Care Home: 1 Wood Close

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What the care home does well The home continues to provide a gentle, relaxed and stable environment to suite the range of residents needs residing at the home. feedback about experiences at the home included "they look after my daughter to a high standards, treats her with respect" "My son loves being at wood close, which makes me pleased" and "our home is good at understanding clients and their needs ( dietary and health) also the daily activities ourhome is very caring and all staff try their best to make sure the service users and other staff are very happy and supported if needed". Person centred care plans helps to ensures that residents support needs are assessed enabling the staff to provide individual support with residents actively engaged in the development and review of their plans. A relative fedback "does lots of activities outside of the home, the environment encourages individuals to achieve things, he attends college courses etc". Staff make a positive contribution in residents lives as residents benefit from a supervised, well trained and enthusiastic staff team that know them and who are robustly recruited and employed in sufficient numbers as is necessary to meet their needs. feedback about staff included "staff are easy to talk to they are always polite . I can visit when I want without prior notice" and "The home has a very good team all the staff are well trained to provide service users needs and wishes". Resident`s benefit from a well-motivated and knowledgeably manager who promotes good practises and has a clear sense of leadership and who runs the home in the best interest of residents. A staff member fedback "The home is the best managed organised and service user focused I have worked in". What the care home could do better: In order to ensure that residents are being safeguarded by the homes medication practises standards of recording must improve to ensure that residents receive medication in accordance with their prescribed instructions. Standards of daily recording should reflect the actions, events and activities in order to help evidence that residents assessed needs are being addressed. Random inspection report Care homes for adults (18-65 years) Name: Address: 1 Wood Close 1 Wood Close Salfords Surrey RH1 5EE three star excellent service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Jane Jewell Date: 2 0 0 5 2 0 1 0 Information about the care home Name of care home: Address: 1 Wood Close 1 Wood Close Salfords Surrey RH1 5EE 01293430685 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Jacqueline Carol Jones Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ashcroft Care Services Ltd care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 6 The maximum number of service users to be accommodated is 6. The registered provider may provide the following category of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home 1 Wood Close is a residential care home registered to provide care and accommodation for up to six younger adults who are assessed as having complex learning disabilities, including behaviour which can be described as challenging. The home is managed by Ashcroft Care Services which is a large national organisation which have many Care Homes for Adults (18-65 years) Page 2 of 11 Brief description of the care home registered small care homes across the country. The home is located just off the main A23 road in a private residential estate, access to the home is through Harwood park road. The town of Horley is a short car journey away or is described by the home as within walking distance. The residential estate has its own nature reserve and small pond within walking distance. The home is a domestic dwelling converted for its current use. The home is presented across three floors with residents bedrooms presented across all floors, with access via stairs. Communal space consists of a large kitchen, large through dinning room and lounge which leads out into a rear secure garden. The garden area is mainly grassed and provides seating and recreational facilities. Residents accommodation is for single occupancy with four bedrooms providing en suite facilities. The home has its own vehicle and one that it shares with another service, one resident also has their own car. The manager reported that the fees for residential care currently range from £48,000 to £72,000 per annum, depending on the services and facilities provided. Extras such as: newspapers, hairdressing, chiropody, some transport , toiletries are additional costs. Care Homes for Adults (18-65 years) Page 3 of 11 What we found: At the last Key inspection the home was assessed as providing excellent outcomes for residents, there has been no evidence to indicate that this has changed and therefore it was agreed that instead of a key inspection a random inspection was undertaken, to focus on some key outcome areas for residents. The random inspection was undertaken across three and half hours and was facilitated by the registered manager Jacqueline Jones. The inspection involved a brief tour to the premises, observations, discussion with two staff and examination of some of the homes key documentation. Feedback surveys were sent to the home for distribution and sixteen were returned, eight from staff . three from service users and five from relatives. Their feedback is included in this report. There are five residents residing at the home who are assessed as having a range of needs including learning disabilities and some complex physical and behavioural needs. Residents ages range from 36 to 65 years and are both male and female. Residents present as a close cohesive group who have lived together several years. There has been no admissions to the home for four years . Residents continue to live in a clean and homely environment with their personal space individualised to reflect their lifestyle and preferences. There is a plan of maintenance and upkeep to help ensure that good standards are able to be maintained, any areas noted by the inspector that needed addressing had previously been identified by the home and action being undertaken to address. Much work had recently been undertaken to upgrade fire protection equipment within the home, which had involved major investment. A resident fedback that what the home could do better was to provide a Jacuzzi, this was fed back to the manager. The manager reported that there are plans to create a wet room shortly and that equipment is available to create a Jacuzzi feel to a conventional bath. A Resident fedback that what the home does best is to provide them a safe and clean home and to be healthy. A sample of feedback from relatives about their experiences of the home included they look after my daughter to a high standards, treats her with respect and My son loves being at wood close, which makes me pleased. What a relative felt that the home does well is supporting service users achieving their goals and needs, achieving a better living and interaction with the community. Staff feedback about what the service does well included Putting the service users needs at the fore front, hygiene, health and safety and our home is good at understanding clients and their needs ( dietary and health) also the daily activities our home is very caring and all staff try their best to make sure the service users and other staff are very happy and supported if needed. Three individual plans of care were viewed which contained comprehensive, detailed and up to date information on residents needs and the appropriate guidance for staff on how to support residents to meet these needs. In addition to care plans each resident has a personalised Person Centre Plan which presents important information about residents, and what they would like others to know about them. The Manager fedback that there is some further work needed to these documents in order to more fully reflect residents individual lifestyles. It was clear that residents are actively encouraged to participate in the development and review of their plans in accordance with their individual strengths Care Homes for Adults (18-65 years) Page 4 of 11 and preferences. Staff consulted with were very knowledgeable about the individual support needs of each resident and the actions to be taken in the event of any challenging behaviour, which helped to ensure consistent support . Any changes in residents needs and preferences are identified promptly through the regular review of care plans. Daily notes are recorded on each resident. However these did not always provide a record of events or activities or could be crossed reference to the individuals assessed needs. Therefore the home could not always evidence when the residents assessed needs were being addressed. The manager agreed to review the daily note recording and provide additional support and training to staff in order to improve standards of recording. Respecting residents rights to make decisions about their lives is integral to the ethos of the home. Observation of practises showed several different ways that residents were offered choice in their daily lives. This included choices about food and drink, how they wanted to spent their day and what leisure activities to undertake. Any potential restrictions on a residents freedom of choice have been dealt with appropriately through new legislation (Mental Capacity Act) which effects residents rights to make decisions in their lives. The home has a developed system in place for enabling residents to take responsible risks as part of an independent lifestyle. For example core risks faced and posed by residents are assessed and any measures to reduce or mange the risk is recorded for staff to follow. The manager confirmed that each resident has a structured weekly activity schedule which are reviewed approx six monthly These included swimming, pub visits, walks, theatres, eating out at restaurants, music group, bowling, drives out in the car, trips to the coast, horse and carriage riding, trampoline, sensory sessions, music and rhythm and picnics. A relative fedback does lots of activities outside of the home, the environment encourages individuals to achieve things, he attends college courses etc, another relative confirmed that their relative is always encouraged to get out into the community through going shopping, walks or going out in the car. Residents were given the choice of going out for a short drive and walk during the inspection as the weather was nice. However as previously noted records of what residents did were not always kept and therefore the home was not able to evidence the range of activities and opportunities that they reported are undertaken. The manager agreed to address this immediately, and remind staff of the importance of accurate recording. Consistent feedback was received from relatives and staff regarding the need for additional vehicles to increase the opportunities for people to access the community. The manager confirmed that they are in the process of another resident obtaining their own vehicle, and although public transport is accessible, its use can be severely restricted by the risks posed by some behaviours. However the manager felt that residents were not disadvantage by not having access to an additional vehicles but that daily activities needed to be well planned. Residents are encouraged to participate in the preparation of snacks and meals in accordance with their strengths and preferences. Much work has been undertaken with Care Homes for Adults (18-65 years) Page 5 of 11 health care professionals and staff to address the complex dietary needs presented by a resident. This has resulted in many positive improvements for the resident. Residents are supported to access a wide range of health care services, to meet their individual needs and their individual health action plans. This includes input from GPs, specialist nurses teams, Occupational Health, speech and language therapists, dentists, and opticians. It was clear that where there are concerns regarding the health or welfare of residents prompt medical advice or intervention is sought on their behalf by staff. A relative fedback that what they felt the home does well is ensuring that all health care appointments are met. None of the residents are assessed to administer their own medication. The manager confirmed that only staff who have undertaken medication training administer medication. Medication records did not always provide a clear up to date record of what individual residents had been prescribed or were receiving. This is with particular reference to not all medication being recorded on medication records, stock records not being maintained, prescribed instructions not being followed for some creams. In addition medication records contained numerous instructions which were reported to be no longer relevant. It has been required that these areas be addressed in order to ensure residents safety. Good practises were noted on the individual instructions provided for staff on the administration of As required medication. These made clear the individual requirements for when these medicines should be administered. There is an accessible complaints procedure for residents, their representative and staff to follow should they be unhappy with any aspect of the home. No formal complaints has been received or recorded by the home since the previous inspection. A sample of feedback received included If there is a problem myself and the staff try to solve it together and I am very pleased with wood close staff they listen to what I have to say and we work together should any problems arise such as behavioural. The home has written policies covering adult protection and whistle blowing. These make clear the vulnerability of people in residential care, and the duty of staff to report any concerns they may have to a responsible authority for investigation. Staff have received formal training in safeguarding adults and prevention of abuse. Where safeguarding referrals have been made by the home they have followed the appropriate procedures. Staff felt that there was always sufficient staff on duty to be able to provide the support or advice residents needed when they wanted it. Staff confirmed that there is some flexibility in the staffing hours should they need additional cover. There is a small stable staff team who have worked at the home for some time and who knew the residents well and were observed providing dignified sensitive support, which also used appropriate humour to help aid communication with one resident. A sample of feedback about staff included staff are easy to talk to they are always polite . I can visit when I want without prior notice and The home has a very good team all the staff are well trained to provide service users needs and wishes. Staff feedback about their experiences at the home included The home has caring staff that helps with the service users needs and we work well as a team always trying to improve ourselves. The manager confirmed that all but one staff member has obtained A National Vocational Qualification (NVQ) in care. The manager reported that there is little staff turnover and therefore limited recruitment. The personal files of a staff member recently recruited showed that a good recruitment Care Homes for Adults (18-65 years) Page 6 of 11 process is followed which includes the use of an application form, interviews, Criminal Records Bureau (CRB) checks and written references prior to employment commencing to help ensure that only staff who are suitable to work with vulnerable people are employed There is a commitment to improving staff skills through an ongoing training programme both in practical matters and the broader aspects of working with people who have learning disabilities. Staff confirmed that there is a formal programme of monthly supervision and direct supervision with the manager working along side staff each shift. The registered manager has much experience in working and managing services for people who have a learning disability. They confirmed that they hold the recommended management qualifications and have undertaken ongoing training to keep updated in best care practise issues and changes in legislation. They demonstrated much commitment and understanding of the promotion of independence and in the daily running of a care home. They provide a clear sense of leadership and direction which enables staff to then provide good individual support. A sample of comments about the management included the home is well managed and The home is the best managed organised and service user focused I have worked in. There are several mechanisms in place for the manager to obtain feedback on the services of the home and whether it is achieving its aims and objectives. These include, annual placement reviews, staff meetings, internal quality audits, written feedback from relatives and health care professionals. Examples were noted whereby improvements to the homes working practises, residents individual lifestyles and the environment have been made based on this feedback. Written guidance is available on issues related to health and safety. Records submitted by the manager prior to the inspection stated that all of the necessary servicing and testing of health and safety equipment has been undertaken. The manager confirmed that there are regular health and safety checks around the building. Systems are in place to support fire safety, which include, regular fire alarms and emergency lighting checks, staff training and maintenance of fire equipment and fire drills were reported to have been undertaken. The manager reported that a fire risk assessment has been undertaken by a fire safety officer with each resident also having their own individual fire evacuation assessment. These records significant findings and the actions taken to ensure adequate fire safety precautions in the home. An area manager undertakes the required monthly audit of services and facilities on behalf of the provider to monitor the quality of the homes services and facilities. They complete a written report on their visit. Previous reports provided comprehensive feedback for the manager, highlighting areas of good practises and of any areas for future service development, however, in recent months the information was limited. The manager agreed to discuss this with the area manager. What the care home does well: The home continues to provide a gentle, relaxed and stable environment to suite the range of residents needs residing at the home. feedback about experiences at the home included they look after my daughter to a high standards, treats her with respect My son loves being at wood close, which makes me pleased and our home is good at understanding clients and their needs ( dietary and health) also the daily activities our Care Homes for Adults (18-65 years) Page 7 of 11 home is very caring and all staff try their best to make sure the service users and other staff are very happy and supported if needed. Person centred care plans helps to ensures that residents support needs are assessed enabling the staff to provide individual support with residents actively engaged in the development and review of their plans. A relative fedback does lots of activities outside of the home, the environment encourages individuals to achieve things, he attends college courses etc. Staff make a positive contribution in residents lives as residents benefit from a supervised, well trained and enthusiastic staff team that know them and who are robustly recruited and employed in sufficient numbers as is necessary to meet their needs. feedback about staff included staff are easy to talk to they are always polite . I can visit when I want without prior notice and The home has a very good team all the staff are well trained to provide service users needs and wishes. Residents benefit from a well-motivated and knowledgeably manager who promotes good practises and has a clear sense of leadership and who runs the home in the best interest of residents. A staff member fedback The home is the best managed organised and service user focused I have worked in. 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 2. Care Homes for Adults (18-65 years) Page 8 of 11 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 9 of 11 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, 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 1 20 9 That there are arrangements 22/06/2010 in place for the adequate recording and safe administration of medicines at the home. To ensure that service users receive medication in accordance with their prescribed instructions. 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 14 That daily notes record the actions, events and activity opportunities and those undertaken in order to help evidence that residents assessed needs are being addressed. Care Homes for Adults (18-65 years) Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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