Care Home: A Woodlands House

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What the care home does well A Woodlands House provides a good standard of care to vulnerable people. Staff retention is good and there has been little change to the care team since the previous inspection. The home does not use agency workers. The atmosphere was calm and relaxing. Staff were observed interacting with residents in a respectful way. Residents said they were able to go out regularly with staff members, which they enjoyed. Some of the residents were happy to discuss the care provided at the home and all gave positive feedback. Staff members on duty were able to demonstrate a sound understanding of the needs and preferences of the residents. An in-depth staff training programme, includes specialist training relevant to the resident group, which enhances good practice. What has improved since the last inspection? Since the last inspection, a maintenance programme for the building has been on going. Some rooms have been decorated and there are plans to re-decorate the bedrooms on the first floor in Spring 2008. The upstairs bathroom is being refurbished in February 2008 and all the fittings and fixtures will be replaced.A new wide screen television has been fitted to the wall in the residents lounge and there is now a large tropical fish tank in the main hallway. What the care home could do better: The Medication Record Sheets were examined during the visit and a few gaps were found for one resident on a specific day. The Matron noted this and intends to speak to the staff member on shift to ensure this does not re-occur. Staff appraisals and supervision for staff do occur on a regular basis for staff but it was noted this has been sporadic at times. The manager agreed she would benefit from a timetable to ensure staff are supervised no less than 6x annually. Following the visit it is her intention to put this in place. There were no requirements made at this inspection as overall A Woodlands continues to provide a good standard of care to its residents. CARE HOMES FOR OLDER PEOPLE A Woodlands House 4 St Winefride`s Road Littlehampton West Sussex BN17 5NL Lead Inspector Beth Tye Unannounced Inspection 24 January 2008 09:00 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 A Woodlands House DS0000014852.V347220.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. A Woodlands House DS0000014852.V347220.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service A Woodlands House Address 4 St Winefride`s Road Littlehampton West Sussex BN17 5NL 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) 01903 725458 Mrs Oonagh Patricia Cacioppo Mr Gerard Bradford Hawkes Mrs Oonagh Patricia Cacioppo Care Home 14 Category(ies) of Dementia (14), Dementia - over 65 years of age registration, with number (14), Old age, not falling within any other of places category (4) A Woodlands House DS0000014852.V347220.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Only persons in the DE(E) (Dementia over 65 years) to be admitted to the home. 24th July 2006 Date of last inspection Brief Description of the Service: A Woodlands House is a home for older persons who suffer from dementia. It is registered to accommodate up to fourteen residents. Mrs O P Cacioppo and Mr G B Hawkes privately own the home, and Mrs Cacioppo is the registered manager involved in the day-to-day running of the business. A Woodlands House is detached and located in a residential area of Littlehampton West Sussex close to local amenities and the sea. The property is arranged on three floors. Accommodation comprises of ten single rooms and three double rooms, one of which is on the ground floor. A passenger lift serves the first floor. Only residents who can mange the stairs unaided should be accommodated on the second floor. There is a medium sized secluded garden to the rear of the building, with private parking to the front. Facilities include two lounges, comfortable seating in the entrance hall and dining room. A Woodlands House DS0000014852.V347220.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 the people who use this service experience good quality outcomes. Prior to the inspection all relevant information and correspondence relating to the home was examined including the service history and Annual Quality Assessment document, which was completed by the homes manager. During the course of the inspection the inspector spoke to some of the people living in the home, interviewed staff and spoke at length to the manager and matron. A tour of the premises was undertaken. The inspector observed lunch being served and staff interaction with residents. Four care plans and three staff files were examined and the inspector saw other records including, resident questionnaires, staff training, supervision and appraisal records, maintenance, incident and accident reports and all those relating to health and safety. This is the first inspection of 2007/2008 This is called a key inspection and will determine the frequency of visits/inspections hereafter. What the service does well: What has improved since the last inspection? Since the last inspection, a maintenance programme for the building has been on going. Some rooms have been decorated and there are plans to re-decorate the bedrooms on the first floor in Spring 2008. The upstairs bathroom is being refurbished in February 2008 and all the fittings and fixtures will be replaced. A Woodlands House DS0000014852.V347220.R01.S.doc Version 5.2 Page 6 A new wide screen television has been fitted to the wall in the residents lounge and there is now a large tropical fish tank in the main hallway. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. A Woodlands House DS0000014852.V347220.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 A Woodlands House DS0000014852.V347220.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): Quality in this outcome area is good. To ensure residents needs can be met appropriately by the home, the manager carries out a full assessment prior to admission. Each resident is provided with a written contract of terms and conditions, which is signed by all involved parties, so residents are clear about their rights within the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the visit, pre-admission assessments were examined for four residents. These identified relevant areas of need including; diet, communication, health, social and cultural needs. Additional information and correspondence by community-based professionals is also held on file. This information is then translated into care plans and reviewed on a regular basis. All records are kept in a locked cabinet only accessible by care staff to ensure confidentiality. A Woodlands House DS0000014852.V347220.R01.S.doc Version 5.2 Page 9 Risk assessments were in place for each of the four residents and contained information relating to their specific needs and assessed areas of risk. This promotes independence for residents in all aspects of daily living. All residents are given up to date information about the home prior to admission, including a Service Users guide and complaints procedure. This information helps them (and their families) to make an informed decision about moving to the home and what to expect. All residents have received a copy of their Terms and Conditions for the home, which they or their families had signed following admission. This informs residents of their rights and what to expect of the home. A Woodlands House DS0000014852.V347220.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): Quality in this outcome area is good. Arrangements are in place to ensure that the health care needs of residents are identified and met. Medication procedures are in place and staff receive medication training. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four care plans of residents were examined as part of the case tracking process. Case tracking, feedback and discussion with the residents confirmed good practice is maintained in the home. Each care plan contains relevant details relating to the residents health needs and social well being. Information was up to date and easily accessible. There was evidence to demonstrate residents sign monthly reviews. This practice demonstrates the residents are involved in the planning and changes in their care. Individual risk assessments held on care files support residents to maintain independence where possible and ensures they are safe within their environment. A Woodlands House DS0000014852.V347220.R01.S.doc Version 5.2 Page 11 In relation to health and personal care needs, observation and feedback from residents and relatives reflected that individuals are treated with respect by staff, and their privacy and dignity is upheld. Staff receive specialist training in respect of dementia, challenging behaviour, incontinence, pressure sore prevention and infection control. Alongside completing a full mandatory training programme. This training provides staff with the skills and knowledge base to respond appropriately to resident’s health care needs. Other specialist needs such as mental health issues are referred to communitybased professionals via the GP’s. Correspondence held in individual files supported this. A Chiropodist visits the home on a six weekly basis. The residents seen during the visit were very tidy in appearance wearing appropriate clothing with their nails and hair well groomed. Most residents were alert and cheerful. Staff were observed communicating with them in a caring and respectful manner. One resident said ‘We are looked after very well.’ Another said ‘ all the staff are very kind, they can’t do enough for us’. Staff receive medication training in house. The matron, who is a trained nurse, audits the homes medicines and records on a daily basis. The home has an up to date policy, procedure and code of practice relating to dispensing medication. Medication charts and storage of medicines within the home was examined. On the whole, records were in good order, demonstrating staff follow appropriate procedures. A Woodlands House DS0000014852.V347220.R01.S.doc Version 5.2 Page 12 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): Quality in this outcome area is good. A range of activities is offered within the home. The meals are nutritionally balanced and varied according to dietary requirements and preference. Residents are treated with dignity and respect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Resident’s visitors are welcomed to the home and feedback from residents confirmed that contact with family and friends are encouraged. A visitor’s policy is in place to support this. The home employs a part time activities co-ordinator. Activities are organised at the home on a regular basis, offering stimulation to those residents who are less able to explore interests outside the home. The home organises hand and feet massages for the residents. Local walks and organised outings. Staff escort residents to community events and appointments as required. A Woodlands House DS0000014852.V347220.R01.S.doc Version 5.2 Page 13 The menu offered at Woodlands offers a wide range of balanced, home cooked food. The cook takes in to account the preferences of residents and specialist dietary needs. This promotes choice for the residents and provides an opportunity for them to eat what they prefer. One resident stated ‘the food is really delicious and portions are very generous’. Another said ‘if we don’t like what they serve we can always have something else’ Staff were observed knocking on rooms before entering and those seen speaking to residents demonstrated relaxed but respectful interactions. Resident’s feedback about the staff confirmed this. A Woodlands House DS0000014852.V347220.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good. The home has provided residents and their families with information in respect of complaints. Staff receive adult protection training to ensure they can respond appropriately, should an issue of suspected abuse arise. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints procedure included in the Statement of Purpose and Service Users Guide. Residents spoken with said they knew who to complain and felt confident to do so to should the need ever arise. Annual questionnaires are distributed to encourage residents and their families to comment on the standard of service at Woodlands. The Commission has received no complaints about the home since the previous inspection. The home holds a complaints log and no entries had been made since the last inspection. All staff have undertaken a full induction and Adult Protection training to ensure they respond appropriately to suspected abuse in the home. A copy of the West Sussex County Council Multi Disciplinary Adult protection Policy is kept in the office for reference. A Woodlands House DS0000014852.V347220.R01.S.doc Version 5.2 Page 15 Staff files seen demonstrate the procedures for the recruitment of staff are robust and provide the necessary safeguards to offer protection to the residents living in the home. All care staff have undertaken a Criminal Records Bureau enhanced check to ensure they are suitable to work with vulnerable people. Staff stated they felt the management at the home was ‘supportive and approachable’ if there was an issue of concern they needed to discuss. A Woodlands House DS0000014852.V347220.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): Quality in this outcome area is good. The communal areas of the home and residents bedrooms were clean and homely providing the residents with a pleasant living environment. Specialist equipment is provided to maximise the independence of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home maintains a clean and well presented environment for its residents. A part time cleaner attends the home 5 times a week to ensure all residents rooms and communal areas are kept clean and tidy. Policies and procedures including infection control and fire safety are regularly reinforced by formal training and staff meetings. This is supported by the homes policies and procedures. A Woodlands House DS0000014852.V347220.R01.S.doc Version 5.2 Page 17 Specialist equipment, including a passenger lift, is provided throughout the home to maximise the independence of residents. A decorating and maintenance programme is planned to commence at the end of January 2008. The upstairs bathroom will be completely refurbished and all residents bedrooms on the second floor are to be decorated. A call bell system is available throughout the home to ensure residents can contact staff quickly should the need arise. Each bedroom is individually personalised by resident, their family or staff giving residents a sense of ownership of their environment. Bedrooms seen are homely and comfortable. Locks on bedroom doors are provided when appropriate and risk assessed. Environmental risks are assessed for each resident prior to arrival and this is reviewed on an on-going basis. Residents have access to various communal/seating areas. Chairs and tables are available for visiting in bedrooms as well as tea or meals if the residents prefer to eat alone. Laundry facilities are maintained regularly and correct procedures for washing are reinforced through induction and training. A Woodlands House DS0000014852.V347220.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): Quality in this outcome area is good. The staff numbers are sufficient to meet the assessed needs of residents. An induction and training programme for staff is provided, to ensure resident’s needs are met in full. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Recruitment policies and procedures are in place, to ensure staff employed by the home have the necessary skills and experience to fulfil their roles. CRB checks, terms and conditions and references were seen on file for staff members. This ensures that residents are protected in the home. It was concluded from examining the duty rotas, speaking to staff and residents and information accessed in individual files, that staffing levels are sufficient to meet assessed needs of residents. Records show that staff complete a induction prior to working with the residents, then go on to undertake a comprehensive training programme specific to the needs of residents. In addition, the required ratio for 50 of staff to complete NVQ Level 2/3 or equivalent by 2005 has been met. This ensures residents will have their needs appropriately met by staff within the home. A Woodlands House DS0000014852.V347220.R01.S.doc Version 5.2 Page 19 Staff members spoken to, demonstrated commitment and a clear understanding of the resident’s needs. The majority of the staff are qualified health care workers from abroad and have a range of relevant skills. The staffing records showed that the staff group are fairly consistent and some have worked at the home since it first opened in 1990. Records showed that staff meetings occur on a regular basis to ensure staff have a clear understanding of their role and responsibilities. The manager is on duty most days; in her absence a senior takes charge of the day-to-day running of the home. A Woodlands House DS0000014852.V347220.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): Quality in this outcome area is good. Resident’s benefit from a well run home and are safe guarded by the homes policies, procedures and record keeping. The management of the home is competent and committed to the best interests and welfare of the people who live and work there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An annual development plan and quality assurance system is in place, which includes contributions from residents and their families. Use of consultation with residents, staff and their families ensure those providing and receiving care have an input into how the home is run. It was recommended during the visit that the results of the questionnaires be collated and published for interested parties. A Woodlands House DS0000014852.V347220.R01.S.doc Version 5.2 Page 21 Feedback from a health professional linked to the home included ‘the home looks after the residents very well. I have no concerns about the staffs ability, they know what their doing here’ Regular staff meetings mean staff are kept up to date with changes and able to give their views about how the home is run. Records reflected supervision sessions for staff were being held and recorded. Although the manager stated she intends to devise a regular programme of supervision to ensure the sessions were consistent. Other areas of support for staff include annual appraisals, discussion at daily handovers and the hands on approach of management. ‘So we can be available at all times if the staff need us’ No resident is responsible for their finances due to their mental frailty; this is undertaken by a family member or solicitor acting on their behalf. All additional expenditure by residents is invoiced to appropriate parties by the home. Resident’s possessions and valuables are logged and signed for on their admission. The home has comprehensive policies and procedures in place in line with current legislation to safeguard the interests and rights of the residents and staff. The homes insurance is up to date and the last inspection report from the Commission was displayed in an area accessible to residents and parties involved in the home. All care records are kept in a locked office to maintain confidentiality. The inspector examined all health and safety records including fire checks, accident book, maintenance checks, water temperatures, regulation 37 reports and risk assessments. All were found to be up to date and in good order. Overall it was concluded the resident’s health and well being are priority within the home, appropriate record keeping and administrative systems support this. A Woodlands House DS0000014852.V347220.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 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 A Woodlands House DS0000014852.V347220.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations A Woodlands House DS0000014852.V347220.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 A Woodlands House DS0000014852.V347220.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. 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