CARE HOME ADULTS 18-65 Woolsington Court, 48-49 Bedlington Northumberland NE22 5UH
Lead Inspector Anne Brown Announced 8 September 2005 09:30 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. Woolsington Court, 48-49 Version 1.10 Page 3 SERVICE INFORMATION
Name of service Woolsington, 48-49 Address Bedlington Northumberland NE22 5UH 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) 01670 823139 01670 823139 communityhome@woolsingtonnhs.fsworld.co.uk Northgate & Prudhoe NHS Trust Mr Peter Richardson CRH 3 Category(ies) of LD Learning disability (3) registration, with number of places Woolsington Court, 48-49 Version 1.10 Page 4 SERVICE INFORMATION
Conditions of registration: No conditions apply. Date of last inspection 16/11/05 Brief Description of the Service: Woolsington Court is a Northgate and Prudhoe NHS Trust home that accommodates three adults with a learning disability. The residents can live in the home for as long as they wish provided their individual needs can be safely and appropriately met. The home is situated in a small residential estate in Bedlington. The accommodation is a ground floor flat and each resident has their own bedroom and shares the communal areas which include a kitchen/dining room and a lounge. The home is in the centre of Bedlington and is close to a range of local amenities such as shops, pubs and restaurants. The home has its own transport. Woolsington Court, 48-49 Version 1.10 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was announced and took place over three and a half hours. A tour of the premises took place and the care records were inspected along with the fire log book, accident book, complaints records and minutes of meetings held in the home. Discussions were held with the manager and one member of staff. Two residents were present. What the service does well: What has improved since the last inspection?
The recommendations made at the last inspection have been carried out. One requirement remains outstanding with regard to staffing files but ongoing discussions are taking place between the CSCI and management of the Trust. Two bedrooms have been redecorated and a specialist chair has been provided for one resident following an assessment by an occupational therapist. Regular house meetings are now taking place and the minutes are recorded. The manager has updated the supervision sessions with staff members and a programme is now in place. Woolsington Court, 48-49 Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Woolsington Court, 48-49 Version 1.10 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 Woolsington Court, 48-49 Version 1.10 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 and 5. Comprehensive information is made available when a referral is made and the home carries out detailed assessment prior to agreeing to admit people to ensure that the home can meet their needs. Individual contracts have been drawn up. EVIDENCE: A training programme is in place to ensure the staff team are equipped to meet the individual needs of the residents. Comprehensive assessments were available and these are reviewed by care managers on an annual basis. Written contracts were in place but were not signed by the residents and/or their representative. Woolsington Court, 48-49 Version 1.10 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 and 9. Care plans are comprehensive which helps to ensure that the staff team are well informed about the needs of the residents living in the home. Residents’ rights to make decisions about their day-to-day lives are respected by staff members which ensures their lives are fulfilling and satisfying. They are supported to take risks and any limitations are recorded. EVIDENCE: Health and social care needs are clearly addressed and the staff team are fully informed. All appointments with health care professionals are recorded in the care plan and an ‘OK’ health check is carried out annually. Residents are well supported by staff and the necessary levels of support are recorded in the care plans that show the level of care and support the staff team need to provide. The current residents cannot sign their own care plans and they are not signed on their behalf by their representatives. Comprehensive risk assessments are available on the case files. These assist the residents to lead fulfilling lives and they are well supported by staff to take calculated risks as necessary.
Woolsington Court, 48-49 Version 1.10 Page 10 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) 13, 14, 15 and 17. Links with the community and opportunities to participate in social and personal development activities had reduced at the last inspection. The manager has now taken steps to resolve this problem. Visitors are made welcome and residents are supported to maintain contact with family and friends as they wish. Residents are offered a healthy and varied diet. Special diets are catered for in the home. EVIDENCE: At the last inspection the staff stated that the weekly activity programme did not always take place due to staff shortages. The manager confirmed that this problem has now been resolved. One resident attends a day centre and the staff are actively seeking appropriate placements for the other two residents. The staff on duty confirmed that outings are spontaneous and take place on a regular basis. This was recorded in the care plans.
Woolsington Court, 48-49 Version 1.10 Page 11 There were entries in the recording systems to confirm that visitors are made welcome in the home. Staff sometimes escort one relative to and from the home to visit her son. A nutritious menu plan is in place and the staff confirmed that alternatives are always available. Any changes to the menu are recorded. There are guidelines in place to ensure residents receive appropriate support at mealtimes. One resident is closely monitored as they suffer from diabetes. Woolsington Court, 48-49 Version 1.10 Page 12 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 and 20. Residents are given the personal support they require and according to their preferences. Professional medical advice is sought, and reassessments are requested when necessary. An appropriate system is in place for dealing with medications. EVIDENCE: Staff provide personal support in such a way as to promote and protect residents’ privacy, dignity and independence. There was evidence that the staff team seek advice and support from relevant professionals in respect of the residents’ health and well-being. All appointments are recorded along with any advice given. A random sample of medication records and the system for storage and handling medications were looked at and found to be appropriate. A discrepancy was found between the date one medication had been issued by the pharmacist and the date it entered the home.
Woolsington Court, 48-49 Version 1.10 Page 13 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 and 23. The home has a satisfactory complaints system and staff receive training in adult protection to help protect residents from abuse. EVIDENCE: A complaints procedure and policy is in place and a leaflet ‘Tell Us’ has been produced that contains guidance on how to make a complaint. A copy of the complaints procedure is not displayed in the home. A complaints log is maintained and monitored on a monthly basis. No complaints have been received since 2000. A procedure for responding to allegations of abuse is available. The staff have received training on multi-agency POVA procedures. Arrangements are being made for a new member of staff to receive this training as soon as possible. A sample of financial records maintained on behalf of the residents was examined and no problems were noted. The Trust carries out regular audits of residents’ financial records. Woolsington Court, 48-49 Version 1.10 Page 14 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, 25, 27, 29 and 30. The standards of the facilities and décor within the home is good, providing residents with an attractive and homely place to live. Bedrooms are personalised and provide the residents with the necessary facilities. EVIDENCE: The staff team have made every effort to ensure the premises are homely and comfortable. No health and safety hazards were observed. The premises are well maintained although the corridor, laundry and shower room would benefit from redecoration. Residents’ bedrooms were pleasantly furnished and decorated. They have been individualised with their personal effects. The staff confirmed that the residents are involved in choosing the décor. The home has a walk-in shower and a bath that is fitted with a hoist. One resident has recently been assessed by an occupational therapist and has been provided with a special chair suitable to his needs.
Woolsington Court, 48-49 Version 1.10 Page 15 The home was clean and hygienic and hazardous substances are stored in a lockable facility. Paper towels are available for hand washing in the kitchen but not in the bathrooms and toilets. Infection control forms part of the staff training programme. Woolsington Court, 48-49 Version 1.10 Page 16 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) 32, 35 and 36. Minimum staffing levels are maintained which means that there are enough staff on duty to meet the needs of residents. The staff team are well trained and supervised to enable them to provide good care to the residents. EVIDENCE: There are two members of staff on duty during the day and one sleep-in staff member during the night. Training programmes are in place that cover mandatory health and safety and specialist training. The staff member on duty stated they felt the training offered was very good and enabled the staff team to meet the individual needs of the residents. The manager has ensured that all staff receive regular supervision. The staff on duty stated the manager is supportive and they were provided with adequate training and supervision. The staff on duty were observed to be meeting the residents’ needs in a competent and caring manner. Good relationships were observed between the staff team and the residents. All members of staff have completed NVQ Level 2 training or above with the exception of one staff member. Woolsington Court, 48-49 Version 1.10 Page 17 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, 40 and 42. The home is well run by a competent manager in the best interests of the service users and staff are well supported. Health and safety of the service users is promoted by well trained staff and appropriate risk assessments are in place. EVIDENCE: The staff make every effort to ensure the residents are consulted in all aspects of the day to day running of the home. The residents have communication difficulties and the staff have developed ways of communicating with them individually. The staff receive regular training in health and safety issues and all accidents are recorded and monitored on a monthly basis. Risk assessments are carried out on the premises by staff in the home on a regular basis. Woolsington Court, 48-49 Version 1.10 Page 18 The fire log book was examined and was up to date. The log recorded that fire instruction is provided to staff at the appropriate intervals but staff had not signed to confirm this. A copy of an up to date maintenance certificate was not available for the gas appliances and electrical installation. The manager confirmed that the tests had been carried out and agreed to obtain a copy of the certificate and forward this to CSCI. No health and safety hazards were observed during the inspection. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 Standard No 22 23
ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 2 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 2 3 x 3 x 3 2 Standard No 11 12
Woolsington Court, 48-49 x x Standard No 31 32 33 34
Version 1.10 Score x 3 x x
Page 19 13 14 15 16 17 3 3 3 x 3 35 36 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 x x 3 x 2 x Woolsington Court, 48-49 Version 1.10 Page 20 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. 2 Standard 20 42 Regulation 13(2) 13(4) Requirement Investigate discrepancy on dates medications enter home. Copies of test certificates for gas appliances and electrical installation must be forwarded to CSCI. Timescale for action 19/9/05 30/9/05 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 4 5 6 Refer to Standard 5 6 22 24 30 42 Good Practice Recommendations Contracts/terms and conditions should be signed by residents and/or their representatives. Care plans should be signed by the residents and/or their representatives to confirm their involvement in their development. A copy of the complaints procedure should be displayed in a prominent place within the home. The corridor, laundry and shower room would benefit from redecoration. Paper towel dispensers should be provided to reduce the spread of infection. Staff signatures should be retained to confirm they have received regular fire instructions. Woolsington Court, 48-49 Version 1.10 Page 21 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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