Care Home: Windwood Lodge Care Home

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What the care home does well The service is small and flexible and is able to respond effectively to the needs of the people who use the service s. The home has very good staff retention and this reflects in the care being provided, as the staff are very aware of the people who use the service and their needs. The manager and staff are working with the people who use the service to enable them to retain a level of independence and to express their wishes and needs. All of the people who use the service have a comprehensive care plan together with any associated risk assessments. Some of the people who use the service require a high level of support in meeting some of their health needs and every effort has been made in ensuring their needs are being met by working closely with the psychiatrists and other health professionals. All of the people who use the service are encouraged to participate in daily activities within the home and leisure activities within the community. Contact with families is also seen as a priority and some people who use the service visit their families and go on holidays with them with support from staff. Both people who use the service and relatives were complimentary of the care being provided at Windwood Lodge. People who use the service comments were "I like living here", "the staff are good to me" "they look after us well". As far as possible all people who use the service are supported to contribute towards the daily running of the home, primarily through informal discussions and key worker sessions. There was evidence that the management and staff continue to provide for the diverse needs of people who use the service s, particularly in relation to their cultural, nutritional and religious needs. What has improved since the last inspection? There have been significant improvements since the last inspection and all of the previous Requirements have been met. Individual contract or statement of terms and conditions with the home are signed by all parties involved in the care of that individual. Each people who use the service has an individual care plan which reflects his/her personal goals and how these will be met by the home in consultation with the people who use the service and his/her representatives. Risk assessments are in place so that all staff are aware of how to deal with any situation that may arise. Suitable arrangements are in place for the recording, handling, safekeeping, safe administering and disposal of medicines received into the care home and staff have received updated medication training. Most staff have attended mental health awareness training in order to equip them to understand and meet the needs of the people they are caring for. Systems are in place to ensure there is routine monitoring of the service by providing a quality assurance and monitoring process to show the home`s success in achieving the aims, objectives and the Statement of Purpose of the home. This is being further developed to include seeking the views of other stakeholders. CARE HOME ADULTS 18-65 Windwood Lodge Care Home 47 Blake Hall Road Wanstead London E11 2QW Lead Inspector Ms Harina Morzeria Unannounced Inspection 15th May 2008 10:00 Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 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 Windwood Lodge Care Home DS0000067585.V364190.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 Adults 18-65. 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. Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Windwood Lodge Care Home Address 47 Blake Hall Road Wanstead London E11 2QW 020 8532 9463 020 8519 5520 liz.handley@btconnect.com 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) Forest Lodge Health Care Group Ltd Acting manager Dominica Noyoru Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Windwood Lodge Care Home DS0000067585.V364190.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 only - Code PC to people who use the service of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning disability - Code LD 2. The maximum number of people who use the service who can be accommodated is: 7 25th September 2007 Date of last inspection Brief Description of the Service: Windwood Lodge Care home is a residential care home for younger adults with learning disabilities providing personal care and support. It is also registered to provide services to individuals with learning disabilities who may have physical disabilities and/or associated mental disorder (dual diagnosis). People who use the service can be admitted for respite or long-term care needs. Care and support planning allows the people who use the service and support workers to develop individualised care plans reflecting both short and long-term goals enabling people who use the service to mix in the community independently. Individuals are continuously encouraged to take full control of their lives with one-to-one key working and regular reviews of their needs. People who use the service are enabled to participate in the community by being actively encouraged to join in organised activities in the home, as well as using public leisure facilities and make links with other education, health and social organisations that work with people with learning disabilities. The home is located in a quiet residential area in Wanstead with easy access to local amenities. The home is close to an underground station as well as bus routes. Windwood Lodge is a newly refurbished and specially adapted care home with six rooms and one self-contained flat. The home has been designed to provide a spacious environment which enables the people who use the service to maximise their independence as well as maintaining privacy. All rooms have en suite facilities which are accessible to all disabled users. A lift is also provided giving access to both levels of the house for the people who use the Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 5 service. The home has been fitted with all modern amenities and is a non-smoking environment. There is a specific quiet/sensory lounge with some sensory equipment, providing a relaxing environment for people who use the service when distressed or displaying raised emotions. There is a large landscaped garden to the back of the house as well as an activities room at the bottom of the garden intended to be used for the provision of day facilities. The fees range from £900 - £2,500 per week. A Statement of Purpose and Service User Guide are available to the people who use the service and their representatives. Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 6 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 was unannounced and was carried out as part of the inspection programme for 2008/09. The inspector spoke to the current manager and staff as well as people who use the service present at the time of the inspection. The inspector was informed that the manager who assisted with the inspection is transferring to manage a new service and the deputy manager has been appointed to manage at Windwood Lodge. The deputy manager was not present at the time of inspection and has yet to make an application to be registered with the Commission. A tour of the premises was undertaken and a number of records were checked including staff records and people who use the service s’ files. The manager was also asked to complete the Annual Quality Assurance Assessment. Some of the information provided in the assessment has been incorporated into this inspection report. As part of this inspection we looked at safeguarding issues to assess whether people living at the home feel safe. Care staff were asked about the care that people who use the service receive and were also observed carrying out their duties. Social care professionals were contacted and comments were “ the home is ace in terms of meeting her needs, there is a friendly atmosphere, the manager has a real good understanding of ---- needs, she is stimulated, staff have done relevant training in order to understand and meet her needs”. The advocate stated that the people who use the service she visits is “quite relaxed when I visit. However, he is quite independent and wants to be living elsewhere”. A tour of the home was undertaken and the rooms seen were clean and tidy. People who use the service s’ files were case tracked; including risk assessments and care plans, together with the examination of staff files and other home records. These included medication records, staff rotas, menus, accident/incident forms, staff recruitment procedures and health & safety records. Additional information relevant to this inspection has been gained from the Annual Quality Assurance Assessment and Regulation 37 notifications. The inspector had a discussion with the manager on the broad spectrum of equality & diversity issues and she was able to demonstrate an understanding of the varied needs of the service users around religion, sexuality, culture, disability and gender. Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? There have been significant improvements since the last inspection and all of the previous Requirements have been met. Individual contract or statement of terms and conditions with the home are signed by all parties involved in the care of that individual. Each people who use the service has an individual care plan which reflects his/her personal goals and how these will be met by the home in consultation with the people who use the service and his/her representatives. Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 8 Risk assessments are in place so that all staff are aware of how to deal with any situation that may arise. Suitable arrangements are in place for the recording, handling, safekeeping, safe administering and disposal of medicines received into the care home and staff have received updated medication training. Most staff have attended mental health awareness training in order to equip them to understand and meet the needs of the people they are caring for. Systems are in place to ensure there is routine monitoring of the service by providing a quality assurance and monitoring process to show the homes success in achieving the aims, objectives and the Statement of Purpose of the home. This is being further developed to include seeking the views of other stakeholders. 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. Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have information, which they could rely on in making a decision to live at Windwood Lodge. The process of assessment is robust so that people who use the service are assured that their needs would be thoroughly assessed and know that the home they enter will be able to meet their needs. People who use the service have a statement of terms and conditions/contract which details the obligations of the registered persons in meeting their needs. EVIDENCE: There were no new admissions to the home since the last visit. At the time of inspection all the rooms were occupied. As at the last inspection, prospective people who use the service have access to information through the home’s Statement of Purpose and the Service User Guide. The Service User Guide details what the prospective residents can expect and gives a clear account of the services provided, quality of the accomodation, qualifications and experience of the staff and how to make a complaint. It is in a format that is suitable to the people who use the service and provides an option for conversion to larger prints or alternative languages upon request. Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 11 The home has a comprehensive admission policy and procedure. The manager stated that all prospective people who use the service would be assessed prior to admission and that information would also be gathered from health and social care professionals as well as relatives and other significant people. This procedure was followed for the people who currently live in the home. The admission process would be designed around the needs of the prospective people who use the service . The prospective people who use the service are given the opportunity to make several visits to the home and overnight and weekend stays. This would enable the prospective people who use the service to meet the other people who use the service and to see whether they liked the home. This transition period would also allow staff to get to know the prospective people who use the service and to know whether they can meet their needs. All people who use the service except to have a signed contract setting out the obligations of the provider and the people who use the service and this included details of a trial stay. This document outlines the obligations of the registered provider as well some of the key rights of the people who use the service . People who use the service sign their statement of terms and conditions, along with the registered manager and their Local Authority representative, this confirms acceptance of the document by all parties. The manager has made several attempts for the Local Authority representative for one person to sign the contract of terms and conditions without success and evidence was seen that she is in the process of having this signed as soon as possible. Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 12 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each people who use the service has a care plan which is detailed and tailored to meet individual needs. People who use the service are consulted and involved in decisions affecting their lives and are reassured that information held on them is handled in line with the home’s policy on confidentiality. People who use the service are involved in negotiating their daily routines and objectives and are encouraged to live life to their full potential subject to a risk assessment. EVIDENCE: The manager and staff have ensured that the people who use the service are involved in all decisions about their lives. Detailed care plans were completed with the involvement of the people who use the service and their relatives/representatives (if appropriate). Staff understand the importance of people who use the service being supported to take control of their own lives. Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 13 The care plans are person centred and agreed with the individual. They cover in sufficient details all aspects of health and personal care needs, mobility as well as social, religious, cultural and recreational needs and goals are clearly identified. The likes and dislikes of people who use the service are also recorded. Staff have the skills and ability to support and encourage people who use the service to be involved in the ongoing development of their plan. A key worker system allows staff to work on a one to one basis and contribute to the care plan for the individual. All of the people who use the service s, to varying degrees are able to participate in activities within the home. Evidence was seen that the activities room is being regularly used by some of the people who use the service with the art therapist. They also assist with making cups of tea, dusting, hoovering, loading and unloading the dishwasher, putting the dishes away, making their beds and keeping their bedrooms tidy. This is to improve the daily living skills of individuals. People who use the service are also involved with menu planning and shopping trips. Some of the people who use the service are able to handle money and are encouraged by staff to spend their money responsibly. Records seen showed people who use the service s’ choice of meals and whether or not they participated in activities within the home and the community. The care plan is a working document which is reviewed regularly involving the people who use the service and their representatives, as appropriate. The files checked indicated that care plans are being reviewed monthly and six monthly or when a change in need is identified. However some monthly reviews were missing which the manager was made aware of. She stated that all key workers will be asked to undertake regular reviews of care plans and will be explained the importance of this. Care plans were examined alongside the daily records and compared with the support being given. The care staff know the people who use the service well and give a verbal handover. Each person who uses the service has their own daily log sheet, which is completed by the care staff. The daily logs are completed at the end of each shift; they were of a good standard and reflect the care that is being given and activities that have been undertaken. Staff were observed interacting with the people who use the service, their relationship was easy going, friendly and professional. Staff were seen to ask people who use the service what they wanted and gave them ample time to express their wishes. Each care plan includes a comprehensive risk assessment, which is reviewed regularly. The management of risk is positive in addressing safety issues while aiming for improved outcomes for people. People who use the service are encouraged to take reasonable risks and there were detailed risk assessments, guidelines and protocols in place. These cover areas such as, behaviour, hygiene, personal safety, financial issues and activities within the home and what action is needed to be taken. One people who use the service has a 1:1 Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 14 worker when accessing the community; which has proved to be successful. There was evidence that risk assessments have been regularly reviewed or when a change in a risk has been identified. There is a policy in place in the event of a person going missing from the home and staff are made aware of it. There are procedures in place to ensure that people using the service are informed of their rights to confidentiality. Individuals understand when staff may have to share personal information and can access advocacy services for support. One resident regularly meets an advocate. The inspector spoke to the advocate and a brief comment made by the person has been included in the summary section of this report. Service Users’ records and other information is stored in a lockable cabinet in the office and staff are aware of issues of confidentiality. Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 15 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Opportunities for social and leisure pursuits and personal development are actively promoted and supported by staff for all people who use the service to enable them to participate in the wider community in which they live. People who use the service are provided with varied and nutritional meals, staff promote healthy eating and individual preferences are catered for. Visitors are made to feel welcome in the home and people who use the service are supported to maintain and establish family links and friendships. EVIDENCE: The service has a strong commitment to enabling people who use the service to develop their skills including social, emotional, communication and independent living skills. People who use the service s’ care plans identify lifestyle choices, such as going to college, day centre, shopping, going to church, clubs , local leisure activities and visiting families. The daily log sheets record whether these activities have taken place and who has participated. All Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 16 of the people who use the service have opportunities for personal development and a varied activity programme, which takes into account their preferences and interests. People who use the service attend day centres and participate in meaningful daytime activities of their choice according to their individual interests and capability. Where appropriate, education and occupational opportunities are encouraged, supported and promoted. Two people who use the service go to a daycentre and one other person goes to college. People who use the service also enjoy a variety of activities within the community; such as swimming, trips to the local cinema, snooker and billiards at the local leisure centre, accessing library services and days out for example, to Greenwich for a boat trip. They also go out individually with their key workers for example, one person went to Brighton with his key worker for a day trip which he enjoyed. The people who use the service are planning for their annual holiday. One people who use the service enjoys going to an evening club organised by the Downshall club. As stated earlier in this report the people who use the service are fully involved with the day-to-day activities within the home. One to one activities take place as well as art therapy. People who use the service are encouraged and assisted to stay in contact with friends and relatives. Most of the people who use the service s’ family’s/representatives visit them (some more regularly than others). The staff at the home have worked closely with one people who use the service ’s mother encouraging her to visit him regularly and take him out for one to one time together. Feedback from relatives was that they receive a warm welcome from the staff when they visit. Visitors to the home stated that the staff are always welcoming and doing activities with them. One Chinese people who use the service was taken to a cultural event and a chinese meal to celebrate the Chinese New Year. People who use the service are involved with planning the weekly menus; these take into consideration people who use the service s’ likes and dislikes, as well as dietary and cultural requirements and alternative choices would be cooked if the people who use the service did not want the meals. Some of the people who use the service are involved in cooking the meals with staff. The staff encourage people who use the service to choose healthy options and encourage them to try new and sometimes unfamiliar food. The meals are balanced and nutritious and cater for the varying cultural and dietary needs of individuals including those requiring special diets e.g diabetic or food sensitivity. Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 17 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are prompted and encouraged to take responsibility for their own personal care. The people who use the service s’ physical and emotional health care needs are monitored and this ensures that people who use the service s’ needs are recognised and met. The medication policies and procedures are clear. Staff have undertaken medication training in order to ensure the safety of the people who use the service s. EVIDENCE: The care plans examined show that the physical and emotional needs of the people who use the service are identified and strategies were in place to provide support for each individual. People who use the service receive personal support in a way they prefer, with encouragement provided to enable them to carry out their own personal support tasks in a way that maintains their independence, privacy and dignity. Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 18 There was evidence that people who use the service s’ needs, based on assessments, were recorded and they were carried out to promote their health, safety and welfare. Records that were inspected showed that all of the people who use the services’ health care needs are being recorded in their personal health care plans. All people who use the service are supported to access dental care, opticians, chiropodist, psychiatrist, physiotherapist, psychologist and any out patient hospital appointments. Some staff have completed training in working with people with mental health issues and are able to observe changes in the general and specific healthcare needs of people who use the service and make interventions as appropriate to ensure their health and safety needs are met. Three staff are waiting to attend mental health training which has been arranged to take place in the next fortnight. Hence staff have specific mental health training which will enable them to recognise and deal with mental health breakdown. Two people who use the service have diabetes and they are supported by staff to attend regular monitoring at diabetic clinics. On the day of the inspection one people who use the service found out that her condition was not adequately under control meaning a radical change in her treatment plan. This was clearly upsetting for the people who use the service and staff were very supportive to her. Although staff have basic diabetes awareness they are are waiting to attend specific diabetes awareness training so that they are competently able to deliver the care required by people who use the service s. Records were maintained where people who use the service attended health related and professional appointments. People who use the service may see professionals privately in their rooms or in one of the offices at Windwood Lodge. The aims and objectives of the home reinforce the importance of treating individuals with respect and dignity. A medication policy and procedure are in place. Medication records are completed, contain required entries and are signed by appropriate staff. Only senior staff who have had medication administration training and are competent, administer medication. An assessment has been carried out to ensure each member of staff is competent to handle, record and administer medication properly. Medication issues raised at the previous inspection have now been addressed. One people who use the service is given support by staff to self medicate and an appropriate risk assessment is in place. Medication storage was satisfactory as was the recording of drugs administered by staff. Accurate records are kept of all medicines received, administered and leaving the home or disposed of in order to ensure that there is no mishandling. Evidence was seen that all staff received in house updated medication administration training since the last inspection. Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 19 Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 20 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager and staff make every effort to sort out any problems or concerns and make sure that the people who use the service feel confident that their complaints and concerns are listened to and will be acted upon. Staff working in the home have received training in safeguarding adults in order to ensure that there is a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has policies and procedures for dealing with complaints. The complaints log was examined and three complaints have been recorded since the last inspection. Evidence was seen that these were appropriately investigated with the outcomes recorded. The complaints procedure is that all complaints verbal and written, would be recorded with details of investigation, any action taken and the outcome reported to the complainant. The people who use the service know what to do if they were unhappy about anything in the home and said that they would speak to the manager or their key worker. The complaints policy is in a pictorial format and is displayed in each room and the corridors, with information about how to contact the Commission, if the complainant remains dissatisfied with the outcome of any investigation. There is a written policy and procedure for dealing with safeguarding and whistle blowing. As part of the inspection process the inspector concentrated on gathering evidence regarding safeguarding adults and asked specific Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 21 questions to staff to gather as much information as possible regarding the home’s procedure for dealing with safeguarding issues. The inspector also looked at the home’s safeguarding records, policies and procedures. Staff spoken to confirmed that as part of their induction and as part of their ongoing training, they are given training regarding safeguarding adults. The training provided includes discussions with the staff team about their duty to balance the rights and choices of people living in the home, with a legal duty to safeguard and protect people who use the service s. The policies and procedures for safeguarding adults are available to all staff and give clear specific guidance to them. Staff working in the service know what to do if a safeguarding issue is raised and when incidents need external input, who to refer the incident to. A copy of all the relevant Local Authority Adult Protection protocols is kept in the home for the guidance of staff. All staff working in the home have received training in safeguarding adults and staff were aware of the action to be taken if there were concerns about the welfare and safety of people who use the service in order to ensure that there is a correct response to any suspicion or allegation of abuse. There is a clear system for staff to report concerns about colleagues and managers and so staff are aware of the whistleblowing policy. One safeguarding adults referral was made which was appropriately handled by the manager following the home’s safeguarding adults policy and procedure. The home understands the procedures for safeguarding adults and will always attend meetings or provide information to external agencies when requested. The outcomes from any referral are well managed and issues resolved by implementing an appropriate action plan to avoid any recurrence. Training of staff in safeguarding is regularly arranged by the manager. Other training around dealing with physical and verbal aggression is also made available to staff. All staff understand what restraint is and alternatives to its use in any form are always looked for. Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 22 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable environment for people who use the service, with well-maintained communal spaces. The bedrooms are suited to individual tastes/preferences and promote their independence. The décor, furnishings and fittings in the home are of a good standard and the home is clean and hygienic. EVIDENCE: The home is purpose built and was opened in March 2005. The house is in keeping with the other properties on the street and a tour of the home showed that it has been furnished and specially adapted to meet the needs of people with special needs. A lift has also been installed to make all areas accessible to people in wheelchairs. Each people who use the service has a single bedroom that is suitable for Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 23 his or her needs. All of these have an en suite toilet, shower and washbasin. Bedrooms are personalised according to individuals’ likes and staff continuously work with people who use the service to personalise their rooms. All the people who use the service spoken to said they like their rooms and were comfortable and feel safe in them. However, the inspector is concerned that one person’s bedroom experiences ongoing problems regarding a defective radiator which means her room is not adequately heated. The inspector saw evidence that this matter is being dealt with and there is additional safe heating provided in this bedroom. A requirement has been made that this issue is resolved as soon as possible and the manager to notify the inspector when this work is completed. There is also a separate bathroom with an assisted bath and a separate toilet and shower and these are suitable to meet the people who use the service s’ needs. The shared areas provide a choice of communal space with opportunities to meet relatives and friends in private. There is a large landscaped garden at the back of the house which is enjoyed by the people who use the service during fine weather. One people who use the service has brought her pet rabbit with her and is helped by staff to care for him. There is a separate utility room with laundry facilities where people who use the service can do their laundry independently. The home is well lit, clean, tidy and smells fresh. Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 24 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35,36 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service receive care and support from a committed and motivated staff team. The staff team are receiving training that is appropriate to the needs of people who use the service s. Staffing levels are adequate to meet the individual needs of the people who use the service at all times. The procedures for the recruitment of staff are robust and provide safeguards for people living in the home. EVIDENCE: Staff observed and spoken to during the course of the inspection demonstrated good commitment to supporting each people who use the service in the home. They understood the needs of the people who use the service group and were skilled listeners and work well in motivating them. People who use the service spoken to said they were happy with the efforts of staff, stating that the carers listen and act on what they say. Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 25 All staff have achieved at least an NVQ level 2/3 in care. The staff team is mixed in terms of ethnicity and this provides a solid platform for meeting the diverse needs of the people who use the service group. Records assessed indicated that staff maintained positive relationships with professionals in the best interests of individual people who use the service. Staff members undertake external qualifications beyond the basic requirements. The manager encourages this and recognises the benefits of a skilled, trained workforce. All staff receive relevant training that is focused on delivering improved outcomes for people who use the service in a person centred way. Hence, feedback from staff confirms that they were provided with training that was specific to meet the needs of the people who use the service group they are looking after e.g. safeguarding adults, mental health awareness, epilepsy training, medication administration and a number of staff are enrolled to complete equality and diversity training, diabetese training as well as first aid. Hence, they have an understanding of people who use the service s’ health issues and can respond appropriately. The AQAA states that the manager seeks specialist in-put from an in-house Psychiatrist, C.P.N., art therapist, nutritionist and psychologist. Assistance from other specialists would be requested as needs are identified. Hence, the home have developed good links and relationships with other professionals and specialists. The staff group reflects the gender, age and culture of people who use the service s. There are consistently enough staff available to meet the needs of the people using the service, with more staff being available at peak times of activity and weekends. The staffing structure is based around delivering outcomes for people who use the service and is not led by staff requirements. Regular reviews of staffing levels take place to ensure they are being utilised to the optimum. There is a good recruitment procedure that clearly defines the process to be followed. This procedure is followed in practice with the home recognising the importance of effective recruitment procedures in the delivery of good quality services and for the protection of individuals. The files for two recently recruited staff were examined and these contained copies of two written references, CRB(Criminal Records Bureau) checks and POVA (Protection Of Vulnerable Adults) and UKCC registers. New staff are only confirmed in post following completion/receipt of these checks. One people who use the service at the present time participates in the recruitment process. She shows new staff around the house and is involved in the interview process and introductions to the rest of the people who use the service s. Some other people who use the service are also involved in this process and are encouraged to ask questions to the potential member of staff. Staff meetings take place regularly and are recorded and actioned. Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 26 Staff stated that they receive regular supervision and staff files checked confirmed this. Evidence was seen that supervision is planned in advance and staff find supevision helpful, with focus on improving outcomes for people using the service. Notes and action points are taken of the meetings and sessions and progress is regularly reviewed. Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 27 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41,42,43 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The acting manager is an experienced and qualified person. The home is run in a way which ensures that the people who use the service s’ best interests are safeguarded by the home’s record-keeping. Staff are aware of the lines of accountability and monitoring systems within the home are robust enough to ensure that the manager is fully appraised of any issues relating to the day-to-day running of the home and the specialist needs of the people who use the service s. Appropriate management arrangements are in place to ensure that a good quality of service is provided to people who use the service s. The health, safety and welfare of the people who use the service are promoted and protected by the systems in place which ensure that overall there is a safe environment for the people who use the service s. EVIDENCE: Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 28 The acting manager (who was the deputy manager) at the home, has completed NVQ Level 4 and RMA qualification and has also achieved a diploma in community mental health. She is competent to run the home and is in the process of applying to Commission’s Registration Team to register as a ‘fit’ person to manage the home. However, at the time of this current inspection the acting manager was not present but the previous manager assisted with the inspection. Evidence was seen that the manager leads and supports the staff in all areas of running the home. She is aware of current developments both nationally and by CSCI and plans the service accordingly. The AQAA contains clear, relevant information that is supported by a wide range of evidence. The AQAA lets us know about changes they have made and where they still need to make improvements. The manager is supported by the provider to run the home in the best interests of the people who use the service s. There is a strong focus in the home on equality and diversity issues and promoting human rights, especially in the areas of dignity, respect and fairness. The manager supports the staff team to work in a person centred way to meet the people who use the service s’ needs. The following feedback was received from staff, “the manager works hard and supports and guides us” “Manager is approachable, works as part of the team.” The manager promotes equal opportunities, has good people skills and understands the importance of person centred care and effective outcomes for people who use the service. There is a business and annual development plan in place. There is a quality assurance policy and procedure in place, which includes seeking the views of the people who use the service regularly via holding the people who use the service meetings and feedback questionnaires. The registered provider checks the quality of care in the home through monthly Regulation 26 monitoring visits and a written report on the conduct of the care home is prepared and made available to the CSCI upon request. The home works to a clear health and safety policy, all staff are fully aware of the policy and are trained to put theory in to practice. The home’s standardised policy and procedures file is available and staff are required to read and sign these on a regular basis. There is a clear organisational structure that is available to staff, people who use the service and their relatives. Checks show that the home’s records were found to be up to date and secure with confidential files stored in locked cabinets. People are supported to manage their own money where possible. Where this is not possible there is a clear reason why. Individuals have access to their records whenever they wish. Appropriate insurance cover is in place. Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 29 The manager has taken positive steps to ensure that people who use the service are safe and that their well-being is clearly recorded. She has worked closely with the Commission advising them of any significant events within the home, which could adversely affect the well-being or safety of any people who use the service . A range of records were looked at including fire safety. There was evidence that actions were taken to promote the health and safety of people who use the service and this included staff training in health and safety and individual training records reflect this, safety signage, fire drills and procedures, risk assessments on safe working practice topics, fire training for staff and the maintenance of updated gas and electrical certificates. COSHH risk assessments are carried out. Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 30 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 3 3 3 3 3 x Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 31 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 YA37 Regulation 8,9 Requirement The manager must apply to be registered as a “fit” person to manage the home by the CSCI. A valid application must be submitted to the Commission’s registration team. The defective radiator in a resident’s bedroom must be repaired and the inspector must be notified when this work is completed. Timescale for action 31/07/08 2 YA24 23 30/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Windwood Lodge Care Home DS0000067585.V364190.R01.S.doc Version 5.2 Page 33 - 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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