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Inspection on 09/12/08 for Woodthorpe View Care Home

Also see our care home review for Woodthorpe View Care Home for more information

This inspection was carried out on 9th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

People have their needs assessed before they move into the home to make sure they can be met. Some of their needs are clearly laid out in a plan of care. People receive care and support in a way which promotes their privacy and dignity. There are various visits to the home from friends and family, and people are encouraged to be as independent as possible. People can raise any concerns or complaints about the home. The building is well maintained and everywhere is kept clean and tidy. Staff know how to prevent the spread of infection. The majority of staff have achieved a professional qualification.

What has improved since the last inspection?

There are sufficient supplies of people`s medication available which are appropriately stored and records are kept when medication is administered. People are able to take part in activities they enjoy. There are systems in place to protect people from abuse. People are protected by recruitment practices followed.

What the care home could do better:

Ensure all people`s needs are recorded in their care plan so staff are aware of all people`s needs they are required to attend to. People must be observed to take their medicine to ensure they receive the correct medication. Introduce a menu which provides people with a choice of meal. The rota must show which staff are on duty at all times to show there are sufficient staff on duty to meet people`s needs. Develop the staff induction programme, this will help staff have a good understanding of their responsibilities towards people living in the home

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Woodthorpe View Care Home 53 Woodthorpe Drive Woodthorpe, Arnold Nottingham NG5 4GY     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Stephen Benson     Date: 0 9 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Woodthorpe View Care Home 53 Woodthorpe Drive Woodthorpe, Arnold Nottingham NG5 4GY 01159624556 01159532853 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Rhoda Emaline Ellis,Mr Michael Ellis Name of registered manager (if applicable) Mrs Rhoda Emaline Ellis Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Woodthorpe View is a large converted residential house on two storeys with a modern extension. It provides care for up to 28 older people. The home is in a residential area Nottingham and is close to local shops, park and other amenities. The home has a large sitting room with a range of comfortable armchairs, and a dining room with small tables so that service users can sit together to eat. There is an all season conservatory leading off the dining room. This looks out on to a patio area, which has seating and can be accessed via a patio door. There are twenty-eight single bedrooms, twenty-one of them with en- suite facilities. The bedrooms are well decorated and furnished and service users can personalise them with their own belongings. There are bathrooms on each floor with adapted baths and shower, 4 toilets on the ground floor and 2 on the second. There is a lift between the two floors, which is large enough for a wheelchair. All access within the home is level. The home has a number of pets including small Care Homes for Older People Page 4 of 29 0 Over 65 28 care home 28 Brief description of the care home dogs, a cat and birds. There is a parking area to the side of the home. The manager said on 06/06/08 that the current fees are between £290 and £320, depending on the assessed level of dependency of individuals. Residents pay for any hairdressing and chiropody in addition to the fee. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for people accommodated and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This was our second visit to the home since 1st April 2008. This inspection involved one inspector; it was unannounced and took place in the daytime, including lunchtime. Prior to the visit an analysis of the home was undertaken from information gathered over the last year including that from the Annual Quality Assurance Assessment they Care Homes for Older People Page 6 of 29 completed. We sent survey forms entitled Have your say about... to a sample of 10 people and 6 of these were returned. The main method of inspection used is called case tracking which involves looking at the quality of the care received by a number of people living at the home. We also use evidence from our observations; we speak with them about their experience of living at the home; we look at records and talk with staff about their understanding of the peoples needs who they support. The premises were not inspected in detail but various areas of the home were visited as part of the inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 29 Care Homes for Older People Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed before they move to the home to ensure their needs can be met. Evidence: The care file of a person recently admitted to the home was seen and this had a Community Care Assessment in, which had been sent to the home prior to the person moving in. The deputy manager said that they always get an assessment before someone comes to the home, and if the person does not come for a visit they will visit the person to assess their needs. Staff said they know when someone new is coming to the home and that they see their assessment and any discharge notes from the hospital if they are admitted from there. Care Homes for Older People Page 11 of 29 Evidence: The person recently admitted said she was bought to the home for a visit by a social worker. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There have been improvements in the planning of peoples care and the management of medicines in the home, but there is still room for further improvements Evidence: A sample of three care files were seen and these contained assessments, risk assessments, care plans and various monitoring forms. The care plans seen gave clear detail as to how the persons needs should be met, however these were limited to one care plan covering all activities of daily living and other needs, such as religious or social, were not addressed. The plans are reviewed on a monthly basis and updates were seen where changes had occurred. The manager said she didnt think care plans were too bad, but agreed that there should be plans covering other needs. Care Homes for Older People Page 13 of 29 Evidence: Staff said they read through care plans and can refer to them to see what has happened since they were last at work. One person had a care plan for being fed through a peg feed. This said that all staff have received training for this and staff training records showed this to be so. In our survey forms four people said they always receive the care and support they need, one person said they usually do and one person said they sometimes do. One person said, I get the help I need to get up. There is a section of the care file to record any contact with healthcare professionals and entries seen showed there was regular contact with various services. The deputy manager was heard telling staff to observe someone who was not feeling well and that she was contacting the doctor. A visiting district nurse said she had no concerns about the way peoples healthcare needs are met in the home. Staff said they ask people how they are feeling and will call a doctor if they do not seem to be well. One person said he had been having problems moving around the home and someone had come to see him and measured him up for a walking stick, and now he can get around the home. In our survey everyone replied that they receive the medical support they need. Comments made by people concerning their healthcare included, If you are not well they put you to bed and the nurse comes and If I have an attack they call the doctor straight away. The Medicine Administration Records were fully completed showing people have received their medication as required. One person was seen sat in the dining room with some tablets on the table besides her. The deputy manager said that the person insists on having her tablets to take when she has finished her breakfast, which has also been requested by a relative, and that all other people are observed taking their medication. The person was seen to drop one of the tablets on the floor without her knowledge. This was pointed out to the manager who said she will be observed to take her tablets in the future. Care Homes for Older People Page 14 of 29 Evidence: All creams and drops are now dated when opened and a record is kept of all medication coming into and leaving the home. The deputy manager said there have not been any instances where they have run out of medication. There were a number of references seen in care plans to maintaining peoples privacy and dignity, including giving details as to how this should be done. A male member of staff said he always asks people if they are happy for him to assist them with their personal care or if they would prefer to have a female member of staff. Staff were able to describe good practices in promoting peoples privacy and dignity. One person said, When I have a bath they do it very nicely. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have opportunities to join in activities and make choices about what they do, although there could be greater choice over what they have to eat. Evidence: There is a book to record any activities people take part in. Recent activities recorded were a sing a long, film nights, motivation sessions and games. The manager said they are busy at the moment making plans for Christmas. Staff said they organize things such as quizzes, bingo and card games. Staff saids they ask people what they would like to do. In our survey forms three people said there are always activities organised they can take part in and two said there sometimes are. One person who was admitted to the home recently said, I would love to have a game of bingo. Another person said, I think we are having a Christmas party. Care Homes for Older People Page 16 of 29 Evidence: Staff said that people can have visitors at anytime, although they prefer people to avoid mealtimes. One person said, I have had my brother and sister come to visit me and another person said, We can go for walks out of the home and sometimes visit the park. There were references seen in care plans to giving people choices and one entry in the daily notes said that one person had been up until midnight watching television. Staff said that they try to give people choices over everyday matters such as what clothing they will wear. People were seen using different areas of the home and one person said, I prefer to use this lounge. There is not a menu in current use and the cook said he asks people each day if they want something different from the main meal. Records seen showed that this rarely happened. The cook said he was working on introducing a new two week menu which would provide people with a choice of dish. Lunch today was roast beef with potatoes and vegetables followed by sponge pudding and custard for pudding. In our survey forms four people said they always like the meals at the home and one person said they usually do. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can raise anything they are not happy about and staff know how to safeguard people. Evidence: There were notices seen giving details of the homes complaints procedure and there is a a copy in each persons room. The deputy manager said there have not been any complaints made. Staff were aware of the complaints procedure but said they had not had to deal with any complaints. A recently appointed member of staff said she had been told about the complaints procedure as part of her induction. In our survey forms everyone said they new how to make a complaint. One person said, If I am not happy about something I just mention it to the deputy manager and she will look into it for you. There was information about the safeguarding procedures seen in the care files looked at and staff were aware of things that would require these to be followed. There have not been any safeguarding incidents and one person said, I feel perfectly safe here, all the staff speak nicely to us. Care Homes for Older People Page 18 of 29 Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe and well maintained environment, which is clean, pleasant and hygienic. Evidence: Areas of the home seen were suitable decorated and in good order. People were seen using different areas of the home. One member of staff said he carries out some minor repairs but is anything needs a contractor one is called in. Staff said they feel able to carry out their duties in the building and it is appropriately laid out. People coming into and leaving the home are asked to use a alcohol had gel to help prevent the spread of infection. All areas of the home seen were clean and tidy and smelt fresh. One person said, The girls work very hard to keep it clean and everything. Care Homes for Older People Page 20 of 29 Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. More could be done to induct new staff in to their role. Evidence: The rota was seen and this was not correct for today, but there were three care staff on duty. The rota did not show that there are always at least two staff on duty. The manager and deputy manager said that this was an oversight and that there were always at least two staff on duty. The rota had not been properly amended following a member of staff leaving and they are waiting for a new person to start when they have received the required pre employment checks. Staff confirmed that there are always at least two care staff on duty and a third person was on duty today as one member of staff had to leave the building for a while. The deputy manager said there are six care staff who have completed National Vocational Qualification level 2, two of whom are now working towards level 3. A new member of staff has started working towards level 2. One member of staff has been appointed since the last visit and the persons file showed the correct recruitment practices have been followed. Care Homes for Older People Page 22 of 29 Evidence: The member of staff said she had not been able to start work until her Criminal Records Bureau check had been returned. The member of staff said she had received an induction and a copy of this was seen in the training file, however this was somewhat brief and did not follow the common induction standards. Staff training files showed they have received training previously and where this is due for updating the manager said this is arranged over the next three months. In our survey forms three people said staff are always available when they need them and three people said there usually are. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is an experienced manager in post. People are able to influence the running of the home and peoples health and safety is promoted. Evidence: The manager, who is also one of the providers, has been in post since the home opened 24 years ago. The manager has not got a relevant qualification, but said she may consider taking one in the future. Staff said they thought the home was well run. There are survey forms sent out to people living in the home and their relatives, the most recent one was commented upon in the last inspection report. Following the last inspection where the home received a poor rating the manager and deputy manager wrote to all relatives explaining where the shortfalls were that had been identified and giving details of where they could read the report. Care Homes for Older People Page 24 of 29 Evidence: The majority of people replied to the letter saying they were very happy with the care provided in the home and a number of people praised the care provided and the cleanliness of the home. The manager said there is not a system for handling peoples monies as this is done by their families. The manager said that all the required health and safety checks are carried out at the required frequency and there are service contacts in place for servicing all the equipment. It was stated on the Annual Quality Assurance Assessment that equipment is tested or serviced as recommended by the manufacturers or other other regulatory body. It was also stated that there are written assessments on hazardous substances. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Ensure all peoples needs are recorded in their care plan. So staff are aware of all peoples needs they are required to attend to. 01/02/2009 2 9 13 People must be observed to take their medication. This will ensure they receive the correct medication. 11/12/2008 3 27 17 The rota must show which staff are on duty at all times. To show there are sufficient staff on duty to meet peoples needs. 01/01/2009 4 30 18 Develop the staff induction programme. This will help staff have a good understanding of their responsibilities towards people living in the home. 01/03/2009 Care Homes for Older People Page 27 of 29 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 15 Introduce a menu which provides people with a choice of meal. Care Homes for Older People Page 28 of 29 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - 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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