Inspection on 01/03/07 for Woodville

This inspection was carried out on 1st March 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 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.

Other inspections for this house

Woodville 24/02/09

Woodville 28/02/06

Woodville 16/08/05

Woodville 14/12/04

Woodville 19/05/04

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Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Woodville 91 West Street Ryde Isle Of Wight PO33 2NN Lead Inspector Ian Craig Unannounced Inspection 1st March 2007 12:00 Woodville DS0000012558.V326878.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 Woodville DS0000012558.V326878.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. Woodville DS0000012558.V326878.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodville Address 91 West Street Ryde Isle Of Wight PO33 2NN 01983 612521 01983 564008 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) Mr John Raymond Clewley Mrs Miranda Cruz Clewley Suzanne Diana Thornton Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Woodville DS0000012558.V326878.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th February 2006 Brief Description of the Service: Woodville is a residential home providing care and accommodation for up to seven younger adults with learning disabilities. The home is a large detached property centrally located in Ryde, within walking distance of the main shopping area, and the bus and train stations. The home offers single room accommodation on two levels, one room having an en-suite facility. A stair lift has been installed specifically for one resident. The home’s fees are £413.91 a week. Woodville DS0000012558.V326878.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection consisted of a tour of the premises, discussions with the manager, examination of records, documents, policies and procedures. One resident was spoken to during the inspection and residents were observed using the home’s facilities. 3 residents returned survey questionnaires. The inspection was also based on information contained in the Commission service file. What the service does well: What has improved since the last inspection? The home continues to review and updates its procedures and staff training, as well as improving the environment. Woodville DS0000012558.V326878.R01.S.doc Version 5.2 Page 6 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. Woodville DS0000012558.V326878.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 Woodville DS0000012558.V326878.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, 3 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are reviewed by both the home and referring social services care managers. The home meet s the needs of the residents. EVIDENCE: Each of the three survey forms from residents stated that they had received sufficient information about the home to help them decide if it was the right place to move into. The residents at Woodville have lived at the home for several years. Records were examined for four residents, which show that needs are reviewed on a regular basis. These include reviews by individual’s care managers and by day services attended by residents. It was clear from examination of records and from discussion with the manager, that the home has taken steps to meet the changing needs of residents, sometimes, involving constructive liaison with the district nursing service, occupational therapists and relatives. Adaptations have been made to Woodville DS0000012558.V326878.R01.S.doc Version 5.2 Page 9 the home to meet the changing mobility needs of a resident by the installation of a stair lift. Residents’ files included copies of terms and conditions of residence at the home. Woodville DS0000012558.V326878.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are detailed in individual care plans, although these are in need of updating to reflect changing circumstances. There are opportunities for residents to be involved in the decision making in the home and in their daily lives. Residents are supported to maintain and develop independence within the safeguards of risk assessments. EVIDENCE: There are wide ranging written details regarding individual resident’s needs and associated care plans of how these needs are to be met. These show that Woodville DS0000012558.V326878.R01.S.doc Version 5.2 Page 11 resident’s preferences and independence are promoted. For instance, there is a skills assessment and training needs document for each person with guidance on how the person is supported with activities such as dressing, washing, bathing, household activities, using public transport, safety awareness and so on. These emphasise the maintenance and development of independence. Records also detail the person’s wishes and wants. At the time of the inspection the home was introducing a Person Centred Planning approach to record individual resident’s needs and wishes regarding their daily lives. Of the 4 care plans reviewed, one had not been updated since 2004. This resident’s care plan did not include the procedures being followed by staff for dealing with a specific health care need. Additional details are needed in the written risk assessment for one person regarding the level and type of support needed when going out accompanied by staff. The home utilises pictorial diagrams and displays to communicate care and social needs with the residents. For instance, bedrooms have a pictorial diagram display, including the use of makaton symbols to show the resident his or her daily preferred activities. Other photograph and picture displays are used so that residents know which staff are on duty as well as other relevant information. Residents’ meetings are held so that residents are able to become involved in the home. Pictorial diagrams are used to aid communication with the residents regarding the meeting’s contents. Resident’s surveys confirmed that they are able to make decisions about their lives and are able to do what they like. Woodville DS0000012558.V326878.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to develop independent living skills and independence. Residents have a varied and full lifestyle including social, leisure and educational activities. EVIDENCE: Records show that residents attend activities at different day services. Copies of resident’s reviews at the day centre are held with personal records. Care plans and daily running records also demonstrate that residents attend college courses and various social activities such as going to the shops, visits to restaurants and cafes, a yacht club, horse riding and trips to zoos. There is evidence of residents attending family events such as weddings and parties. Daily activity programmes are displayed in individual resident’s bedrooms in Woodville DS0000012558.V326878.R01.S.doc Version 5.2 Page 13 pictorial format. There are also photograph displays of holidays, outings and other events attended by residents. Staff accompany residents to holidays at activity centres and holiday camps. The home has its own ‘people carrier’ to take residents out and about. Assessments and care plans show that residents are supported to develop independent living skills within the house by involvement in cooking, cleaning and other domestic activities. Residents are consulted at the residents’ meetings about the meals they prefer and the home uses this to help devise the 6-week menu plan. A packed lunch is provided for residents when they go out to day services. Fresh fruit is available for residents in bowls in the communal areas. Woodville DS0000012558.V326878.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health and personal care needs are met. EVIDENCE: Each resident has a dedicated Health File, which includes a health profile and health plan of care. Records are maintained to show that appointments are arranged with the following: optician, dentist, general practitioner, chiropodist and hospital. Daily running records show that medical needs are appropriately followed up with the respective resident’s general practitioner. Records also show that weight is monitored, as well as blood pressure and other health checks such as for heart function. The lack of a care plan for staff to follow in applying ointment for a specific health need is detailed in the Individual Needs and Choices section of this report. Care plans include details of how personal care needs are to be met and emphasise the individual maintaining his or her independence. Woodville DS0000012558.V326878.R01.S.doc Version 5.2 Page 15 Medication procedures were examined. Staff receive ‘in house’ training in medication as well as attendance at a local college course. Records of medication administered are maintained. Care plans give guidance to staff of the circumstances and symptoms that medication ‘as required’ should be given. The storage of medication was discussed and the inspector advised that a controlled drug cupboard is fitted should the home have to administer controlled medication on a regular basis. Woodville DS0000012558.V326878.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ views are listened to and the home protects residents from possible abuse. EVIDENCE: The home has a complaints procedure and there is a folder with details of any actions the home might take should a complaint be made. Each of the three survey forms included confirmation that residents feel that their views are listened to and that they know who to speak to if they are unhappy. The manager explained that residents are told of the complaints procedure at the residents’ meetings. Other than this, there is no other method that the home has to inform residents of the procedure. The inspector discussed the introduction of a complaints procedure that is easier for the residents to understand. The manager agreed to look into this. The home has an adult protection policy and procedure. Staff have either attended, or will attend in the near future, an adult protection training course. Staff have not received training in challenging behaviour, such as Strategies for Crisis Intervention Prevention (SCIP), as this is not considered necessary to meet the needs of the residents. Woodville DS0000012558.V326878.R01.S.doc Version 5.2 Page 17 The home handles residents’ finances and has a system of recording by 2 staff any amounts deposited, withdrawn and a corresponding balance. This includes the provision and keeping of receipts. The home has a written protocol for staff to follow. A weekly audit of this system is carried out and recorded. Two aspects of this system need to be improved: • The holding of cash due to difficulties with the previous counter signatory staff member leaving. The manager is attempting to resolve this. • Residents are charged 25p per mile for travelling in the home’s car. Details of this are included in the contract. An invoice is submitted to the resident at intervals but this does not include the amount of miles travelled, but just a total amount due. Documents should be available showing how many miles travelled and charged for each resident so that each person knows what he or she is being charged for and to provide an account that can be audited. Woodville DS0000012558.V326878.R01.S.doc Version 5.2 Page 18 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, 26, 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Areas of the home are showing signs of wear and tear, which are included in a planned refurbishment of bedrooms. The home has ample bedroom and communal space including a garden, which residents can work in. EVIDENCE: Residents were observed using the lounge of the home, which has television and karaoke equipment. The lounge is comfortable and homely. Woodville DS0000012558.V326878.R01.S.doc Version 5.2 Page 19 One bedroom has an en suite bathroom, which has a shower and toilet. The manager explained that each bedroom is to be redecorated following the replacement of the ceiling in each bedroom. This will include replacement of stained carpets. At the time of the inspection, redecoration of one bedroom was complete. Bedrooms contained numerous personal items showing that residents are able to express themselves in their bedrooms. It was unclear if each resident has been offered a key to his or her bedroom, or if the resident has been assessed as not being able to have a bedroom door key. One resident currently has a key to her bedroom. Drawer units in bedrooms contain a drawer with a lock, but, again, it was unclear whether or not the residents had a key to the lock. Toilets and bathrooms are supplied on each floor. These are decorated to a good standard with the following exceptions: • • The ceiling in a first floor bathroom was marked with mildew, which the manager stated will be removed when the room is redecorated. A first floor toilet did not have a privacy lock and there was no soap or towel provided. The manager states that the soap dispenser was empty. As the manager has agreed to address this, it is not included as a requirement. There is a rear garden, which residents have been involved in developing by planting shrubs and decorating with ornaments. Woodville DS0000012558.V326878.R01.S.doc Version 5.2 Page 20 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, 33, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from a well trained staff team, supplied in sufficient numbers to meet their needs. The home has a thorough staff recruitment process, which protects residents. EVIDENCE: The staff rota shows that there are normally 2 staff on duty at any given time. At nighttime there is a sleep in staff member. At the time of the inspection there were two staff on duty. The owners have appointed a training officer to coordinate and plan staff training. Newly appointed staff have an induction programme, which is recorded. 80 of staff are qualified to NVQ level 2, with staff able to complete NVQ 3 and 4 also. The home’s policy is that each staff member must be trained in the following: first aid, food hygiene, infection control, fire safety and moving and handling. Records show that staff receive supervision. Woodville DS0000012558.V326878.R01.S.doc Version 5.2 Page 21 Recruitment procedures were examined for newly appointed staff and showed that the required checks had been carried out before the staff commenced work. These include the Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks as well as 2 written references, one of which is from the most recent previous employer. Each of the three resident survey forms commented that staff always treat the person well, and, always listen and act on what the resident says. Woodville DS0000012558.V326878.R01.S.doc Version 5.2 Page 22 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 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is motivated and manages the home in the best interests of the residents. Attention is needed to ensure that adequate precautions are taken to protect residents from possible burns from radiators, scalds from hot shower water and possible falls from windows. EVIDENCE: Woodville DS0000012558.V326878.R01.S.doc Version 5.2 Page 23 The manger has attained a number of management qualifications namely, the NVQ 4 in Care and the Registered Manager’s Award. She has also completed other training courses, such as palliative care. Her time as manager is divided between Woodville and another home owned by Mr. and Mrs. Clewley, Clifton Cottage in Ryde. The home has a maintenance plan for the physical environment and an audit is carried out against the Conduct and Management of the Home section of national minimum standards. A report is completed each time a member of the management team carries out a monthly audit of the home. Residents’ meetings allow the residents to be consulted about the home’s operation. Further work is needed for the home to meet the quality assurance standard as set out in the national minimum standards, including the following: an audit of the home which incorporates the use of surveys of residents, relatives and involved professionals regarding their views of the home, and an annual development plan. The inspector was informed that an annual development plan is completed but this was not available on the day of the inspection. Suitably qualified personnel service the home’s appliances, such as the gas heating, electrical equipment and the stair lift. The fire logbook shows that the fire safety equipment is tested in accordance with fire safety regulations. Fire drills are carried out. Protecting residents from possible burns from hot surfaces and scalds from hot water needs to be addressed, as well as preventing residents from possible falls from first floor windows. Hot surfaces. A number of radiators have covers to prevent possible burns. It was unclear why some had been covered and others had not. There are no written risk assessments to clarify this when the manager was asked during the visit. The manager has written to the Commission stating that the home has a risk assessment on Heating of the Building. Window restrictors. It was noted that these are not fitted to a first floor bedroom window to prevent falls, and there are no written risk assessments when the manager was asked at the time of the visit. The manager has since written to the Commission stating that risk assessments are held in the health and safety file, and that there is a written risk assessment for a resident on this dated 2004. Hot water. Temperature control devices are installed on bath taps to regulate the water so that residents are not scalded. There is a device installed on the shower, which is not a thermostatic mixer valve, which controls the temperature. However, checks are not taken of the shower hot water temperature and this is not covered in the risk assessment. This measure is needed to ensure residents are protected from hot shower water. Woodville DS0000012558.V326878.R01.S.doc Version 5.2 Page 24 The home does not have a copy of the Health and Safety Executive book Health and safety in Care homes, which gives guidance on the above. Woodville DS0000012558.V326878.R01.S.doc Version 5.2 Page 25 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 3 4 X 5 3 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 X 26 2 27 2 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 2 X Woodville DS0000012558.V326878.R01.S.doc Version 5.2 Page 26 N/a 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 YA6 Regulation 15 Requirement Residents care plans must be reviewed and updated. Care plans must detail the steps being followed by staff in providing specific personal care. 2 YA26 16 The home must be able to demonstrate that residents have been offered lockable storage in their bedroom and a key to their bedroom door. The home must develop the quality assurance system including obtaining the views of residents, relatives and involved professionals, as well as an annual development plan. 01/06/07 Timescale for action 01/05/07 3 YA39 24 01/06/07 4 YA42 13 The home must ensure the 01/04/07 health and safety of residents by the following: • water temperature controls and checks for showers • risks from hot surfaces based on the current assessment of the capabilities and needs of residents. DS0000012558.V326878.R01.S.doc Version 5.2 Page 27 Woodville • • Provision and maintenance of window restrictors based on the vulnerability of and risk to residents and is available in the home. Under a risk assessment framework provide and maintain window restrictors according to the needs of individuals. 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 YA42 Good Practice Recommendations The home should obtain a copy of the following publication: Health and safety in Care Homes. HSE Books HSG220. ISBN: 0 7176 20282 4. Woodville DS0000012558.V326878.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Woodville DS0000012558.V326878.R01.S.doc Version 5.2 Page 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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