Inspection on 25/05/05 for Woody Point

This inspection was carried out on 25th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Woody Point 05/09/07

Woody Point 20/09/06

Woody Point 04/10/05

Woody Point 16/12/04

Woody Point 11/08/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Woody Point Station Road Brampton, Beccles Suffolk NR34 8EF Lead Inspector Anna Rogers Announced 25 May 2005 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. Woody Point I54 - I04 S59654 Woody Point V217434 050525 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Woody Point Address Station Road Brampton Beccles Suffolk NR34 8EF 01502 581539 01502 575927 ambercare@brampton.homepcinternet.co.uk Amber Care (East Anglia) Ltd 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) Mrs Karen Ann Palmer Care Home 5 Category(ies) of LD Learning Disabilities (5) registration, with number of places Woody Point I54 - I04 S59654 Woody Point V217434 050525 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 16th December 2004 Brief Description of the Service: Woody Point is a registered care home for five adults with learning disabilities. It changed its category of registration early in 2004, in response to the fact that each of the service user’s living there had reached 18 years of age. The Certificate of Registration for the home now reflects the fact that the home may only accommodate five young adults in the age range 18 – 25 years. Woody Point is a large extended bungalow, set back from the road that runs through the hamlet called Brampton Station. The nearest town to the home is Halesworth. The home is privately owned by Amber Care (East Anglia) Limited. Mrs M Frost was previously the Registered Manager of the home, and is now the Responsible Individual. Each service user has their own bedroom. There are three communal areas for social recreation including a lounge / dining room, a snoozelum, and an activity room with a range of musical equipment, arts and crafts materials, videos and books. A conservatory has been added to the side of the house, and this is used as the laundry. The home does not have designated sleeping-in facilities for staff, as the home employs waking night staff, to cover each night. Woody Point I54 - I04 S59654 Woody Point V217434 050525 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and started at 10.00 a.m.. It took place over five and a half hours during a weekday. Time was spent with staff on duty including the manager and deputy manager. A tour of the premises was made. A number of records were examined including those relating to the care of residents. One of the three service users was seen briefly on return from their education placement. The inspector intends to spend more time with service users during the unannounced inspection when service users are not attending education/day services programmes. What the service does well: What has improved since the last inspection? The staff team have supported the service users through the transition from a Children’s Home to a Care Home for Adults (18-65) since August 2004. The development of the staff team’s skills from children to young adult care means they recognised that one service users needs required a re-assessment Woody Point I54 - I04 S59654 Woody Point V217434 050525 Stage 4.doc Version 1.30 Page 6 following concerns about the management of their behaviour. The Manager was very clear that the home would not manage the presenting behaviour through the use of medication. Decisions are to be made about the return of the service user by their placing authority and the staff team are clear that staffing levels to support the service user will be a factor in the decision. 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. Woody Point I54 - I04 S59654 Woody Point V217434 050525 Stage 4.doc Version 1.30 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 Woody Point I54 - I04 S59654 Woody Point V217434 050525 Stage 4.doc Version 1.30 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) 3 Residents can be assured that their needs will be met at the home and if there are concerns residents needs would be reassessed to ensure they receive the appropriate care. EVIDENCE: The home has clear procedures in place for assessing residents’ needs. Although all of the present group of young men have lived at the home for a number of years there was evidence that the home continually reviews residents needs. One resident was admitted to Walker Close (Mental Health Services assessment unit) in April 2005 following a number of incidents where staff were attacked and injured. The home is currently in discussion with the young persons’ placing authority to ensure appropriate staffing levels are in place before they return to the home. Woody Point I54 - I04 S59654 Woody Point V217434 050525 Stage 4.doc Version 1.30 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) 6,7 & 9 Service users can be assured that their care plan will identify their needs and that they will be supported to make decisions about their life. Service users can be assured that risk assessments will identify where they require support. EVIDENCE: Each service user has an individual Care Plan. There was evidence of these being regularly reviewed and updated as necessary. The Manager has developed the review of care plans by arranging a six monthly review, which all relevant people will be invited to attend. The Manager confirmed that this arrangement would be in place whether or not Placing Authorities carry out their statutory reviews. Care plans are seen to be very important with an expectation that staff will follow them without any deviance. If they fail to do this they would be disciplined. The service users at Woody Point are unable to verbally express themselves but with the use of signs, symbols and the picture exchange communication system (PEC system), their views are sought. PEC boards are located in the lounge and are designed in a way to enable service users to make choices, for example if a service user wanted to follow an activity staff would identify the symbols and then enable the service user to choose the activity and place the symbol on the board. On the day of this inspection the inspector only met one Woody Point I54 - I04 S59654 Woody Point V217434 050525 Stage 4.doc Version 1.30 Page 10 service user who was dancing to music in the lounge but it was evident from observation that the member of staff involved was communicating effectively with the service user. There was good eye contact and the member of staff was talking with the service user. The home has a key worker system in place and it was evident from discussion with the manager that key workers play an important role in supporting service users. Risk assessments are given a high priority to support service users. A sample of risk assessments seen supported community based activities as well as in house routines and activities. Woody Point I54 - I04 S59654 Woody Point V217434 050525 Stage 4.doc Version 1.30 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) 12,13,15 &16 Residents can be assured that they will be supported to take part in appropriate activities within the local community and have opportunities to mix with other adults. The staff team actively promote and support residents to maintain appropriate contact with their families and friends. Residents can be assured that their rights will be upheld. Staff will encourage residents to make decisions based on their individual needs and choices. EVIDENCE: Woody Point I54 - I04 S59654 Woody Point V217434 050525 Stage 4.doc Version 1.30 Page 12 It is clear that none of the three service users currently living at Woody Point are capable of living independently in the community. However it is clear that they are being supported to develop their everyday living skills. Risk assessments have been developed to support service users involvement in a range of educational, leisure, and recreational pursuits, both in-house and by making use of services in the local community. There was evidence of arranged trips to Beccles, Lowestoft and Norwich. The residents also enjoy walks in the local area as well as picnics. In house there is a well equipped activities room, which has music equipment for example a drum kit and CD player, toys and games for use by the residents. The range of toys was discussed as to whether they were age appropriate. The manager confirmed that the consultant involved with the service user had recommended their access to these. It was also evident through discussion with staff and reading of care plans, that service users chose how they spent their time and that staff respected their right to make their own decisions within the risk management framework. Two of the three service users continue to attend special school placements and the third attends an adult day service placement. A number of areas are available for use by service users when meeting with their relatives, friends and representatives. These included their own rooms, communal areas or in the summer, areas of the garden. Such relationships are actively encouraged and supported by arranged meetings if required. Service users are also encouraged to use the house as their home. Their bedrooms have been personalised. There was evidence that they have opportunities for privacy with staff knocking on their door before entering. Staff spoken with indicated their awareness that as young adults, service users may need personal time alone to relieve any sexual frustrations. Service users are encouraged to take part in keeping their home clean and tidy and there is an expectation that they will be involved in the routines of the house for example washing up, cleaning, and setting and clearing meal tables. Service users are also supported with their laundry and making their own beds. Woody Point I54 - I04 S59654 Woody Point V217434 050525 Stage 4.doc Version 1.30 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) 18,19 & 20 Service users can be assured that they will be consulted about the manner in which staff members should meet any identified personal care needs. They will be given good access to healthcare. The home has adopted secure and appropriate procedures for the safekeeping and administration of medication and service users individual abilities to self-administer are assessed. EVIDENCE: Woody Point I54 - I04 S59654 Woody Point V217434 050525 Stage 4.doc Version 1.30 Page 14 Care plans identify where service users require support and assistance when undertaking personal care. The care plans detail the preferred routine of each service user and how they are to be supported from their morning washing routine, bathing to bedtime routines. One service user likes to have a bath each evening and enjoys the opportunity to relax in the bath and ‘have a soak’. Clear guidelines are in place but the service user has indicated that the temperature of the hot water is too cold. The record of hot water temperatures seen shows that staff ensures that the temperature is within the recommended safe temperature. The manager requested that the temperature is raised. A recommendation to develop a risk assessment was made to support this. Through discussion with staff it was evident that the healthcare needs of the service users were being met in an appropriate manner. All service users were registered with local general practitioners and have attended surgery, (if they were not too ill to do so in which instance a GP ‘house call’ would be requested/made.) There was evidence that staff seek the support from other health care specialists when necessary. One service user is currently undergoing a re-assessment of their needs. Arrangements are also in place to access dentists and chiropody services. Service users have been assessed as not able to care for their own medication. Medication was being administered in accordance with the policy and procedure of the home. The Manager confirmed that the home preferred not to have PRN medication prescribed for managing or changing behaviour preferring to discuss with consultants as necessary. The staff training records showed that staff have attended appropriate medication training. Accidents and significant events in the home had been clearly recorded. Behaviour management guidelines have been drawn up with evidence of them being reviewed to ensure their effectiveness. Woody Point I54 - I04 S59654 Woody Point V217434 050525 Stage 4.doc Version 1.30 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 staff team are aware that service users would be unable to advocate on their own behalf if they had a concern. Staff would ensure that a range of options are available to support service users including outside independent advocacy. EVIDENCE: There have been no complaints since the last inspection. The complaints procedure was available. None of the service users (because of their cognitive ability) would be able to identify the procedure set out for complaints that the home should follow. Staff at the home clearly see it as important to advocate on the service users behalf. It was evident that they know the service users very well and would be able to recognise if something was troubling them and encourage them using the picture exchange communication system (PEC system) to communicate their concerns. The manager confirmed that the home has investigated providing external, independent advocacy with an appropriate person to act in the role of advocate. Woody Point I54 - I04 S59654 Woody Point V217434 050525 Stage 4.doc Version 1.30 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, 27 & 30 Service users can be assured of a safe and well-maintained environment. All areas are kept clean. EVIDENCE: The home’s Statement of Purpose makes it clear that service users should be able to access all parts of the home. There is clearly a good maintenance programme of the building. The staff team are aware of the (sometimes) destructive behaviour of service users towards their personal belongings and together with the maintenance man have taken aesthetically pleasing adaptations to protect sensitive equipment such as CD players and music centres. Service users bedrooms have been personalised to match the service users interests and the two bedrooms seen on this occasion had been attractively decorated and furnished There are three bathrooms and two separate toilets for use by service users. These facilities are located close to service user bedrooms, and communal areas of the home. All of these facilities were seen during the inspection and were found to be satisfactory. Woody Point I54 - I04 S59654 Woody Point V217434 050525 Stage 4.doc Version 1.30 Page 17 Health and safety is taken seriously. Training records confirm that staff have attended appropriate health and safety training. Records inspected confirmed that fire safety checks are carried out as well as general risk assessments covering the house and equipment and COSHH Assessments. Staff spoken with confirmed that disposable overalls and gloves were available and worn by staff carrying out intimate personal care. Woody Point I54 - I04 S59654 Woody Point V217434 050525 Stage 4.doc Version 1.30 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) 33,35 &36 Service users can expect to be well cared for by a staff team who work well together, are trained and receive good support and supervision. EVIDENCE: The staff rotas show that there is always a minimum of two staff on the early shift each morning and three on the late shift. At night there is one sleeping in and one waking night staff with either the manager or proprietors on call. These levels were felt by the manager to be appropriate for the care of the three service users. However it is recognised that staffing levels do need to continue to be monitored to ensure the staffing levels reflect the needs of the service users. Currently there are two staff on long-term sickness and the manager confirmed that the total hours of 53 hours per week are being covered by a combination of additional hours by existing staff and use of bank staff. Staff meetings are held monthly. Staff spoken with said this did provide an opportunity to raise anything they wished. The first part of the meeting is for support workers only to discuss any concerns. Senior staff join the meeting later to answer the issues raised by the support workers. The minutes of meetings confirmed a wide range of topics are discussed including the progress of the service users. Woody Point I54 - I04 S59654 Woody Point V217434 050525 Stage 4.doc Version 1.30 Page 19 The organisation is committed to having a skilled and trained workforce. New staff receive an in-house induction and are enrolled for TOPSS training. On completion of this training there is an expectation that staff would move onto NVQ training. The Manager acknowledged that the number of NVQ trained staff is slightly below the recommended 50 but there is a commitment to improve upon this. There was evidence from discussion and confirmed in records that staff are receiving one-to-one formal supervision, in a structured way, and that supervision was recorded with the agreement of both parties involved. Staff spoken with said the quality of supervision was good and the process supportive. Woody Point I54 - I04 S59654 Woody Point V217434 050525 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) 37, 39 &42 Service users can be assured that the home is well managed. The registered manager is aware of service users needs and ensures that the staff team receive the appropriate training and support. The organisation operates a quality assurance system and the home provides a safe environment to residents in relation to health and safety matters. EVIDENCE: The manager has the qualifications, skills and experience to manage the service. From discussion with the manager it is clear that they have identified the need to ensure their development needs are addressed to ensure their skills and knowledge are maintained. As noted at the previous inspection (undertaken in December 2004) the Manager has developed a quality assurance system to ensure there is an ongoing process for checking and monitoring the practice. This includes the use of questionnaires to other professionals. Evidence from the Pre Inspection Questionnaire (PIQ) indicates that policies and procedures are reviewed and updated throughout the year. Woody Point I54 - I04 S59654 Woody Point V217434 050525 Stage 4.doc Version 1.30 Page 21 Records seen show that staff are trained in health and safety matters. Training records indicate that fire safety, Unisafe training, food hygiene, first aid, administration of medication, infection control and health and safety are statutory training for all staff. A record is kept of the temperature of hot water. There was also evidence that checks are made of equipment on a regular basis. Woody Point I54 - I04 S59654 Woody Point V217434 050525 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 x 3 x x Standard No 22 23 ENVIRONMENT Score 3 x 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 3 x x 3 x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 x Standard No 31 32 33 34 35 36 Score x x 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Woody Point Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 3 x I54 - I04 S59654 Woody Point V217434 050525 Stage 4.doc Version 1.30 Page 23 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 Regulation Requirement Timescale for action 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 18 Good Practice Recommendations A risk assessment should be undertaken to support the service users wishes to have the temperature of the hot water for a bath above the safe water temperature agreed. Woody Point I54 - I04 S59654 Woody Point V217434 050525 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 5th Floor St Vincent House Cutler Street Ipswich IP1 1UQ 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 Woody Point I54 - I04 S59654 Woody Point V217434 050525 Stage 4.doc Version 1.30 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!