Inspection on 18/08/05 for Woodview

This inspection was carried out on 18th August 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Woodview 09/04/08

Woodview 26/06/07

Woodview 01/12/06

Woodview 19/02/06

Woodview 09/03/05

Woodview 07/10/04

Woodview 17/03/04

Woodview 23/09/03

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

CARE HOME ADULTS 18-65 Woodview 58A Park Road West Birkenhead Merseyside CH43 8SF Lead Inspector Jeanette Fielding Announced 18 August 2005 08:50 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Woodview Address 58A Park Road West Birkenhead Wirral CH43 8SF 0151 653 6566 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Alternative Futures Limited Gary Knowles - acting manager CRH PC 4 Category(ies) of 4 - LD registration, with number of places Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1) One (1) named male service user over 65 years of age (LD/E) within an overall total of Four (4 )(LD) Date of last inspection 9 March 2005 Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 5 Brief Description of the Service: Woodview is a two storey detached house which backs on to Birkenhead Park, with the back of the house and the large garden having attractive views across the park. It is on a busy main road, less than half a mile from Claughton Village where there are local shops and bus services. The home has its own minibus for the use of service users. The home has a large lounge and dining area on the ground floor. The kitchen adjoins the dining room and there is a very small lounge on the other side of the kitchen. There is a shower room, toilet and laundry on the ground floor. All service users have large single bedrooms on the first floor, which also houses an office, toilet and bathroom. Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over a period of six hours and involved speaking with the manager, staff and service users. Service users were not able to give their views of the home due to their disabilities. Records relating the care required by and afforded to service users were inspected and found to be detailed and informative, although some inappropriate comments were included in daily reports. Risk assessments were in place and included risk management strategies. Staff records were inspected and were found to include all necessary information to demonstrate that checks had been made on staff to ensure the protection of service users. Evidence of staff training is held on their individual files. A tour of the premises showed that these are poor with little evidence that any effort had been made in relation to maintenance or repairs. The décor is poor and damaged in many parts of the home. Bathrooms are in a poor condition with paint peeling from walls and service users being placed at risk from unsafe facilities. The home was not maintained in a clean condition and did not provide a homely and pleasant environment for the service users. The fencing in the garden was damaged and did not therefore provide a safe area for service users. What the service does well: What has improved since the last inspection? What they could do better: The physical standard of the home is very poor. The décor is stained and damaged and there is no evidence that a programme of maintenance or repair has been prepared or implemented. The home was not clean and did not provide a satisfactory environment for the service users. Please contact the provider for advice of actions taken in response to this Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 An admissions procedure exists to enable any prospective service user to make decisions regarding their accommodation at the home. EVIDENCE: There have been no new admissions to the home since the last inspection. A procedure to be followed in the event of a new admission to the home being considered is in place. This procedure identifies that any new service user would be fully assessed and given the opportunity to visit the home prior to admission. There are no plans at present to admit any new service users. Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 9 Care plans are detailed and up to date to enable staff to provide the appropriate level of care required by service users. EVIDENCE: Detailed care plans are prepared for all service users. These contain information regarding the individual care required by the service users, together with information for staff regarding individual preferences regarding social activities. These were seen to have been updated to include all necessary information to enable the staff to provide the level of care required by each individual service user. The service users accommodated at this home lack the ability to identify with any risk to themselves or others. Risk assessments have been undertaken by the staff on all activities both within the home and during trips out. Risk management strategies have been prepared to remove or reduce any potential risks to the service users. Daily reports are completed by the staff and these give details of the care afforded to each service user in individual diaries. Staff must take care to not Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 11 to write inappropriate comments in the daily reports and to ensure that all information is in accordance with the homes policy on report writing. The new manager stated that he intends to review the documentation within the home and add additional information as necessary. Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15, 16, 17 Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: A range of activities is accessible to service users and is dependent on their preferences and individual abilities. None of the service users are able to undertake employment, education or training. Some basic skills are taught within the home to encourage the service users to participate in the day to day running, although these are limited according to ability. Service users are encouraged to participate in the local community and use the local swimming pool, pub and shops. The home has a mini-bus to give greater opportunities to use local facilities and amenities. Trips to New Brighton are enjoyed along with walks in the local park. Three service users have visits to the home by family members and two of these service users go to visit their family on a regular basis. Family Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 13 relationships are encouraged, although none of the service users are able to develop friendships. The new manager is working towards identifying each service users individual skills and will look to develop new skills and abilities. These will all be subject to risk assessment. The records held in the home provide evidence that a varied and balanced diet is offered. The menus reflect the service users individual preferences and a choice of meal are made available where possible. Fresh fruit and vegetables are used as much as possible and these are supplemented by frozen and tinned fruit and vegetables to provide a greater selection. Meals are taken at individual tables within the dining room. Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 The security of medications is inadequate thereby placing service users at risk. EVIDENCE: Service users are accommodated in single bedrooms. Personal care is given in their bedroom or in the bathroom as appropriate to ensure that their privacy and dignity are protected. No accidents have taken place since the last inspection although the home has a procedure to follow in the event of an accident occurring. All service users have their health care needs reviewed on a regular basis. A record is held of all visits made to and by the GP and other health care professionals. These records also include any advice or information given and any changes made to their medications. Full reviews of medications are undertaken separately by GP’s and consultants as appropriate. None of the service users are able to administer their own medications and so the staff attend to this. Medications are stored in service users own bedrooms. One box of Paracetamol was found to contain tablets with different dates on the packaging indicating that the box had been topped up from another container. This practice is not acceptable and all medications must be stored in the original container supplied by the pharmacist. Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 15 Paracetamol was found for one service user, having been prescribed by the GP, but this was not recorded on the Medication Administration Record sheet. One service user had been prescribed medication on an ‘as needed’ basis, but there were no records to indicate the criteria for which the medication would be given. This medication had been given on a regular basis. The GP should be contacted to give direction to the staff regarding the use of this medication and such advice must be clearly documented. The keys for the medication storage areas were not held securely. They should be held by the person in charge of the home to remove any risk of inappropriate access. Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23 Staff have a knowledge and understanding of Adult Protection issues to protect service users from abuse. EVIDENCE: None of the service users have sufficient communication skills to enable them to make comment on the home or the service provided. No provision has been made for the views of family, advocates and visitors to the home to make comment on the service provided. The home has a complaints policy and a procedure to be followed in the event of a complaint being made. The complaints information available to service users, family and advocates, and visitors to the home is to be amended to reflect the change in manager of the home. No complaints have been made since the last inspection. The home has a whistle blowing policy and procedure to ensure the protection of the service users. Training is given to all staff when they commence work at the home regarding the different types of abuse and of the action to be taken if it were suspected. A copy of Wirral Adult Protection booklet is held in the home and is accessible to all staff. Staff spoken to during the inspection were able to demonstrate their knowledge of adult protection and action to be taken. Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 30 There has been no change to the décor or furnishings in the last twelve months and although this does not pose a risk to service users, it does not create a pleasing and pleasant environment to live in. EVIDENCE: This home has not been maintained to an acceptable standard. The décor, particularly the paintwork, is marked and damaged in the lounge, the dining room and the service users bedrooms. The paintwork on the walls is stained and damaged. This is not acceptable and does not provide a pleasant environment for the service users. No lampshades are provided in the dining room and so the room is lit by bare bulbs creating a cold and impersonal atmosphere. Curtains were seen to be hanging down from the rails. The paint is peeling from the walls in the ground floor shower room and the shower base is stained and dirty. In the first floor bathroom, the pedestal on the washbasin is loose and presents as a risk if any service user were to knock it or lean on the washbasin. A cupboard in this bathroom contained old razors which, again, presents as a risk to service users. Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 18 In one bedroom, a triple adaptor is used at one of the socket outlets. This practice should cease and sufficient sockets must to be provided to meet the needs of the service users. The home was not clean and the remnants of last Christmas’ decorations still hung from walls and ceilings. Cobwebs were hanging from the ceiling and a heavy layer of dust was seen. The home denies the service users a pleasant environment in which to live. There is some indication that service users bedrooms have been provided with items suited to the needs and preferences of service users, but the communal areas are poor with no evidence to suggest that consideration has been given to improving or maintaining these on a regular basis. The inspector was advised that a full redecoration and refurbishment programme will be undertaken at the home but this will not take place for some months. It is essential that improvements are made to the home as a matter of priority and that a programme of on-going maintenance and repairs is prepared. The fence around the garden is damaged and a full risk assessment of the garden should be undertaken with immediate effect as service users spend considerable time in the garden during the warm weather. The home has an infection control policy and appropriate measures are in place for the disposal of waste. Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34, 35 A new manager has been appointed to give direction and leadership to the staff team. EVIDENCE: All prospective staff are required to complete an application form prior to being called for interview. Two references are taken together with checks through the Criminal Records Bureau and the Protection of Vulnerable Adults list. An occupational health check is made on all staff. The recruitment is in line with equal opportunities. All new staff complete a six week induction training programme which includes health and safety, basic food hygiene, first aid, understanding learning disability and moving and handling. Additional training is given to staff as appropriate and updates in the core training are given. The new manager is currently making arrangements for the supervision of all staff. Annual appraisals will be undertaken to identify training needs and opportunities. Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, 42 The manager has a good understanding of the areas in which the home needs to improve. Arrangements will be made for identifying how the improvements would be resourced and managed. EVIDENCE: A new manager has now been appointed to the home. He had been in post for only six weeks at the time of the inspection. An application to register the manager has been submitted to CSCI and is being processed. The manager holds an NVQ in management at level 4 and holds the Registered Managers’ Award. He is an experienced manager who is also experienced in providing care to adults with disabilities. The manager stated that he has an open door policy for staff, service users and visitors to the home to establish a positive and inclusive atmosphere. Staff meetings are being arranged to give staff full information of the changes that he proposes to make to improve the service. No quality assurance or quality monitoring system is in place. This has been identified at previous inspections but no effort has been made to obtain the Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 21 views of service users, staff, visitors or care professionals with a view to improving the service offered. Records relating to the safety of the premises were not all available for inspection. A valid NICEIC electrical wiring certificate should be obtained and a copy held in the home. Recent training in fire prevention and of the action to be followed in the event of a fire has been given to all staff. The new manager is currently reviewing the health and safety of the home. Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x x x x x 1 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Woodview Score 3 3 1 x Standard No 37 38 39 40 41 42 43 Score x x 1 x x 2 x Version 1.30 Page 23 F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Yes Are there any outstanding requirements from the last inspection? 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 39 Regulation 24 Timescale for action The Registered Person must 30th ensure that an effective quality September assurance and quality monitoring 2005 systems based on seeking the views of service users must be in place to measure success in achieving the aims, objectives and statement of purpose of the home. The Registered Person must 19th make arrangements for the September recording, handling, safekeeping, 2005 safe administration and disposal of medications received into the care home. The Registered Person must 30th ensure that the premises are September kept in a good state of repair 2005 both internally and externally. The Registered Person must 30th ensure that all parts of the home September are kept clean and reasonably 2005 decorated. The Registered Person must 30th ensure that the external grounds September which are suitable for, and safe 2005 for use by, service users are provided and appropriately maintained. Requirement 2. 20 13(2) 3. 24 23(2)(b) 4. 30 23(2)(d) 5. 24 23(2)(o) Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 24 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 N/A Good Practice Recommendations N/A Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Liverpool Area Office 3rd Floor 10 Duke Street Liverpool, L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Woodview F52_F02_s18957_Woodview_v237793_180805_Stage 4.doc Version 1.30 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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