Care Home: The Woodmill

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What the care home does well The Woodmill is managed well and managerial structures are clear giving people accountability for areas of work. Staff are supervised and communication about the needs of people living at the unit is effectively made available to staff. The environment is suitable for people`s assessed needs and the location is amenable for people progressing to more independent living. Staff are dedicated and knowledgeable about the roles they are employed to perform. Robust staff recruitment processes ensure that vulnerable people receive protection from employment of unsuitable staff. What the care home could do better: We have not made any statutory requirements as a result of this visit. 2 recommendations for good practice have been made. The first is in relation to maintaining confidentiality of personal information when records are stored. The second recommendation is concerned with capturing information about an applicant`s suitability to work with vulnerable people via an employee or personal reference. We have made some suggestions to the service as part of useful discussions with the management on how to improve further other processes. Detail of this was included in the body of this report. Random inspection report Care homes for adults (18-65 years) Name: Address: The Woodmill Exeter Road Cullompton Devon EX15 1EA 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: Judith McGregor-Harper Date: 1 0 0 5 2 0 1 0 Information about the care home Name of care home: Address: The Woodmill Exeter Road Cullompton Devon EX15 1EA 01884836220 01884836229 the.woodmill@thedtgroup.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Mark Hunter Robson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Brain Injury Rehabilitation Trust care home 19 Number of places (if applicable): Under 65 Over 65 0 0 mental disorder, excluding learning disability or dementia physical disability Conditions of registration: 19 19 The maximum number of service users who can be accommodated is: 19. The registered person may provide the following category of service only: Care Home only (code PC), to service users of either gender whose primary care needs on admission to the home are within the following categories: Physical Disability (code PD), Mental Disorder, excluding learning disability or dementia (code MD). Date of last inspection Brief description of the care home The Woodmill is a single storey building, which was specially adapted in 1993, for the Brain Injury Rehabilitation Trust. It operates in conjunction with other residential Care Homes for Adults (18-65 years) Page 2 of 10 Brief description of the care home services and community services, to provide a continuum of services operated by the Brain Injury Rehabilitation Trust. There are 19 single bedrooms all with en-suite facilities. There is a conservatory lounge and an activity /TV Lounge, with another activity area with pool table and seats. There is also an art room. A physiotherapy room is available. There is a training kitchen with a high/low sink and a work skills area. Outside there are two landscaped patios, BBQ area and a gardening section. The current weekly charge is between 1480 to 2240 pounds per week. Additional charges are made for clothing, toiletries, telephone calls, gifts for family members, chiropody, taxis, individual hobbies or one-to-one care support. Care Homes for Adults (18-65 years) Page 3 of 10 What we found: This was an unannounced routine inspection. We reviewed the one requirement made at the last key inspection in 2007 and we focused the remainder of our inspection on records in relation to assessment and admission, on-going and changing care needs, risk assessment of the individual, medication management, staff recruitment, the homes environment, management and health and safety measures. Choice of home. We looked at assessment and care records of two people who had been admitted to The Woodmill since the last key inspection in 2007. One of the people whose records we examined had been admitted to the service within the preceding 7 days. Our inspection found there were comprehensive, detailed and full records assessing peoples needs prior to admission to the unit. There was also clear evidence of peoples changing needs being assessed and action of plans of care being adapted to ensure that current needs will be met. We asked some duty staff about peoples care needs and staff were knowledgeable about how to provide care in order to meet peoples needs. Prior to the inspection we sent surveys to 10 people who live at the service. We received 10 replies. 6 people told us that they were asked if they wanted to move into the service and that they received enough information about the service for them to make an informed decision about moving in to the unit. 3 people told us that they were not consulted about moving in and that they feel they did not receive enough information about the service before moving in. 1 person told us that they were not consulted about the decision to move in. This person did not tell us whether they received information abut the service. We discussed the Statement of Purpose with the registered manager and asked if the contents remained relevant. The manager said that the Statement of Purpose is an accurate reflection of services provided. Individual Needs and Choices By examining care records and in talking with duty staff we saw that there are good systems within the unit to ensure that peoples needs are regularly reassessed and monitored. Prior to the inspection we received survey returns from 9 staff who work at The Woodmill. Staff told us that generally they are kept up to date with changes made in care plans. We saw that staff maintain good daily records of care people receive and that handover sheets are prepared for staff shift changes. We questioned whether confidentiality could be maintained on the daily care summary, as it provided details of a personal nature for more than one person on each page. We recommend that the confidentiality of storing such information be further considered. Care Homes for Adults (18-65 years) Page 4 of 10 Lifestyle. Survey returns from people received prior to the inspection visit indicated that expected 1:1 care provision was not always available, and some people expressed frustration that this impacted upon the ability to access community activities at times. On the day of the inspection staffing levels were sufficient for the number and needs of people living at the unit. Survey returns from people living at the unit indicated that their opportunity for decision making is compromised, never, by living at the home. Personal and Healthcare Support. People living at the unit benefit from on-site multi-disciplinary clinical specialist support. This specialist support is coordinated and monitored at the unit. Prior to the inspection we sent 5 surveys to community based social and health professionals independent to the unit who provide visiting support to people living at The Woodmill. We received 4 replies. All 4 told us that they consider the unit to always properly monitor, review and meet peoples social and health care needs. 2 professionals did indicate that, in their opinion, momentum toward moving people into more independent living services had slowed. We inspected how medicines are managed at the service. We saw that systems are in pace to monitor completion of medication records and to ensure that peoples medicines are reviewed. Medicines were stored safely and securely. We saw that although cold storage of medicines was safe, staff had probably not been resetting the medicines fridge thermometer on a daily basis, as recommended. (The max/min daily fridge record always had the same max/min temperatures entered. 4 to 7 degrees Celsius). We reset the thermometer and established that the temperature inside the fridge was safe. We suggested that staff be reminded to re-set the thermometer after recording the daily temperature measurement and that a prompt of the normal range (plus 2 to plus 8 degrees Celsius) be entered onto the medicines fridge record pro-forma. Concerns, Complaints and Protection. Survey returns from people living at the service indicated that 8 out of 10 people knew how to make a complaint if they were unhappy with the service they receive. 2 people said that they did not know how to do this. The home has a book for raising concerns or complaints in the foyer of the unit. We examined some records of written complaints to the service since the last inspection. We saw that the service took concerns and complaints seriously and took appropriate action in order to resolve the complaint or areas of dispute. Staff we spoke with during the inspection gave us credible accounts of process to follow should they have concerns about the safety of people living at the service. All staff survey respondents (9) told us that they knew what to do if someone had concerns about the home. Environment. We conducted a tour of the environment. The unit was clean and provides good wide Care Homes for Adults (18-65 years) Page 5 of 10 spaces for wheelchair users, both indoor and outside in the unit grounds. Rooms were personalised and people were able to move freely around the unit to socialise with other people. There are plans to extend communal living space at the service by the addition of a conservatory. This will help in solving problem of storage space for wheelchair and lifting equipment. Staffing. Staff surveys received prior to the inspection told us that staff underwent preemployment checks before they started work at the unit. We examined staff recruitment records for 3 staff employed since the last inspection. We saw that appropriate checks were carried out prior to employment to ensure that people unsuitable for working with vulnerable adults did not gain a post at the home. These checks included exploring gaps in employment history at interview. We saw that 2 references were received prior to people starting work in the unit. We recommend that reference requests invite the referee to comment on the persons suitability for work with vulnerable people, as the reference form currently does not specifically request this information. Our surveys to staff asked if their induction covered everything they needed to know to do the job when they started. The surveys gives staff four possible answers, very well, mostly, partly and not at all. 3 staff said their induction covered this very well, 5 staff answered mostly and 1 person answered partly. This feedback may suggest that further exploration of induction content or timetabling may be worth pursuing by the home management. The induction for staff at the unit is comprehensive and lasts 6 months. Conduct and management of the home. The service is managed well and there are clear lines of accountability. We looked at accident and incident records and saw that reporting was appropriately logged. Incidents and accidents were monitored monthly by management with statistical analysis available for trends and patterns. We have been appropriately notified of significant events in the home via the required reporting process. The Annual Quality Assurance Assessment (AQAA) that was submitted to us prior to the inspection gave us the information we asked for and demonstrated that the service was able to take a self-critical approach to its business operations. We spent a morning at the unit on a site visit and reviewed other records outside of this time. The Woodmill continues to provide excellent outcomes for people living at the home. Care Homes for Adults (18-65 years) Page 6 of 10 What the care home does well: 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 7 of 10 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 8 of 10 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 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 10 It is recommended that the service review the suitability of the lay out of the daily care summary in relation to maintaining confidentiality of personal information. It is recommended that reference requests specifically solicit information regarding an applicants suitability of employment with vulnerable adults. 2 34 Care Homes for Adults (18-65 years) Page 9 of 10 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. 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