Inspection on 24/07/08 for Woolton Manor

This inspection was carried out on 24th July 2008.

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

Woolton Manor 27/07/07

Woolton Manor 23/05/06

Woolton Manor 06/12/05

Woolton Manor 06/05/05

Woolton Manor 27/10/04

Woolton Manor 16/06/04

Woolton Manor 12/11/03

Woolton Manor 27/08/03

Extracts from inspection reports are licensed from CQC, this page was updated on 09/11/2008.

CARE HOMES FOR OLDER PEOPLE Woolton Manor Allerton Road Woolton Liverpool Merseyside L25 7TB Lead Inspector Jeanette Fielding Unannounced Inspection 24th July 2008 10:20 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woolton Manor Address Allerton Road Woolton Liverpool Merseyside L25 7TB 0151 421 0801 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) wooltonmanor@btconnect.com Mr Abid Yousaf Chudary Mrs Margaret Jenkins Care Home 66 Category(ies) of Old age, not falling within any other category registration, with number (66) of places Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing: Code N, to people of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category: Code OP The maximum number of people who can be accommodated is: 66. Date of last inspection 27th July 2007 Brief Description of the Service: Woolton Manor is a fine period residence set in its own grounds close to the picturesque village of Woolton, Liverpool. The home offers 66 single bedrooms, 65 of which benefiting from en-suite facilities. For those service users who choose to share, two rooms would be provided with the second room being a sitting room. There are two large lounges; two separate dining rooms, a quiet lounge and a garden/patio area. A separate smoking room is set-aside for clients. Fees at Woolton Manor range from £315 to £500 plus a top up fee of £20 per week. Outside the grounds, all the local village facilities, shops, post office and bus routes are available within easy walking distance. Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use the service experience good quality outcomes. This inspection took place over a period of eight and a half hours. This was the key unannounced inspection and was carried out as part of the regulatory process. As part of the inspection process, all areas of the home were viewed including many of the service users bedrooms. Assessments and care plans for five service user were inspected together with staff records and certification to ensure that health and safety legislation was complied with. Discussion took place with the owner, manager, nurses, care staff, service users and visitors to the home to obtain their views and opinions of the service. Observation of the interaction between staff and service users provided additional information. The manager had completed an Annual Quality Assurance Assessment which gave further insight into the home. What the service does well: What has improved since the last inspection? What they could do better: Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 6 The planned programme of reviewing the pre-admission assessment and care plan format should progress. Advice from GP’s and the pharmacist should be sought in relation to medications given via a PEG feed to ensure that the most appropriate medication is prescribed and that the medications are administered effectively. Evidence that creams and lotions have been applied should be held. More detailed information should be recorded when the GP advises that one or two medications are prescribed to enable an accurate audit to be undertaken. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed information regarding the services and facilities provided by the home is readily available to enable prospective service users to make an informed decision regarding their care provider. EVIDENCE: The homes Service User Guide provides current and prospective service users with full information regarding the facilities and services provided by the home. A copy of this document has been placed in each service users’ bedroom and is also available in the foyer of the home. Information is also displayed in the foyer of other local services together with information regarding benefits and advocacy. Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 9 A sample of care files of new service users were inspected from both the nursing and the residential areas of the home. A pre-admission assessment is undertaken prior to admission to identify the specific needs of the service user to ensure that the home can meet those needs. The manager explained that the format for gathering information at these assessments is currently being reviewed to enable additional information to be recorded i.e. moving and handling equipment and specialist care services. Information is gathered from the service user, their relatives, hospital staff and any other person involved in their care prior to admission. Service users spoken to during the visit confirmed that a senior member of staff visited them prior to admission to gather information and that they, or their representative, had the opportunity to visit the home to view the rooms available and to meet staff and service users. The home does not offer intermediate care. Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Plans are in place to review and further improve the record keeping in relation to care files to provide staff with greater information regarding service users care needs to increase staff knowledge and understanding of the individual. EVIDENCE: Individual care plans are prepared for each service user. Risk assessments are undertaken and risk management plans are put in place to remove or reduce any potential risk to the service users. The manager explained that the care plans are due to be reviewed to ensure that full information regarding service users care needs are more clearly identified. The plans contain sufficient information regarding the care to be given, but the manager explained that there was a risk of some information not being recorded and so a full audit was to be undertaken. Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 11 The files provide evidence of visits made to and by any other healthcare professional including the GP, Tissue Viability Nurse Specialist and Dietician. Records are also held of recommended changes to care by these professionals to ensure that the care is given consistently by the staff team. Daily records are completed by the staff for all service users and these act as an indicator of change of care needs. The daily records are informative and provide evidence of the actual care given. One care file needs additional information to be recorded. The file states that pressure relief is to be given but does not clearly identify the type of relief that is required. One service user attends to their own medication and an assessment of the service users ability has been undertaken. Advice was sought from the service users GP and the homes policy and procedure has been implemented to ensure that the service user is protected. All other service users have their medications administered to them by the staff. Only the qualified nurses or the senior care staff are permitted to administer medications and additional training has been given to these staff. Care files are held securely in locked rooms, however, arrangements are being made to ensure that care staff have access to the files at all times to enable them to have full information regarding service users care needs. The home has two medication rooms, one having recently been re-located to a more suitable area of the home. Clearer information needs to be recorded regarding information about medications that are to be given via a PEG feed. Advice should be sought from the pharmacist and GP regarding capsules and tablets that are separated or crushed and to request that a liquid alternative can be prescribed. MAR sheets require to be clearly marked by the pharmacist to indicate that the medication is to be given via the PEG. MAR sheets should clearly indicate which eye that drops are to be inserted. Evidence of the administration of thickeners and the application of creams is to be held. Where MAR sheets state that one or two tablets are to be given, the amount administered should be recorded to enable an audit to be accurately undertaken and to provide evidence of the amount of medication that service users receive. All service users are accommodated in single bedrooms, most of which have en-suite facilities, promote privacy and dignity. Personal care is given in service users own bedrooms or the bathrooms as appropriate. Staff were Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 12 observed to knock on bedroom doors prior to entering. Service users spoken to during the inspection confirmed that the staff respect their privacy and dignity at all times. One service user said that she like to spend time alone in her bedroom and that staff respected this. Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A high number of activities and social events are arranged to give service users entertainment and to promote social interactions. EVIDENCE: Detailed information is gathered from service users following their admission regarding their life history and the types of activities that they enjoyed previously. Much of this information is gathered by the activities co-ordinator who spends more social time with service users. A planned programme of activities is prepared and service users spoken to said that they looked forward to the various activities offered and that a huge range of events took place. The activities co-ordinator is employed for 30 hours each week from Monday to Friday but often works at weekends to provide additional activities. Group activities are provided together with one to one stimulation. Service users confirmed that the staff encouraged them to participate but that it was their own choice whether they did or not. Each week, a film is shown on the big Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 14 screen television and popcorn and ice cream are served to give the impression that service users are at the cinema. Detailed records of activities are held and three service users confirmed that they had been taken out on trips. A good range of magazines and books are available and a variety of newspapers were seen. Ministers from two local churches visit the home on a regular basis and provide services in groups or individually for those who wish to participate. Arrangements for visits from Ministers of other religions can be arranged on request. Visitors are welcome at the home at any time and a high number of visitors were observed. Those spoken to during the inspection spoke highly of the staff team but two said that there didn’t seem to be enough. Comments in the survey forms that were completed by relatives gave the same results. One relative said that the staff were extremely knowledgeable about her relative and would give her updated information when she visited and would telephone her when her relative’s condition changed. She said that she was confident that the best possible care was given and that the home was a lovely place. Meals are served in the dining room or in the service users own bedroom on request. The manager said that the menus were slowly being changed to offer a greater range of meals and are changed according to season and availability of fresh fruit and vegetables. The dining room is bright and provides service users with a pleasant area. Tables are attractively laid and the meals served on the day of the visit looked and smelled appetising. Special diets are provided on the advice of the GP or dietician or at the service users request. The main kitchen is clean and organised and a good stock of fresh goods were stored. Service users said that the meals were good but one felt that a little more seasoning was required during the cooking. Snacks and drinks are served between meals and are available both day and night on request. Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All staff have been given training on the Protection of Vulnerable Adults and have a good knowledge and understanding of Adult Protection issues which protects service users from abuse. EVIDENCE: The home has a robust complaints procedure which is detailed in the Statement of Purpose and the Service User Guide. The Service User Guide has been placed in all bedrooms and is available in the foyer. Information on how to make a complaint is also displayed on the notice board in the foyer of the home. Detailed records are held of any concerns expressed by service users or relatives and information is recorded of the action taken to address these. All staff have been given training on the Protection of Vulnerable Adults and evidence of this is held on their personnel files. Staff spoken to were able to demonstrate that they are fully aware of the action they should take in the event of abuse being suspected. Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 24, 25 and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides a bright, welcoming and homely environment for service users to give them a safe and comfortable place in which to live. EVIDENCE: All service users are accommodated in single bedrooms. All bedrooms, with the exception of one, are provided with en-suite facilities. All bedrooms are spacious and are decorated and furnished to a high standard. Service users, relatives and staff have made every effort to personalise bedrooms with pictures, photographs and items of memorabilia. Some service users have brought small items of furniture into the home to make their rooms more homely and familiar. Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 17 The two lounges are decorated to a high standard and plans are in place to replace the armchairs in the near future. Large plasma screen televisions have been provided in the lounges. Corridors are bright and wide and seating has been provided. It was evident that service users enjoyed using this area to spend time chatting with everyone entering and leaving the home. The home is well maintained and all systems are in place for reporting issues that require addressing. The records show that all reported issues are quickly addressed with priority being given to health and safety to ensure that service users and staff are protected. There is an ongoing programme of redecoration and improvement and a number of bedrooms have been redecorated and recarpetted. Some new profiling beds have been provided and new air mattresses where this has been assessed as beneficial to the service users. Specialist equipment is provided to assist service users who have mobility problems. New toilet frames have been provided to assist service users and to ensure their safety. The home provides two passenger lifts, hoists and assisted bathing facilities. Staff have been given full training in the use of all equipment. All areas of the home were clean and fresh. The home is set in extensive grounds and a garden area has been provided with seating and shade and was observed to be well used by service users and their visitors. The area is bright and colourful with flowers and plants and is available for service users to use at any time. Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff are well trained to ensure a high level of care and support to the service users. EVIDENCE: The home is staffed as two separate units, the nursing and the residential units. In the nursing unit, a qualified nurse is on duty at all times who is supported by six care staff during the morning, five care staff during the afternoon and evening and two care staff at night. In the residential unit, a senior care assistant is on duty at all times who is supported by five care staff during the morning, four care staff during the afternoon and evening and two care staff at night. The home has a robust recruitment procedure which requires prospective staff to complete an application form prior to being called for interview. Two references are taken and all applicants are required to have a Criminal Record Bureau and Protection of Vulnerable Adults registers checked to ensure that service users are protected. A record of the issues discussed at interview are held and evidence of qualifications are required to be produced by the applicant. Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 19 Staff records were inspected and were found to be extremely well organised with evidence of training undertaken held on all files. The manager has produced a training matrix to identify the training undertaken by all staff and provides information to identify when updates in training are due. New staff are required to complete an induction training programme followed by a foundation training programme. Evidence of this training is held on their files. A high number of training events continues to be provided for all staff. Domestic staff have now completed their NVQ training and have obtained their certificates. NVQ training continues for care staff at both level 2 and level 3. Management prioritise training and facilitate staff members to undertake external qualifications beyond basic requirements. The home has internal developmental training, to complement formal training as part of an ongoing training plan. The owner and manager explained that they were looking to recruit an additional member of staff at senior level to be responsible for auditing the nursing files and medications. Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Person and the Manager have a clear development plan and vision for the home which they have effectively communicated to service users, staff and relatives. EVIDENCE: The manager of the home is experienced and competent and has achieved NVQ qualifications in management at both level 4 and level 5. She is supported by qualified nurses and senior care staff within the home. The manager is also well supported by the owner of the home who visits most days each week. Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 21 Staff meetings are held regularly and provide a forum for the dissemination of information and an opportunity for staff to suggest ideas and areas for improvement. The meetings are well attended and a record of items discussed are held and were available for inspection. Relatives meetings are held regularly and the manager speaks with service users on a one to one basis. The home is well supported by relatives, many of whom visit the home on a daily or weekly basis. Staff supervision is given on a regular basis to identify training needs and to promote good practice within the home. Records of supervision are held on individual staff files. All safety checks are made on the premises and equipment within the home and certificates of verification were inspected and found to be in place and up to date. Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 4 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 X 3 X 4 X 4 STAFFING Standard No Score 27 3 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 OP9 Regulation 13(2) Requirement Written confirmation must be obtained regarding medications to be administered via a PEG feed to ensure that the medications are suitable and that they are administered appropriately. Timescale for action 15/08/08 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. Refer to Standard OP9 OP9 Good Practice Recommendations Evidence that creams and lotions have been applied should be held. A clear record should be held of the amount of medication administered to service users when the GP has prescribed that one or two tablets be given. Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Woolton Manor DS0000025172.V369180.R01.S.doc Version 5.2 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. 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