Inspection on 24/09/08 for Woolnough House

This inspection was carried out on 24th September 2008.

CSCI found this care home to be providing an Adequate service.

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

Woolnough House 31/10/07

Woolnough House 28/11/06

Woolnough House 29/03/06

Woolnough House 06/12/05

Woolnough House 24/02/05

Woolnough House 10/08/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Woolnough House Woolnough House 52 Woolnough Avenue Tang Hall York North Yorkshire YO10 3RE     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Denise Rouse     Date: 2 4 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Woolnough House 52 Woolnough Avenue Woolnough House Tang Hall York North Yorkshire YO10 3RE 01904413656 01904431755 EPHwoolnough@york.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) City of York Council Type of registration: Number of places registered: care home 35 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Woolnough House provides personal care and accommodation for up to 35 older people and is owned and managed by City Of York Council. Nursing care is not provided. Woolnough House was purpose-built approximately 40 years ago and is located in the Tang Hall area, to the east of the city. There is a regular bus service to the city centre, which is about 2 miles from the home. There are nearby shops and public houses. Accommodation is provided in single rooms on two floors. The upper floors are accessed by a passenger lift. There is a small car park to the front of the home. The service provides an information booklet about the home to prospective residents. The statement of purpose and service user guide, which gives information about the home is available, with a copy of the latest inspection report, for people to read. Care Homes for Older People Page 4 of 27 Over 65 35 0 Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The evidence used in this report had included: A review of the information held on the homes file since its last inspection. Information submitted by the registered provider in the Annual Quality Assurance Assessment, AQAA. Surveys received from people living at the home, and a health care professional. Care Homes for Older People Page 6 of 27 An unannounced visit to the home which lasted five hours, undertaken by one inspector, which included a full tour of the premises. Evidence gained by direct observation during the site visit. This involved talking with people living at the home, talking with senior care staff and the administrator, and asking a visitor their views about the home. Inspection of records, including care profiles, medication administration records, staff files and some of the homes policies and procedures. Fees charged on the day of the site visit ranged from 102.87 pounds to 457.74 pounds per week. additional charges are made for hairdressing and private chiropody. We have reviewed our practise when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations. But only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service People are assessed before being offered a place in the home, to make sure peoples needs are known and can be met. Evidence: Staff who are competent to assess peoples needs go out and visit people who are thinking of moving into Woolnough House. Information is also gained from other health care professionals, care managers and discharging hospitals. Once the assessment has been carried out, and all this information has been considered, the manager and staff make a decision about if the home can meet the individuals needs. Care Homes for Older People Page 10 of 27 Evidence: People are not admitted to the home if their needs cannot be met. Emergency admissions to the home are not undertaken without information about the prospective person being given to the home and an assessment being undertaken. This ensures that peoples needs are known and can be met. People who are thinking of living in the home are invited to spend time at the home with their relatives. They can also stay for a trial period so that they can experience the services the home has to offer them and decide if it is the right place for them. Information about the home is available to people in the last inspection report and statement of purpose, so that they have information about the home to decide if it is the right place for them. People said The manager and staff were very good on admission. Another person said I visited the home with my sister, I had heard it was a nice place to live. It is nice and handy for my visitors. Intermediate care is not undertaken. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health care needs are met and they are treated with dignity and respect. However there are some shortfalls related to recording medications which do not protect peoples health and well being. Evidence: Staff have been rewriting and updating all peoples care documents who live in the home. A lot of work has been undertaken which helps to make sure that peoples current needs are known and can be met. Three peoples care needs were looked at in detail. Care plans were in place and reflected what people could do for themselves and what they needed staff to give them some assistance with. Risk assessments contained information to help people be as independent as possible whilst keeping Care Homes for Older People Page 12 of 27 Evidence: them safe. Staff review this information monthly or as a persons needs change, this review was undertaken but the record of these reviews were missing in two peoples re written files and was added to make sure there was evidence that these important reviews had taken place. People are addressed by their preferred names. People spoken with said that the staff respected them. They could also have a key to their bedroom door which helps to ensure their privacy is respected. People are asked if they want to be checked upon in the night by the staff, some who said they did not want to be disturbed signed a risk assessment to this effect, to make sure peoples choices were respected. Specialist equipment is available within the home, to make sure peoples special needs can be met. People are assisted to attend hospital appointments accompanied by staff. Health care professionals visit the home to make sure that people receive the medical care they need to maintain their health. Medication systems in operation in the home were looked at. It was found that two out of three records looked had a few gaps on their medication administration record (MAR) for medicines they should have received. Staff did not know if these medicines had been refused or not given. Staff should make sure that all medications prescribed are taken and where this does not happen a reason should be recorded on the MAR chart. This will make sure that doctors have a full picture of medications being taken by each individual and can monitor peoples health and well being more effectively. The controlled medications within the home were inspected. They were correct. However two peoples names and medications had not been recorded in the index of the controlled medication register. These were added at the time of the site visit to guide staff to where this medication should be recorded. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples social needs are known, however some people are not having these needs met. People receive a nutritious diet which meets their dietary needs. Evidence: People said what time they preferred to get up and go to bed, their wishes were respected by the staff. Peoples preferred social activities are recorded when they come into the home on a life profile and interests and preferences record. This helps staff understand what people prefer to get involved with so that they can gain social stimulation. In the past few months the manager has tried to increased the activities available to people. There is a monthly activity programme displayed in the lounge. This included pampering Care Homes for Older People Page 14 of 27 Evidence: sessions, outings, residents meetings, as well as quizzes and board games. However people spoken with said It is boring, people sleep after breakfast and after lunch, there is nothing to do. A relative said The television is on in the morning and is still on at night, to the point were people dont want to take part. Very occasionally they will throw a ball whilst having a game of chair basket ball. Staff do speak to people on a one to one basis. However people are sat round the edge of the room, they cannot turn round to see others and speak to others. They did say Staff have tried to get their relative involved in activities. Care staff their best with what they have. One person living in the home said There is always something going on, it is up to you if you join in. I can sit out if it is nice and warm.Two or three of us gather outside, on the whole I am very happy. But another person said I would love to go on bus trips, the meals are very good, staff are polite. I come down and sit down in the lounge, if its a wet day I cannot even get out in the garden, if i couldnt sit in the garden I would go mad, its boring there is nothing for me to do. It is clear that there are some people who are not receiving enough social stimulation, and this should be addressed. Two staff spoken with said they felt because the home had ceased taking people with a high dependency, there was a mix of people, some of whom needed more help and social stimulation than others. Staff also said they would prefer one member of staff to have allocated separate time to provide activities, as often staff who are going to undertake activities have other care needs to attend to. They said We would like to have a dedicated person for activities, so that care leaders are not reminding care staff to do activities. The key worker duties take priority and care has to come first. This has meant that activities scheduled to take place have not always occurred. Management should continue to look at how peoples preferred social needs can be met more effectively. People were seen after breakfast and lunch sleeping in the lounge chairs. About half of the residents in the lounge were asleep after breakfast and lunch. No activities were seen to be happening on the day of the visit. The inspector was told a member of staff had asked people to get involved with activities in the morning, but people didnt want to take part. Only one person spoken to was happy with the social stimulation provided. Staff at the home undertake fund raising activities to help pay for entertainers to visit the home. An outing to Whitby for fish and chips and a bus ride and a steam train outing has been paid for by this fund. This is commendable. Visitors are welcome and can visit the home at any time. A hairdresser attends the home and a chiropodist visits to ensure people can receive this service. Peoples religious needs are known and visiting clergy attend the home on a regular basis. Care Homes for Older People Page 15 of 27 Evidence: The dining rooms in the home are light and airy. People can eat in their bedroom if they wish. Some of the meals are provided by the hospital, breakfast and tea are cooked in the home. People have a choice of meals and those who need help from the staff are assisted by patient staff to make sure they get enough to eat and drink. People said I enjoy the food more or less and the food is good. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given information on how to make a complaint and they are protected from abuse. Evidence: Information about how to make a complaint is given to people in the councils leaflet. The manager and staff act upon issues raised with them. Issues are investigated and the person who has raised the issue would be contacted with the outcome of the investigation, this makes people feel their views and concerns are listened to. A safeguarding policy is in place. Staff have received training about the signs to look out for if someone was being abused. Staff questioned knew what action they should take if they suspected abuse was occurring. This helps to protect people. Prospective staff have to undertake police checks and a thorough recruitment process is in place. This helps to make sure that staff who are not suitable to work in the care industry are not employed by the home. Care Homes for Older People Page 17 of 27 Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is maintained, however there were some shortfalls relating to the laundry, which should be addressed to help maintain infection control. Evidence: The home has a pleasant and welcoming atmosphere. People visiting the home have to use a secure door entry system to gain access this help to protect people from possible intruders. There are a variety of communal lounges and dining areas on the ground and first floor and a smokers lounge for people to use. Hand rails are available in the wide corridors for people to use to help them walk around the home. There is a lift to the first floor which helps people gain access to all areas of the home. Disabled access is provided to the garden where there is a variety of garden furniture for people to use. An ongoing maintenance contract is undertaken to make improvements to the home as necessary to make sure that it remains a pleasant place for people to live. The laundry was inspected. Access to this area of the home was gained by a corridor Care Homes for Older People Page 19 of 27 Evidence: which has restricted access. Infection control measures are in place for handling soiled items of linen.However the area behind the washers and dryers was very dusty and these areas require a spring clean. Under the wash basket next to the washer there were some damaged tiles, and behind this washer 4 tiles were coming away from the wall, and the lino was peeling up from the floor. By the sluice sink the floor required cleaning and there were 4 small holes in the lino. These issues should be addressed to make sure that all the areas of the laundry can be thoroughly cleaned to prevent the chance of cross infection occurring. Hand wash facilities were available for staff throughout the home, this helps protect people. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are looked after by well trained staff. Evidence: Staff are friendly and approachable. Recruitment methods are thorough, all staff have police checks undertaken and new staff do not start work at the home before the results are known. This helps to protect people from people who may not be suitable to work in the care industry. New staff have complete induction training which helps them to understand what is required of them so that they can give good care. Staff have regular training updates in statutory subjects so that they remain safe and effective to look after people. The home has 56 of care staff who have achieved a National Vocational Qualification in care. Staff receive regular supervision so that any issues they have can be raised and they can gain one to one help and support. Care Homes for Older People Page 21 of 27 Evidence: People said The care staff are lovely and The staff do what they can for us when they can, I have no complaints at all. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is managed well and is maintained to make sure it is pleasant for people who live there. Evidence: The home has a manager in post who has been in place for a short time. Staff said she was approachable and was implementing new ways of working and making improvements to the services which benefits people who live there. She has an open door policy so that people can speak to her at any time. She is supported by a service Care Homes for Older People Page 23 of 27 Evidence: manager who visits the home regularly to make sure the home is running well. Quality assurance procedures are in place and written audits take place each month which help the management team to assess the quality of the service they are providing and take any action necessary to improve things. People who live at the home are asked for their views of the service in a yearly questionnaire. The Council also audit the home to make sure everything is running well and the business is being managed appropriately. Personal allowance accounts are available for people living in the home if they do not wish to look after their own money. These were inspected, balances were correct and receipts were available to people. This ensures people are protected from financial abuse. Health and safety checks and regular maintenance is undertaken to make sure the home is nice for people to live in. There was some issues within the laundry which should be addressed to make sure peoples health is produced (See environment). Hot water temperatures supplied to peoples bedrooms are checked and controlled so that people are not at risk from scalds. Fire alarm systems are also checked regularly to make sure that people continue to be protected. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 Medications which are prescribed should be recorded as taken or refused on the medication administration record, to make sure that peoples health can be monitored effectively. The names of people receiving controlled medication should be recorded in the controlled medication register index, to help guide staff. 2 12 Management should look at how they can provide social activities to people to meet everyones preferred social needs. The area behind the washers and dryers and the floor by the sluice sink should be thoroughly cleaned. Tiles which are lifting or damaged, and the lino that is lifting should be repaired so that thorough cleaning can occur. To make sure infection control measures are in place. 3 26 Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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!