Inspection on 26/06/07 for Woodview

This inspection was carried out on 26th June 2007.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Woodview 09/04/08

Woodview 01/12/06

Woodview 19/02/06

Woodview 18/08/05

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 Wirral CH43 8SF Lead Inspector Debbie Corcoran Key Unannounced Inspection 26th June 2007 10:30 Woodview DS0000018957.V333797.R01.S.doc Version 5.2 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 Woodview DS0000018957.V333797.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 Adults 18-65. 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. Woodview DS0000018957.V333797.R01.S.doc Version 5.2 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 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) Alternative Futures Limited Gary David Knowles Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Woodview DS0000018957.V333797.R01.S.doc Version 5.2 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) 1st December 2006 Date of last inspection Brief Description of the Service: Woodview is registered to provide residential care for up to 4 adults who are learning disabled. The service is provided by Alternative Futures. The home 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 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 has its own minibus for the use of people living at the home. The current fee for residing at Woodview is £1,027.96 per week. Woodview DS0000018957.V333797.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit to the home was not announced beforehand. During the visit all 3 of the service users were met. Four members of the staff team and the manager were also met. An area manager for the service was present during the visit. Resident’s plans, staff training records, health and safety records and other relevant records were examined. A tour of the home was carried out. The manager returned a questionnaire on the service to the Commission and some of the information in this has also been used to inform the findings of the inspection. What the service does well: What has improved since the last inspection? The support provided to residents is now being reviewed on a regular basis. Resident’s care plans have been developed to include information on how staff need to support individuals in developing their skills. This enables all staff to work more consistently in this area. Woodview DS0000018957.V333797.R01.S.doc Version 5.2 Page 6 There has been some improvement in the frequency of community activities residents are supported to be involved in. The number of staff who hold a relevant qualification has increased. Six of the nine members of staff on the team have now attained a qualification in care. Staff are being provided with regular one to one supervision meetings with the manager and this provides an opportunity for them to explore their practice, address issues and identify their development needs. The manager has carried out an analysis of staff training and staff training information is now available in staff files. Staff have been provided with medication training and training in other relevant topics such as adult protection and food hygiene have been scheduled to take place in the near future. 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. Woodview DS0000018957.V333797.R01.S.doc Version 5.2 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection Woodview DS0000018957.V333797.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A statement of purpose and service user guide is available to provide residents, prospective residents, and their representatives with information on the home. An assessment of needs is carried out before a resident moves in to the home to ensure that their needs can be met at the home. EVIDENCE: A statement of purpose and a service user guide are available and these describe the services offered at the home. In addition to this the company has produced a handbook for service users which describes the services offered by the company. Information provided for service users includes the use of pictures and is written in plain English. There have been no new residents to the home since the last inspection visit when it was evident that an assessment of needs is carried out by a representative from the company for new residents before they move in to the home. Assessments information is also attained from the referring agency for example Social Services. Woodview DS0000018957.V333797.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s care plans include a good level of information on their needs. The plans are reviewed regularly to reflect changes to the resident’s needs. When residents are involved in an activity which involves taking risks the risk is assessed and plans are put in place to manage the risk. EVIDENCE: Each of the residents has a care plan or person centred plan (pcp). The care plans are clear, informative and easy to follow. The plans include information on the person’s skills and needs, daily routines, likes and dislikes and information as to how to support the person with aspects of their personal support. Where a resident requires support with managing situations or interactions then guidelines are in place which inform staff of how to support the resident to best effect. Staff complete a monthly summary of the resident’s care and support. Resident’s support and their care plans are being reviewed in more detail on a Woodview DS0000018957.V333797.R01.S.doc Version 5.2 Page 10 six monthly basis. The records of these reviews indicate that there has been significant improvement at looking at the individual needs of the residents and providing support around their needs and wishes as individuals. There is also clearer emphasis on supporting the residents to achieve goals. The resident’s plans include a good level of detail to describe their choices and preferences. During discussions with a member of staff they were able to give examples of how they encourage the residents to make choices as and to develop their independent living skills. A visitor to the home commented that they feel staff help their relative to accomplish everyday jobs to the best of the person’s ability. When a service user is thought to be at risk then a risk assessment is carried out and plans are put in place to manage the risk. The risk assessments cover different aspects of the persons support. For example support with communication, keeping safe, managing medication. The risk assessments include information on what the potential risk is and what steps need to be taken to prevent the risk from occurring. Risk assessments which were viewed were found to be up to date and comprehensive. Woodview DS0000018957.V333797.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are supported in community access on a regular basis. The quality of this access, in terms of meeting the needs of the individuals, needs to be reviewed. Staff practice at mealtimes does not promote a valuable and enjoyable experience for residents. EVIDENCE: Resident’s care plans included information on their skills and needs and a member of staff gave some examples of how they support the residents with developing their personal and independent living skills. It was evident that there is more planning to ensure that each of the resident’s have opportunities to learn and develop new skills and to ensuring that staff work consistently in supporting residents to achieve new skills since the last inspection visit. Woodview DS0000018957.V333797.R01.S.doc Version 5.2 Page 12 Each of the residents has a person centred plan and these include information on the activities which the person likes to be involved in. Daily records regarding the resident’s care and support are maintained. These were examined to assess the frequency of leisure opportunities and community access for two of the residents. The records indicated that the residents are having the opportunity of a greater level of outdoor activities than at the previous inspection visit. However the variety of activities needs to be reviewed as many entries refer to residents having gone for a drive or occasional shopping trip. There was some evidence in review records that activities will be more varied and structured around the needs of individual residents in the near future. Residents are supported to maintain relationships. Residents and care staff maintain regular contact with resident’s family members where this is appropriate. In assessing the diet and meals available to residents records were checked and the availability of food was checked. Information on the resident’s likes, dislikes, strengths and needs regarding food and eating are recorded in the resident’s care plan. Menus showed an appropriate variety of meals are being provided. There was an appropriate amount of food in stock. However, food hygiene was not being maintained appropriately as food was not being stored safely. As at the previous inspection one observation of the mealtime arrangements indicated that not much attention is paid to ensuring that mealtimes are a pleasant and enjoyable experience for residents. The details of this were discussed with the manager and the manager must review the current arrangements and must guide staff in appropriate practices and in practices which demonstrate that staff understand the value and importance of mealtimes and food. Woodview DS0000018957.V333797.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Resident’s personal support is based around their preferences and individual needs. Generally resident’s physical and emotional health needs appear to be met but not all required information was available to evidence this. Medication practices and procedures are not as safe as they should be in relation to the administration of some medications and staff practices. Woodview DS0000018957.V333797.R01.S.doc Version 5.2 Page 14 EVIDENCE: Resident’s care plans include guidelines for supporting the resident with their personal care needs. The plans include a good level of information on the individual’s likes and dislikes and preferred routines. During discussions with a member of the staff team they were able to describe the individual needs of the residents and how they support the residents to use and develop their own personal care skills. Each of the resident’s has a ‘health passport’ which describes how their health care needs are to be met. However, some of the information in these was not up to date. Although it was clear that residents see a GP or nurse regularly there was limited information to support that the residents are being supported in all aspects of their health care needs. For example it was not possible to determine when one of the residents had last been seen by a dentist. This was identified at the last inspection visit and although there has been some progress there are still areas to be addressed. A repeat requirement has been given for this to be rectified. Polices and procedure used for the receipt, storage, and documentation of medications within the home are in place. Medication receipt, storage and administration practices were looked at. The majority of medication is locked in the staff office and two staff administer medication whenever possible. The manager has carried out some work into looking at the circumstances around when ‘as required’ medication is administered. This has identified patterns of behaviour and alternative strategies have been employed. One area of practice identified during the inspection which needs to be addressed related to the administration of particular ‘as required’ medication (as discussed with the manager). The manager must ensure that there are clear up to date guidelines in place for staff to follow and any staff administering this type of mediation must be provided with regular training and evidence of this must be available. Woodview DS0000018957.V333797.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies, procedures and practices are in place for dealing with complaints and which aim to protect service users against abuse or neglect and systems are in place for dealing with allegations of abuse. EVIDENCE: The home has a complaints procedure which is time scaled appropriately. Information on how to make a complaint is provided in the service user’s guide to the home. There have been no complaints since the previous inspection visit. The home has an adult protection policy and information on the protection of vulnerable adults. The home also has a copy of the Local Authority adult protection procedures and the home’s procedures link in to this. Staff have been provided with adult protection training since the last inspection visit. It was reported that all staff are scheduled to undertake more comprehensive adult protection training in the near future. During discussions with the manager he was able to demonstrate that he is fully aware of the reporting systems which need to be implemented when there is a potential adult protection issue raised. A record of key events is maintained for example incident reports and accident reports. Some of these were checked and there were no particular issues identified as a result. Woodview DS0000018957.V333797.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides spacious accommodation to service users but the homeliness and cleanliness of environment are failing to meet the residents needs of a hygienic and comfortable environment. EVIDENCE: The home is an ordinary domestic property. It is a two storey detached house with a large garden at the rear which has views across a public park. The home has a large lounge and dining area on the ground floor. The kitchen adjoins the dining room. There is a shower room, toilet and laundry on the ground floor. All residents have large single bedrooms on the first floor, which also houses an office, toilet and bathroom. Woodview DS0000018957.V333797.R01.S.doc Version 5.2 Page 17 A tour of the home revealed that a number of areas require attention; The home feels spacious but the amount of space and lack of furnishings makes it feel stark and clinical in parts. The home therefore does not feel homely. The manager has made some attempts to address this but there is room for further improvement. The carpet on the stairs is stained and dirty and new carpet is needed. The manager provided a date when new carpet was due to be fitted. The home has health and safety practices and procedures which are aimed at ensuring the home is safe and clean and free from hazards to the health and safety of service users and staff. However, a number of areas were found to be dirty including some of the kitchen cupboards, fridge, paintwork and walls. The manager produced a cleaning schedule. However, it was agreed that this has not been followed by staff and the manager must address the cleanliness of the home. Woodview DS0000018957.V333797.R01.S.doc Version 5.2 Page 18 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by well trained and qualified staff. Staff are well supported in their role through team meetings and supervisions. EVIDENCE: The staff team consists of 9 care staff. Of these 6 have attained a National Vocational Qualification (N.V.Q) in care. Staff have been provided with training in topics such as abuse awareness, supporting people, values, personal relationships and sexuality, person centred planning, understanding learning disability, health and safety, first aid, food hygiene and moving and handling. There have been no new staff employed at the home since the last inspection visit and therefore the staff recruitment and selection procedures were not assessed on this occasion. Staff files do not contain all required information. Omitted information includes recruitment and selection details. The manager reported this to be stored Woodview DS0000018957.V333797.R01.S.doc Version 5.2 Page 19 centrally at Alternative Futures’ head office. The manager reported that he is awaiting this information to be sent to the home. Staff records have been updated to include information on staff training since the last inspection visit. Staff meetings take place on a regular basis and staff also have the opportunity of a one to one supervision meetings with the manager. Discussions with a member of staff indicated that they are supporting the aims and objectives of the home in encouraging service users to make choices, develop their independent living skills and have opportunities for community access. Woodview DS0000018957.V333797.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the residents. Procedures, practices and checks are in place which aim to safeguard and protect the health and safety and well being of residents and staff. EVIDENCE: The registered manager has been in post as manager for approximately 2 years and has attained a relevant qualification. The manager had worked at the home for a significant number of years prior to becoming manager. The home is visited on an unannounced basis at least once per month in line with Regulation 26 of the Care Home Regulations 2001. These visits form part of a quality assurance process. An area manager advised that a quality Woodview DS0000018957.V333797.R01.S.doc Version 5.2 Page 21 assurance survey has been carried out since the last inspection and this involved seeking the views of service users (and their representatives as appropriate) in order to form an opinion on the standard of care provided. The home has numerous policies and procedures in relation to the health and safety of service users and staff. Staff are provided with training in some core health and safety related skills. Fire safety and health and safety practices are adopted. Records of fire and health and safety checks were checked and found to be up to date with the exception of the fire alarm which should be tested more frequently. Woodview DS0000018957.V333797.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 3 X 3 X X 3 x Woodview DS0000018957.V333797.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 YA13 Regulation 16 (2) (m) Requirement A review of the opportunities for activities and community access provided to residents should be made to ensure that these are meeting the residents needs and promoting their well being. Residents health records should be maintained appropriately in order to evidence that residents are being supported with all aspects of their health care. Staff responsible for the administration of medication must be provided with training as appropriate to their role. All areas of the care home must be clean and hygienic and infection control practices must be carried out appropriately. There must be appropriate evidence of the staff recruitment and selection procedures available at the home. Fire safety checks must be carried out at regular intervals. Timescale for action 26/08/07 2. YA19 12 (1) (a) 26/08/07 3. YA20 18 (c) (1) 26/09/07 4. YA30 23 26/08/07 5. YA34 17 (2) schedule 2 23 (4)(c) (v) 26/09/07 6. YA42 26/08/07 Woodview DS0000018957.V333797.R01.S.doc Version 5.2 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 YA17 Good Practice Recommendations The manager should review the arrangements for mealtimes and aim to ensure this is a pleasant and enjoyable time of the day for residents. 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