Inspection on 16/08/05 for Woodville

This inspection was carried out on 16th 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Woodville 24/02/09

Woodville 01/03/07

Woodville 28/02/06

Woodville 14/12/04

Woodville 19/05/04

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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 Neil Kingman Unannounced 16 August 2005 th 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. Woodville H55 H04 S12558 Woodville V236238 160805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Woodville Address 91 West Street, Ryde, Isle of Wight, PO33 2NN 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) 01983 612521 01983 564008 Mr and Mrs J R Clewley Ms Suzanne Thornton (not yet registered) Care Home 7 Category(ies) of Learning Disability (7) registration, with number of places Woodville H55 H04 S12558 Woodville V236238 160805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 14 December 2004 Brief Description of the Service: Woodville is a residential home providing care and accommodation for up to seven younger adults with learning disabilities. It is managed by Suzanne Thornton on behalf of the proprietors Mr and Mrs Clewley. Ms Thornton has only recently been appointed as the homes manager and has yet to undergo the process for registration. 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. There is no passenger lift and residents with a mobility difficulty would need to occupy rooms on the ground floor close to a specially adapted bathroom. Woodville H55 H04 S12558 Woodville V236238 160805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Woodville took place unannounced over 3½ hrs. On the inspector’s arrival there was a senior member of staff on duty. The manager arrived about an hour later. There were only two residents present during the morning neither of whom had good verbal communication, so the inspector returned in the evening to speak with the other five before their evening meal. The inspector toured the building with the senior on duty, viewed a sample of the home’s records, and spoke with two members of staff and all the residents. Due to differences in their cognitive abilities it was difficult to obtain informed views about life in the home from all the residents. However, one was very much more able to express a view and clearly enjoyed everything about the home and the staff who worked there. Another was able to show the extent to which he was able to pursue his own interests while living in the home. The others, who had all returned from the Resource Centre looked comfortable and cheerful. As at other homes in the Ryde House group interactions between staff and residents were warm and good humoured. The home’s manager who also manages a similar home nearby in the group had been in post for only two weeks prior to the inspection. She had arranged for a full staff meeting to be held that afternoon. It was clear during discussions that she was still getting to know the home and the residents and had already identified tasks which needed to be carried out to ensure the home was fully meeting the standards. What the service does well: What has improved since the last inspection? The home was last inspected in December 2004, at which time there was no registered manager in post. Since that time apart from some major garden maintenance and the replacement of electrical appliances in the laundry there have been no significant improvements to the service. However, the new Woodville H55 H04 S12558 Woodville V236238 160805 stage 4.doc Version 1.40 Page 6 manager has now been appointed and has confirmed that planned environmental improvements will be completed by the end of the year. Staff training and ideas for expanding the resources for the residents are ongoing. What they could do better: There were two requirements identified during the inspection: • • To forward a plan to the Commission with a timescale for decorating the hall, stairs and landing. To ensure the Door Guard fitted to the lounge door was working properly. Three recommendations were made: • • • To review residents’ care plans and update with current information and risk assessment strategies. To fit additional double electrical sockets in identified rooms. To produce staff training and development profiles. At the time of producing this report the manager has confirmed that all requirements and recommendations had either been met or were in the process of being met. 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. Woodville H55 H04 S12558 Woodville V236238 160805 stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Woodville H55 H04 S12558 Woodville V236238 160805 stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Woodville provides a service for long-term residents and there have been no new admissions for over two years. Those who live in the home have had their needs assessed and reviewed during that time. EVIDENCE: All residents at Woodville are long term and currently there are no vacancies. The home’s admissions policy and procedure is detailed in the statement of purpose. The manager being new to the home had not experienced the process of admitting a new resident, neither had the senior on duty at the time of the inspection. However, the inspector noted quite detailed records concerning the admissions of two residents who both moved to the home in April 2003. Additionally, the inspector was able to speak with the then care manager representing one who confirmed that the admissions process was very appropriate, and included at least two pre-admission visits. Woodville H55 H04 S12558 Woodville V236238 160805 stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9 While the home develops a service user (care) plan for each resident, which describes how individual health, social and personal needs will be met, those seen by the inspector needed to be reviewed and updated with current information. Staff enable residents to take responsible risks. However, care records need updating with information about risk assessment strategies. EVIDENCE: An individual care plan was available for each resident and the inspector looked at a sample of two. It was noted that they generally followed the format used by other homes in the Ryde House group with information covering a range of needs, including personal care, mobility, health, communication, social and leisure. The manager recognised that some sections in the plans lacked detail and continuity. Ms Thornton confirmed that she had been in post for only two weeks and had already determined that a review of residents’ care plans was one of her priorities. In discussions with residents and staff it was clear that individual needs were being appropriately met with residents leading lifestyles according to their preferred activity or choice. Woodville had been without a manager for Woodville H55 H04 S12558 Woodville V236238 160805 stage 4.doc Version 1.40 Page 10 many months. This had resulted in a slippage in record keeping required to evidence the quality of care and support provided for the residents. Woodville H55 H04 S12558 Woodville V236238 160805 stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15, 16 and 17 The home encourages and helps residents to maintain links with family and friends. Residents are given freedom of choice and movement within the scope of their abilities and identified risks. Food served is varied and nourishing. There are three main meals each day, which are served flexibly around the commitments of the residents. EVIDENCE: Residents at Woodville have complete freedom of movement around the home. This was most noticeable when the inspector returned to meet with residents in the evening. Keys are available for all rooms if residents wish to keep them locked. Outside the home, their assessed needs are such that when not at day services most need the support of staff or family for outside excursions. During the tour of the building the inspector noted the senior member of staff knocked on doors before entering residents’ rooms. She confirmed that they variously received mail from time to time and staff assisted where appropriate. Staff confirmed that all residents maintain regular family links either by telephone or personal contact. This was confirmed in discussions with one of Woodville H55 H04 S12558 Woodville V236238 160805 stage 4.doc Version 1.40 Page 12 the more articulate residents. A pay phone is available in the hall for residents’ use. Menus show food to be varied and nutritious. There is no dedicated cook working in the home, therefore staff take turns to prepare and cook meals. During the inspection one member of staff was preparing the evening meal. Later in the day other staff took over the cooking and serving of the food. They confirmed that meals are flexible to take account of activities during the day and changes in preferences. A packed lunch is provided for residents attending day services with a hot meal provided in the evening. Residents spoken with said they very much enjoyed the food provided by the home. Woodville H55 H04 S12558 Woodville V236238 160805 stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 20 Residents’ health care needs are regularly addressed. Residents are assessed as being unable to retain, administer and control their own medication. Medication for residents is held under secure conditions and appropriate records maintained. EVIDENCE: Residents have individual health care files, which contain records of health care needs, visits to practitioners and follow up action where appropriate. The inspector noted a good standard of recording by staff in the files viewed. All residents are registered at one of the health clinics in Ryde, at which there are several GPs. Records showed yearly checks with health care professionals. One resident requires ongoing attention by the District Nurse who visited on the day of the inspection. Medication is dispensed to residents by means of a monitored dosage system by staff deemed competent following training. At the time of the inspection medication was held in appropriate, secure conditions. Records relating to the safekeeping and administration of medicines were checked and found generally to be in order. A minor anomaly with the system of administration was noted. The manager confirmed that being new to the home it was her intention to set Woodville H55 H04 S12558 Woodville V236238 160805 stage 4.doc Version 1.40 Page 14 up a system of monitoring whereby anomalies could be spotted and addressed immediately. Woodville H55 H04 S12558 Woodville V236238 160805 stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 The home has a clear complaints policy and procedure in place. EVIDENCE: The home’s complaints procedure is set out in the service users guide. There is a complaints step-by-step guide for staff and forms on which to record any complaints made about the service. The manager and the senior member of staff on duty confirmed that no complaints had been made in the last year. One resident spoken with had no hesitation in praising staff and expressing confidence in being able to approach them about concerns. Woodville H55 H04 S12558 Woodville V236238 160805 stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 26 Woodville provides a domestic style of environment, which in general terms meets the needs of those who live there. It was noted that the hall, the stairs and the landing are in need of redecoration. All rooms are for single occupancy. They are generally spacious and equipped with furniture to meet the residents’ individual needs and lifestyles. The introduction of additional electrical sockets in four of the rooms would provide greater flexibility for the sitting of electrical equipment and minimise the need for extension leads. EVIDENCE: The inspector toured the building with the senior member of staff on duty. There is a large spacious lounge and separate dining room, which, in terms of space were seen as adequate for the number of residents. The home has a programme of decoration and maintenance. While at the time of the inspection most areas were decorated to an acceptable standard it was noted that the wallpaper throughout the hall, stairs and landing were old and tired, and in need of brightening up. Residents’ rooms are arranged on both the ground and first floors and are furnished and equipped to meet their individual needs. However, four of the rooms had only one double electrical socket, Woodville H55 H04 S12558 Woodville V236238 160805 stage 4.doc Version 1.40 Page 17 which reduces the options for sitting electrical equipment, and increases the need for extension leads. Several showed a high degree of individual personalisation. At the rear of the property is an average sized garden, which is laid to lawn with shrubs, trees and a seating area for use by the residents and staff. Woodville H55 H04 S12558 Woodville V236238 160805 stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Staff at Woodville has appropriate skills and experience to meet the needs of the people who live there. EVIDENCE: The home employs eight care support workers, all of whom have undertaken a wide range of statutory and care related training, which is ongoing. All staff are scheduled to receive training and refreshers in first aid, food hygiene, manual handling and infection control. 62 of staff have achieved the NVQ at level 2 or above. Both members of staff spoken with confirmed that they had completed all statutory training. One had achieved the NVQ at level 3 and was undertaking the training for level 4 and the Registered Managers Award. They were very clear that the Ryde House group had a good training package for staff. The inspector viewed a selection of certificates of achievement that evidenced the training given. However, it is recommended that staff training profiles be produced to provide details of training needs, achievements and dates for when training is scheduled. The proprietor has confirmed that the home’s induction training will, in the near future be accredited with the Learning Disabilities Award Framework (LDAF). Woodville H55 H04 S12558 Woodville V236238 160805 stage 4.doc Version 1.40 Page 19 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) 42 Policies, procedures and staff training are in place to ensure, so far as is reasonably practicable, that the health, safety and welfare of residents and staff. Door guards must at all times be kept in proper working order to be able appropriately to respond to the sound of the fire alarm. EVIDENCE: There are policies and procedures in place to ensure safe working practices in the home and all care staff undertake statutory training, which includes health and safety, food hygiene, first aid and manual handling. The manager confirmed that one of her priorities as the new manager was to arrange for a fire safety inspection and a fire appliance and equipment check. A sample of records was viewed including a full range of risk assessments for the building, accident records, fire alarm tests, gas and electrical certificates and public liability insurance, all of which were in good order. The home’s pre-inspection self-assessment signed by the manager confirmed that all policies and procedures, maintenance and associated records were in place to ensure compliance with regulations and relevant legislation. Woodville H55 H04 S12558 Woodville V236238 160805 stage 4.doc Version 1.40 Page 20 The inspector noted that the door guard fitted to the lounge door was wedged and unable to respond to the sound of the fire alarm. Woodville H55 H04 S12558 Woodville V236238 160805 stage 4.doc Version 1.40 Page 21 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 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 2 x x x x Standard No 11 12 13 14 15 16 17 x x x x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Woodville Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x H55 H04 S12558 Woodville V236238 160805 stage 4.doc Version 1.40 Page 22 No 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 24 Regulation 23 Requirement To provide a written action plan with timescale to the Commission for decoration of the hall, stairs and landing. Door guards must at all times be kept in proper working order to be able appropriately to respond to the sound of the fire alarm. Timescale for action 31/8/05 Immediate requiremen t/feedback notice served. 18/8/05 immediate requiremen t/feedback notice served. 2. 42 13 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. 2. 3. Refer to Standard 6 26 35 Good Practice Recommendations To undertake a review of all residents care plans and update with current information and risk assessment strategies. To introduce additional double electrical sockets to bedrooms identified during the inspection. To produce staff development/training profiles to provide details of training needs, achievements and dates for when training is scheduled. H55 H04 S12558 Woodville V236238 160805 stage 4.doc Version 1.40 Page 23 Woodville Commission for Social Care Inspection Mill Court Furrlongs, Newport Isle of Wight PO30 2AA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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