Care Home: Wood House

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What the care home does well "...staff are helpful and friendly and seem to want the best for those in their care..." "...our aim is to maintain high standards for the residents..." "...I am very happy here..." "...they look after me always..." These were comments received from a professional who visits the service, as staff member and two residents who live at Wood House. What has improved since the last inspection? At the last inspection there had been two areas where the service had to improve. The home has taken action on both of these areas, demonstrating positive developments to the service. Findings from this inspection indicate that the service continues to progress in a positive direction for the benefit of the residents, particularly through good leadership, training and a staff team that have a good understanding of their roles. CARE HOMES FOR OLDER PEOPLE Wood House 7 Laurel Close London SW17 0HA Lead Inspector Louise Phillips Key Unannounced Inspection 9:50am 1st October 2008 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 Wood House DS0000010240.V370570.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. Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wood House Address 7 Laurel Close London SW17 0HA 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) 020 8672 4332 020 8767 5966 juliuss@servitehouses.org.uk Servite Houses Mr Julius Wasiu Seid Care Home 34 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (6), Old age, of places not falling within any other category (34) Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th July 2006 Brief Description of the Service: Wood House is a care home managed by Servite Houses, registered to provide personal care and accommodation for up to 34 older people, six of who may have a mental disorder. The home is situated in a road behind Tooting High Street, within walking distance of Tooting Broadway shopping centre and the public transport links served by the area. The main accommodation at Wood House is on the first floor, accessed by a lift or stairs. The home is divided into four units (A, B, C and D), each with their own dining room/ lounge area, kitchenette, bathroom and toilet facilities. At the time of inspection the fees for the service were: - for privately funded residents - £750:00 per week - for residents funded by Wandsworth Local Authority - £500:14 per week Wood House DS0000010240.V370570.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 stars. This means the people who use this service experience good quality outcomes. This inspection took place over one day by one inspector. Time was spent talking to three staff, two residents and viewing paperwork. A tour of the premises was carried out and care records were inspected. Information has also been gained from the inspection record for the home and the Annual Quality Assurance Assessment (AQAA) that the manager completed. Surveys were received from 29 residents, 18 staff and 3 health and social care professionals involved with the service, and these are referred to in the report. What the service does well: What has improved since the last inspection? What they could do better: Areas where the home could be doing better are highlighted in the report and were discussed with the manager during the inspection. These include improvements to staff handling ad recording of medication, and issues identified in the environment. Please contact the provider for advice of actions taken in response to this Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 6 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. Wood House DS0000010240.V370570.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 Wood House DS0000010240.V370570.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): 3, 5 and 6 Quality in this outcome area is good. The residents are appropriately assessed prior to moving to the home, and they have the opportunity to visit the service to see if it the right place for them to move to. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Prior to moving to Wood House, prospective residents are appropriately assessed by the manager or assistant manager to ensure that the service is able to meet their needs. Initial referral information is obtained from the local authority, and from this the home carries out its own assessment. This information is then used to form the basis of the care plan for the resident during their move to the home. This covers a number of areas such as personal care needs, ‘essential routines’ that are individual to the resident, a summary of their ‘life history’, their likes, dislikes and what foods they enjoy eating. Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 9 As part of the assessment process potential residents and their relatives are invited to visit the home to meet staff and residents and look at the service provided. Residents move in for an initial trial period of six weeks. Prior to the end of the six weeks a review meeting is held between the resident, their relative, social worker and manager of the home to review their stay and for the resident to decide if they want to stay. One resident said that they chose to move to the service because they had previously visited a friend who lived at the home, and that the “…staff always seem so welcoming…”. Intermediate care is not provided by the home. Info re NOK, marital status, religion, ethnic origin ‘ Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Quality in this outcome area is good. The residents’ are positive about the care they receive, and care is planned around their needs. Some improvements are needed to ensure that medication at the service is handled and recorded appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The responses to the surveys provide a valuable insight into the experience of residents living at Wood House, along with the observations of health and social care professionals who visit the service and the staff who work there. Responses from residents indicate that they feel they generally get good care and support from the care staff, and that the staff usually listen to them and act upon what they say. Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 11 One resident did comment that they would “…like help with the small things as well as the big…”, where they added that they would like staff to spend more time with them, than just helping them with their personal care. Health and social professionals say that they believe the care is delivered with respect to the residents’ privacy and dignity. Feedback from staff highlights that they are very positive about their work, where they say that they feel they work well as a team to meet the individual needs of each resident. In addition, feedback from health and social care professionals involved with the service is that they feel the home contact them when necessary, and that staff seek and utilise the advice that they give. Residents say that they get medical support when they need it, and records are kept of all visits by professionals, such as the GP, social worker or community psychiatric nurse. The care plans for a number of residents were looked at during the inspection. All the staff that responded to the surveys said that the care plans are current and detailed, enabling them to support each resident with their care and support needs. Care staff say that the care plans are regularly updated and that any changes to residents care is communicated to all staff by the senior staff. The manager explained that the service is going through a process of changing the care plan formats to make them more person-centred and to include more detailed information about the preferences of each resident regarding their support needs. The manager said that staff are positive about this, though one did comment that the service could improve by “…sticking to one care plan long enough for staff to know what hey are doing…”. Findings form this inspection would indicate that the changes are necessary to create a more person-centred care environment, as the care plans looked at were still in the ‘older’ style. And whilst these are individualised, they are not person-centred and do not show the involvement of the resident (or their representative), in the development of these. Examples of this are for one person, their care plan to address personal care needs states ‘staff to assist (resident) with personal care’, and ‘staff to assist in applying cream as prescribed’. Similarly, for another resident, their care plan for ‘social activity and cultural needs says ‘staff to remind of any activity going on in home’. These do not contain any details about the residents particular likes/ dislikes, abilities, what they are able to do for themselves and specific areas needing support. Also, the care plan format is that all care plans are together on the same sheet of paper. Ideally each care plan need would be on a different sheet of paper to Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 12 allow for amendments to be made when being evaluated/ reviewed, and an overview to be established of changes in need. The medication was looked at for three people, and was seen to be generally managed appropriately. However, the MAR (medication administration record) charts do not all contain a photo of the resident, and some did not have the ‘allergies’ section on the chart completed. One of the residents administers their own eye-drops and prescribed cream to their body, yet their was no separate form to record ‘spot checks’ carried out by staff to ensure this is given. A carer working on the unit said that this is recorded in the residents’ daily notes. The care file was looked at for this resident, where a risk assessment (dated October 2007) for self-medicating was seen to have been carried out. However, the daily notes for the previous week were looked at, and all state ‘medication given’, with no further information about this, and no reference to a spot check having been carried out. This must be addressed to ensure that the resident’s health needs are appropriately monitored. Additionally, one resident commented that the staff “…don’t know about what medicines or tablets we take…”. The MAR chart for a resident indicates that they had received all their medication for the 7 days leading up to the inspection date, however it was observed that their medication was still in the blister pack. The MAR chart also showed that this resident had refused one liquid medication for the week that they had been living at the home, yet the daily notes in their care file states for each day, either ‘medication given’ or ‘took medication’. This must be addressed by the service. The findings indicate that there is an overall improved standard of record keeping in the daily notes in each resident’s file, providing better information about how each resident spends their day. However, in light of the findings above, care must be taken to ensure that these are accurate and reflect the actual situation regarding where medication has been refused or not given, and the actions taken as a result of this. Staff training records indicate that all staff have received training in medication administration, however the service must ensure that all staff are competent in handling medication and recording this appropriately. Staff should also have a good working knowledge of identifying and understanding the different types of medicines they administer to residents. Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. Residents have the opportunity to be involved in activities provided at the service. Improvements could be made to the meals provided, along with staff ensuring mealtimes are an enjoyable experience for all residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service does not have an activity co-ordinator in post, but the manager stated that they have been trying to recruit to this position. Activities are currently provided by the care staff and visiting entertainers to the home. Outings are arranged periodically throughout the year, where residents said that they have enjoyed trips to Brighton and Richmond Park this year. Some residents go to church every week, whilst others are visited at the home by a nun, and church services are held at different times throughout the year. On the notice boards throughout the home a ‘daily activity programme’ is displayed, detailing activities planned for the week, with pictures to reflect what is planned, for example, afternoon movie, ‘music and movement’, puzzles, ball game or a shopping in the high street. Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 14 The manager discussed that the home has registered with NAPA (National Association of Providers of Activities) to enable them to access relevant resources and plan appropriate activities. The ground floor lounge has recently been fitted with a new projector and screen so that residents can enjoy films on the bigger screen. The manager said that a grant provided by Wandsworth local authority was used to purchase this. Most residents said that there are usually or sometimes activities that they want to get involved in, whilst others said that they would like to have a newspaper that they can read each day Health and social care professionals involved with the service say that they feel they home usually provides support for residents to live the life they choose, however one commented that “…often staff cannot take residents out as they have too much to do…”, adding that “…they need to bring in more outside activities…the staff do not have the time or skills…”. One other professional said that the service could improve by: “…increasing staff, or have someone solely for activities…”, In the survey sent to residents, we asked if they like the meals provided at the home, and they are given the option of replying ‘always’, ‘usually’, ‘sometimes’ or ‘never’, with a space for them to add their comments. Of the 29 surveys received from residents, 13 said sometimes, 9 said usually, with 7 saying always. One comment received was: “…I don’t always like what I am given…I usually have to make do…”, whilst another said “…the food is lovely…”. Feedback from one staff member is that the service could provide much better meals, and they say this is because of the reaction of residents when they are given their meal, where they say, “…I do not think they really like most of their meals…”, another staff member said that they are “…not sure if the meals match the different cultures of our clients…”. This feedback demonstrates that this is an area of improvement that needs to be looked at by the service to ensure that all residents are at least usually happy with the food provided. During the inspection lunch was being served, which consisted of salmon, green beans, sweet corn and potatoes. Residents were seen eating this, and a number appears to be enjoying their meal, whilst others left some portions of food on their plate. On one unit, the lunch was seen to be served by bubbly staff that had a good rapport with the residents and were offering them a choice of the lunchtime food available. However, on one unit a carer was observed taking meal plates away from residents who were not eating. They did not ask them if they had finished, instead just replacing the plate with a bowl of pudding, with no choice given and no interaction with the resident at all. This does not promote a relaxed and enjoyable environment for residents to eat their meals in. Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. There are systems in place to respond to and record complaints, and staff have a good understanding of how to deal with concerns raised. Staff receive training in abuse awareness, which helps to minimise risks to residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has a complaints procedure that is provided in the Service Users Guide and Statement of Purpose, and is on display around the home. Feedback from residents is that most know how to make a complaint if there was something they were not happy about, though some did not know how to do this. Survey responses from staff demonstrated that they have a very good awareness of how to deal with a concern should someone approach them, where comments received include: “…I deal with concerns within my role, other concerns I pass onto an appropriate staff member – senior carer, assistant manager or manager…” “…ask them if they want to make a complaint if concerns can’t be resolved…” “…I inform them they can see the manager and show them the complaint form and details of how to make a complaint…” “…we always have complaints forms available which we can give out to people…” Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 16 This feedback is very positive and reflects that the service welcomes any areas of concern or complaint, and that these are dealt with by appropriate staff at the service. Professionals involved with the service said that they feel the service usually deals with areas of concern appropriately. There is a file held in the managers’ office specifically for the logging of complaints, along with records of actions taken and any correspondence relating to these. The service has received one complaint in the past twelve months. Training records indicate that the staff have received recent training in abuse awareness and safeguarding adults, so to minimise risks to residents. Training received from the local authority could not be evidenced through certificates, as they do not provide these, though the service keeps a record of the invitation to training for each staff member. One staff member said that the manager encourages them to report any suspicions of safeguarding issues immediately. Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. The environment is welcoming and relaxed. The staff help create a calm atmosphere throughout the home. The décor and furnishings are good in most areas, though some improvements are needed to make the home more comfortable for the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Wood House is bright and airy throughout and observed to be cleaned to a good standard in all areas. People living at the service say that the home is usually always fresh and clean. Developments to the environment since the last inspection include the installation of the projector screen in the ground floor lounge area and a small seating area outside for residents to enjoy. The rubbish bins outside the home have also been fenced in to make these less unsightly. An ‘audio-visual’ door Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 18 entry system has also been installed onto the main front door which is linked to a new CCTV system to improve security for residents, of people entering the home. A couple of areas were seen to need addressing to make the environment more pleasant for the residents: - the decor is starting to look a bit worn in places, particularly where skirting boards, walls and doors have had wallpaper or paint scraped away through wear. The manager said that this is something he has been looking at addressing - on the ground floor, the light on the wall at the bottom of the stairs is broken and in need of repair, the manager said he has been working on this issue - the ‘Scores on the doors’ report of the visit carried out in January 2008 identifies that the flooring needs to be repaired in kitchen, though this has not been carried out yet. Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. The organisation has an ongoing training programme that provides staff with the knowledge and skills to work with residents. Good recruitment procedures protect the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Wood House has a consistent staff team, some whom have worked at the home for a number of years, and who have a good understanding of the needs of the residents. The manager said that the service has a full complement of staff, but that they are always recruiting to their relief staff bank. Where we asked staff if they feel there are enough staff on duty, the responses were varied, with a couple saying ‘always’, though most saying ‘usually’. Staff said that this can be because some days there are a staff shortage, but that senior carers try and make up the shortfall. One staff member said that “…everyday is not the same with the residents so sometimes it is not easy to meet individual needs…”, whilst another suggested that the service could improve by “…having a ‘float’ staff to give a hand to the resident…”. Residents responded that there are sometimes/ usually staff available when they need them, though one did say that there are ‘never’ staff around. Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 20 Staffing levels need to be kept under review, and increased where necessary, to ensure that there are always sufficient staff on duty to meet the needs of the residents. Some staff also said that they are unhappy with the shift patterns, and that these need to be changed so that they do not work a late shift followed by an early shift. They said that in doing this they do not feel there is enough time between shifts to get a proper break, as the late shift finishes at 10pm and they have to be in work the next day at 7:30am. The home holds recruitment information on each member of staff. The staff files are well organised and contain relevant information such as proof of identification, correspondence relating to offer of job, evidence of Criminal Records Bureau (CRB) check, two references and record of the interview of staff. All staff confirmed that they did not start work at the home until after their CRB check had been received. Staff say that the training they receive gives them the confidence to meet the needs of the residents and promote their well-being. A lot of staff say that they feel there is good teamwork within the staff team, and that they support each other when needed. The healthcare professionals feedback that they feel the staff generally have the right skills and experience to meet residents needs, where one said “…generally staff are empathetic and understanding…”. Where asked what the service does well, one other professional said “…good in-service training…”. All new staff receive an induction to the service, which covers areas such as fire safety, health and safety and communication. Staff who responded to the survey say that they received a good induction that prepared them well for their work, and that involved shadowing other staff by working different shifts throughout the day. Servite Houses provide a comprehensive package of training courses that the manager can access and book staff on where a need is identified. Staff said that they get a lot of training that is relevant to their role and supports them in their work. One staff member who has worked at the home for three years said that they had attended 26 different training courses since they started. Comments received from some staff are: “…training is always available to staff and the manager always sends us on training that is going on…” “…the service provides training for all their staff to try to meet the needs of all the different residents…”, Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 21 “…the training has helped me understand and meet the needs of the residents individually…”, “…the company has given so much training that have improved my skills and knowledge…” Training records indicate that staff have received a lot of training, with recent training in moving and handling, first aid fire safety, mental health in later life, dementia care, basic food hygiene and infection control. Over 75 of staff achieved their NVQ level 2/ 3 in Care, with others working towards achieving this. As highlighted earlier in the report, the service could benefit from introducing a format to assess staff competence after a period following training that they have received, to ensure that they are still promoting good practice in these areas. Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38 Quality in this outcome area is good. There is a committed manager at the home who is progressing the service for the benefit of the residents. The home is well organised and run in the best interests of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: “…the manager is always available to discuss any issue with staff or offer support…” “…the home manager is supportive and he gives feedback to staff…” Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 23 These are comments received from some staff, regarding the manager of Wood House. Staff also say that there is good communication and that they are informed of relevant issues affecting the residents. Where asked what the service does well, the staff responded by saying that there is an open atmosphere and that it is run in a way that promotes the wellbeing of the residents. Two staff also commented that the service is good because: “…it works well in everything concerning the well-being of both the residents and staff…”, “…it is a good environment to work…staff are always nice and ready to assist…” “…there are regular staff meetings where we are kept up-to-date on various issues, and there is good team working amongst staff…”. Staff records also demonstrate that an annual appraisal and one-to-one supervision is carried out with the staff, and the staff say that they get good support from their line manager and senior staff at the service. The manager said that have meetings three times a year with other managers in Servite Houses, and that he receives good support from his line manager, who visits the service at least once a month. Quality assurance is carried out by the service through annual questionnaires sent to relatives for feedback on various aspects of the care, service, activities and accommodation. The manager said that responses received are used to look at the service and make changes to enhance the lives of the residents. Records of demonstrate that there are regular meetings held between the staff, managers and residents. The home holds a personal allowance for each resident that is funded by themselves or their family. This is held in separate envelopes for each resident that detail transactions carried out and the ongoing balance. Receipts are maintained for purchases made. These envelopes are kept in the safe at the service. A weekly check is carried out by two staff to ensure the balance on the envelope matches that the cash held. In September a financial audit was carried out, and a draft copy of the report was seen. The financial auditor assessed the system for managing residents’ funds as ‘good’. The service maintains records to demonstrate that appropriate health and safety checks are carried out on the fire system and equipment, electrical installation and gas safety. The electrical appliances were seen to have a recently dated PAT (Portable Appliance Testing) sticker on them, though there Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 24 was no report or certificate available for this. However, the manager show evidence that they have been trying to obtain the report for this. Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 25 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 X X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X 3 3 X 3 Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13(2) Requirement Accurate recording must be carried out regarding medication administration, and where this has not been given to ensure that the healthcare needs of residents are being monitored and acted upon. The Registered Persons must ensure that all staff, are assessed for their competence in handling medication and recording this appropriately. The home must be kept in a good state of repair to ensure the environment is safe and homely for the residents. Timescale for action 30/11/08 2. OP9 13(2) 31/01/09 3. OP19 23(2)(b) 31/03/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Wood House Refer to Good Practice Recommendations DS0000010240.V370570.R01.S.doc Version 5.2 Page 27 1. Standard OP9 Staff should have a good working knowledge of identifying and understanding the different types of medicines they administer to residents. The service should ensure that the meals provided are based on the individually assessed and recorded preferences and cultural needs of each resident. The service should ensure that mealtimes are an enjoyable and pleasant occasion, and that the residents are offered choice of what they would like to eat. The service should introduce a system of assessing staff competence after a period of approximately six months following any training received. 2. OP15 3. OP15 4. OP30 Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 28 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 Wood House DS0000010240.V370570.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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