supervision ensures their competence is kept under review. EVIDENCE: Observations of staff/service user interactions took place and discussions took place with the patient care manager and a number of service users. The home continues to cater for a number of residents who have significant support needs. It was clear that the management team remain sensitive to keeping the global needs of the resident group under review to ensure this balance is maintained. Management systems remain unchanged as previously evidenced (30/9/05), The clear management; supervision arrangements and formal handover periods at the beginning of each shift change ensure that all staff are up to date and any concerns raised. All are regarded as important factors in ensuring service users are in safe hands. Since the previous inspection staff have received training in End of Life care – this is regarded as important given the high level of care needs affecting the people accommodated here. Staff have also received training in Dementia care awareness. The patient care manager confirmed that both training events had been well received by the staff team who take their responsibilities towards those living in the home seriously. Woodstock Nursing Home DS0000016655.V286852.R01.S.doc Version 5.1 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; 33; 35; 36; 37; 38 The home is well managed; the management team have a clear vision for the home. This ensures the home is run in the best interests of those living here. Staff are appropriately supervised. Systems are in place to ensure the health, safety and welfare of all who work and live in the home EVIDENCE: As previously found (30/9/05) these standards are maintained - Discussions with service users, staff and the management team confirmed that there is clear management of the home (as evidenced throughout this report). An open approach is encouraged amongst the staff team to ensure that problems can be quickly identified and dealt with whenever they arise. Comments from the Patient Care manager confirmed that she ensured that any difficulties with staff performance were addressed to ensure standards were maintained. Woodstock Nursing Home DS0000016655.V286852.R01.S.doc Version 5.1 Page 19 It was clear from comments made by the Patient care manager that she not only takes her role seriously but that she ensures the staff team treat those living in the home with the sensitivity and respect due to them. Woodstock Nursing Home DS0000016655.V286852.R01.S.doc Version 5.1 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 3 3 3 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 3 18 x 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 4 x 3 3 3 3 Woodstock Nursing Home DS0000016655.V286852.R01.S.doc Version 5.1 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. Refer to Standard Good Practice Recommendations Woodstock Nursing Home DS0000016655.V286852.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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. 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