Care Home: Woodbury Court

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What the care home does well Prospective residents are provided with information about the home, which enables them or their relative to make an informed choice on whether the home will meet their needs. There is an admission process and all residents are visited before they come into Woodbury Court to ensure their care needs can be met. Care plans are completed around the care needs of the individual and include details on how the care is to be provided. The Manager has the experience and knowledge of managing residential homes. There are clear lines of accountability with Woodbury Court and also external management support. Care staff are friendly and work well as a team. Feedback from relatives included `I cannot fault Woodbury Court at all. The management, staff, cooks, admin and even the handyman are good - they are a credit to their profession`, `I would like to congratulate Dee and her staff for the way Woodbury Court is run` and `in my opinion this is a well managed and run home where the care of residents is their first priority`. What has improved since the last inspection? Only one requirement was made at the last inspection and this was regarding medication. It was established that since the last inspection regular weekly medication audits are now completed, to check for any anomalies. Although two signatures were found to be missing during this inspection, on discussion with the Manager these had already been identified as part of the medication audit and action had been taken. Other practice within the home around storage and distribution of medication was fine. What the care home could do better: Although documentation was available to show that training had been offered to staff and the home had a competent workforce, some staff needed updates on safeguarding training and infection control. Evidence on the day of the inspection showed that staff received informal support and advice, but this needs to be developed further to ensure they are supported in their role as a care worker and are competent. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Woodbury Court Tavistock Road Laindon Basildon Essex SS15 5QQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sharon Lacey     Date: 1 9 0 8 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: Woodbury Court Tavistock Road Laindon Basildon Essex SS15 5QQ 01268564230 01268564231 woodbury.court@runwoodhomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Runwood Homes Plc Name of registered manager (if applicable) Deenwattie Lal Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 94 The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia - Code DE Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Woodbury Court is a purpose built two-storey establishment, which accommodates 94 older people. The home has surrounding grassed areas, a secure patio area and a Care Homes for Older People Page 4 of 31 care home 94 Over 65 0 94 94 0 Brief description of the care home large car park. The 1st floor and part of the ground floor accommodates residents with dementia. Another unit on the ground floor accommodates residents over the age of 65 years, whose difficulties may be more physical. All bedrooms are single and have en suite facilities. Laindon town centre is situated near to the home. Woodbury Court has a Statement of Purpose and Service User Guide available. Information about the home and most recent inspection report are available to residents/visitors in the homes lobby area and in the visitors area of the home. The home charges between £550.00 and £600.00 a week for the service they provide. There are additional charges for chiropody, hairdressing, personal items and newspapers/magazines. This information was given to us in September 2009. Information about the home can be obtained by contacting the manager. Inspection reports are available from the home and from the CSCI website www.csci.org.uk Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating this service is two (2) stars. this means that people use this service experience good quality outcomes. This was a routine unannounced inspection, which took place over eight hours. The Key Standards were inspected, but also evidence was gained on some of the other National Minimum Standards. A tour of the home was completed and an inspection of relevant records and documentation took place. Areas looked at included information given to residents before being admitted to Woodbury Court, information gained when residents first come into the home, how information is provided to staff on the care required, the facilities and environment of the home and any complaints that may have been received since the last inspection. Also staffing and management of the home were Care Homes for Older People Page 6 of 31 inspected. An Annual Quality Assurance Assessment form was also completed and submitted as requested. This is a self assessment required by law and provides information on the National Minimum Standards and how the management of the home were ensuring these were met. This form had been well completed and contained in-depth information on the service and what planned improvements were in place for the next 12 months. During a tour of the home some of the residents were spoken with about their life and experiences at Woodbury Court. Some of the other residents approached were unable to express their thoughts and feelings, but were observed during the day interacting with staff. Most staff members were spoken with informally during the inspection and any feedback has been included as part of the report. Completed questionnaires were received from five residents and five relatives. Staff questionnaires were also distributed and seven were received back. At the end of the day the inspection was discussed with the manager and advice and guidance was given regarding the findings. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 31 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents will be provided with information about Woodbury Court and the services it can provide, but not all of it will be up to date. They can be sure that an assessment will take place to ensure their needs can be met. Evidence: There are detailed operational policies in place to help with the day-to-day running of the home. The certificate of registration could be found in the foyer and this was found to be correct. Copies of the last inspection were also in the foyer. The Service User Guide and Statement of Purpose were in the foyer. On viewing these documents it was found that some of the information was out of date and needed to be updated. It stated in the Service Users Guide that the home was inspected by the Care Quality Commission twice a year, but this practice changed last year. Also the CQC office details in both documents gave the contact details of the Colchester office, Care Homes for Older People Page 10 of 31 Evidence: but this had closed in January this year. The Manager confirmed that these documents are given when new service users view the home or when their assessment has been completed. Feedback from the resident questionnaires confirmed that they had received enough information about the home before they moved in. There is a thorough admission process and it was established that all new residents would be visited to ensure their care needs could be met. The Manager confirmed this would normally be done by a Care Team Manager or herself. The three files viewed contained a completed assessment form, which identified the individuals needs so that a plan of care could be written. The Manager advised that a contract would be given to all private residents, but those residents under a Social Services contract would have a separate document. Three residents files were viewed and all contained a copy of a Social Service Contract, which included details of thier room number. Four of the residents who returned questionniares confirmed they had received a contract when they first moved into Woodbury Court. The Service User Guide contained details of trial visits and also information on the review process and timescales. The Manager stated that not many new residents chose to have a trial visit, but added that most residents came in for respite care and then decided to come into the home permanently. The AQAA stated that training and support is provided to ensure staff perform and function at the level they are expected to. It was apparent from documentation seen that staff employed at Woodbury Court had received training, which was relevant to the care provided - but some staff required updates. Care Homes for Older People Page 11 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this 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 can be confident that they will receive the care they need. Evidence: Three residents files were viewed and all contained a care plan, which had been completed around the care needs of the individual residents. These had been reviewed on a monthly basis and contained a form, which had been signed by the resident or their family to confirm the content of the plan. All three files contained a moving and handling assessment and a Nortons scale pressure care form, which helped to identify any risks of pressure sores. There was also a copy of a night care plan, which included details on whether the person liked the lights on or off, which side they liked to sleep, whether they liked a night-time drink and general guidance to staff on each residents individual night-time routine. There were details in the Service User Guide on the medical care that residents can expect to receive whilst living at Woodbury Court. The three files viewed contained documentation which showed that residents had been supported in gaining access to a Care Homes for Older People Page 12 of 31 Evidence: variety of health care resources (GP, District Nurse, Hospital appointments etc). On the day of the Inspection an Optician was visiting the home and providing a number of residents with eye checks. The Manager confirmed that a rapid response nurse is allocated to the home to assist in the medical care needs of residents. She added that a physiotherapist also visits the home every Friday. It was confirmed that a Community Psychiatric Nurse liaises with the home on a regular basis and files viewed contained evidence of behavior charts that had been used with specific residents. The home also has a key worker system in place to try and assist in continuity of care. Residents who responded to the questionnaires confirmed they received the medical support they needed. There is a policy on the Administration of medicines, but this was not viewed during this inspection. Medication at the home is mainly managed through a monitored dosage system (blister packs). As part of the Inspection process the administration of the lunchtime medication was observed. The medication folder contained photos of the residents to assist staff in identification. Bottles of medication had been dated when they had been opened and the storage was good. It was established that management at the home now completed weekly medication audits. Whilst looking through medication records two anomalies were found. On discussion with the Manager these had already been identified as part of the medication audit and action had been taken. It was noted that the staff member did not wash their hands before assisting with medication and this was brought to the Managers attention. During the day, staff were observed respecting the residents dignity. Toilet doors were shut, residents are spoken to with respect and there was generally a good atmosphere within the home. All residents looked clean and tidy and many were waiting to have their hair done with the hairdresser. A staff member was observed assisting a resident to drink their tea and this was done with thought and ensuring the tea was the correct temperature for the resident. Staff were also observed knocking on doors before entering, closing doors to ensure residents privacy was respected and encouraging independence where possible. The Manager stated that they try to ensure residents are able to stay at home in familiar surroundings for as long as possible. The Manager confirmed that they receive support from the Palliative Care Nurse, who will also provide training to staff if needed. When viewing the three resident care plans, it was noted that there was a space for death and dying wishes to be recorded and all three of these had been completed. There was also a Bereavement Pack in the foyer of the home, which included details on what relatives may need to know and what they may need to do in connection to funerals. Care Homes for Older People Page 13 of 31 Evidence: Feedback from the residents on the care received at Woodbury Court, included the staff are very attentive, from day one the quality of care received has been first class. We have found the staff in all areas friendly and helpful and I am relieved in the knowledge that my Father is safe and looked after. One relative raised concerns about the oral hygiene of their relative and also the clothes they were sometimes dressed, which were sometimes inappropriate. They added that they were generally happy and they had found some of the staff very good and their relative appeared happy. Care Homes for Older People Page 14 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are a variety of activities that resdietns will be able to take part in and the food provided by the home is of a satisfactory quality. Visitors will be made welcomed. Evidence: Woodbury Court has two Activities Coordinators. A board is in the foyer of the home, which provides details of the activities for the day. It was noted that this was in large print, so it could be easily seen and also had pictures to help those residents with dementia. Activities for the day included reminiscence, hairdresser, snoozlem room, one-to-one is and games. Other activities organised at the home included hand massage, games hour, coffee morning, card games, singalongs, Pat dog, bingo and also visiting entertainment. Whilst touring the home there was evidence of arts and crafts on the wall of the different units, which have been done by the residents. There were also touch and feel boards around the corridors for those residents with dementia and to help aid stimulation. On the day of the inspection the Activities Coordinator had a large group of at least 20 residents in the courtyard and they were doing reminiscence. Feedback from one resident included I am happy with a home, we do games, cards and they have just started a knitting class. I have been here for four years and I have no complaints. Three of the residents who returned questionnaires Care Homes for Older People Page 15 of 31 Evidence: confirmed that activities are usually organised and one added they need to organise more stimulating activities - perhaps go out for little walks. The AQAA stated they are looking into arranging outings for their residents and looking at liaising with other care homes to access transport so they can take their residents out on day trips. The AQAA stated that relatives are allowed to visit at any time which is convenient to them. Details of visiting could be found in the Service User Guide, it stated this was between 9.00am and 21.00pm. It also stated in the Statement of Purpose that they encourage relatives to have meals with the residents, but there is a nominal charge. There were two rooms on the lower floor, which could be used for visiting and both appeared comfortable. There were also other quiet rooms around the home, which could be used when visitors arrived. There is a book in the foyer for visitors to sign when they arrive and leave. Visitors were noted to come and go throughout the day and staff made them very welcome. One relative who returned a questionnaire added they welcome families into the home. There was a daily menu displayed in the Foyer, which clearly showed the choice of meals for the day. On viewing the menu there was a good choice of food and it was noted that sandwiches were provided at teatime and cheese and biscuits at supper time. During the inspection staff were observed providing residents with snacks, biscuits and tea and coffee. When visiting the dining room downstairs it appeared a nice relaxed area and tables were set with salt, pepper, vinegar, napkins, glasses, place mats, bright tablecloths and flowers. Cranberry and orange juice were offered with lunch and some residents were noted to have chosen to have their meals in their rooms. Todays meal was roast potatoes, brussels, mixed vegetables, stuffing, savoury mince or chicken. Staff were observed offering each resident a choice of a meal. Feedback from residents included the food is nice, plenty of it and they are really nice they work hard, but not always appreciated. The home had completed a survey on the food in April 2009. Ten of the resident stated that the food tasted good and most (eight) stated that the food portion was enough, although some raised concerns about the heat of the food. Some feedback in the questionnaires regarding the food included would like more varied meals at tea time - sandwiches 6 days a week not impressed with the food provided and provide more traditional food. Some residents needed assistance to eat their meal. One carer spoken with raised concerns that there are often only two staff to feed five residents in the dining room and that meals are often left until they can get round to them. An observation of lunchtime meal was undertaken Tulip Lounge/diner. The dining room was very busy and there were 18 residents. Five residents needed assistance with feeding, and Care Homes for Older People Page 16 of 31 Evidence: sufficient staff had been made available. A male carer was observed encouraging a resident to eat and provided assistance when needed. It was pointed out that Tulip Lounge/diner was a very dependent lounge, so staff were under more stress. The Manager advised that she would assess staffing needs at meal times. The kitchen was visited and this was found to be clean and tidy. Stocks of food were viewed and there was meat, dry stocks, fresh fruit, vegetables and frozen produce. Woodbury Court was not overstocked with food, but it was explained that this was due to limited storage areas. Care Homes for Older People Page 17 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this 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 and relatives can be confident that any concerns or complaints will be listened to and acted upon. They can also be confident their systems in place to help them keep safe. Evidence: There is clear written guidance in the Service User Guide and Statement of Purpose on how relatives and residents can make complaints. It stated that these documents had last been reviewed in February 08 and December 08, but it was noted that the address in these documents needed to be updated to reflect the Newcastle CQC address and contact numbers. On viewing the complaints folder, this contained a set form to record any complaints received and included space to record any investigation and outcome. The AQAA submitted stated that 26 complaints had been received in the last 12 months and all had been resolved within the 28 day timespan. The complaints folder contained details of the complaints and how these had been investigated and whether a satisfactory outcome had been reached. The Manager stated that she oversees any complaints and these are also monitored by upper management. Most relatives and residents stated that they knew who to approach in the home to make a complaint, although a couple stated they did not. The home has policies and procedures for the safeguarding of vulnerable adults and the Manager is aware of the local authority guidelines. There was evidence that Care Homes for Older People Page 18 of 31 Evidence: safeguarding training had been provided to staff, but on viewing the training matrix it was apparent that at least nine staff still needed to be trained. A whistle blowing policy was available in the staff room and also guidance on the protection of vulnerable adults. Staff spoken with confirmed they had attended training on safeguarding adults and had a good understanding of the process. The AQAA stated that the Home had received three safeguarding referrals, but these have been fully investigated and a satisfactory outcome reached. Care Homes for Older People Page 19 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this 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 live in home that will meet their needs and is comfortable and well maintained. Evidence: Woodbury Court is a purpose-built home, which provides residents with a spacious and comfortable environment. It is a large detached property that has been built to meet the needs of older people. The environment and furnishings are set to a high specification. There are communal areas on each of the units, which consists of a dining and lounge area. Whilst touring the home there were pictures around the walls and in the corridors for residents to look at and help with orientation and stimulation. Woodbury Court has a smoking room downstairs, for those residents who may need this. Both in communal areas and also bedrooms there was appropriate furniture, which was in good condition. Radiators had been covered to help keep residents safe and there were sensors on the bathroom lights and toilet lights, which helped reduce electricity usage. The home had sufficient lighting. Residents were noted to use wheelchairs, walking frames and walking sticks and there was a rail around the corridors of the home, which could be used to steady residents. There is a call bell system and this was seen working on the day of the inspection. It was noted that doorways of in the home were wide enough for wheelchair users and there were also ramps available where needed. Care Homes for Older People Page 20 of 31 Evidence: The Service User Guide provided guidance to residents on what they could bring in with them, when they were first admitted. Each bedroom viewed contained personal belongings and appeared very homely with photographs and small ornaments etc. Residents bedroom doors had names and pictures to help residents with orientation. The grounds were well maintained, although it was noted that there are no grass areas and only a courtyard in the centre of the home for residents to use. The garden was in use on the day of the inspection and activities were provided outside. There were tables and chairs in the garden for residents to sit on and the grounds were assessable to wheelchair users. The home had recently introduced raised flower beds with the intention of residents growing and picking their own vegetables. The home is well maintained and the maintenance man had been voted the best maintenance person in 2008. The maintenance man discussed the program of routine maintenance and was painting one of the dining areas on the day of the inspection. There are sufficient bathing and toileting facilities within the home and each bedroom also has ensuite facilities. The bathroom downstairs was light and airy and had a large collage on the wall, which had been done by the residents. Residents could choose from having a bath or shower and appropriate equipment was made available. All bathrooms and toilets inspected had the use of paper towels, soap and liquid gel to assist in infection control in the home and there was guidance to staff on the correct procedures for hand washing. During a tour of the home it was noted that sluices on each of the units had been kept locked, to ensure residents safety. There were pedal bins in the bathrooms for clinical waste and bathroom waste. When looking at infection control training the Matrix showed that only nine staff had attended. Documentation was available to show that water temperatures were regularly checked to ensure resident safety. The water temperatures in two residents bedrooms were tested and one was found to be more than hand hot and took a while to regulate. This was brought to the Managers attention. The home is generally odour free, although it was found that a couple of residents bedrooms and one bathroom had a strong smell of urine. Three of the four residents who returned questionnaires stated the home was usually fresh and clean, but comments included hygiene in the dining room, sink area and cups could be better, my mothers room is not cleaned thoroughly enough, tables are not wiped regularly and the smell of urine is quiet bad at times. On speaking with one of the domestics, she advised that two domestics worked upstairs and two downstairs and every room was cleaned everyday. Care Homes for Older People Page 21 of 31 Evidence: On viewing the laundry room it was found to have a very good system. Both staff spoken with had been at the home for a number of years and confirmed that there were sufficient washing and drying facilities. There was an ironing machine to assist with any large objects. It was noted that the laundry staff needed something to fold washing on, as they were presently using a garden table. Both staff confirmed they had been offered training and that they met regularly with management and were supported. The only area of concern raised was with regard to residents clothing not always being named and often only having room numbers, which is unhelpful as residents sometimes move rooms. Care Homes for Older People Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this 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 can be confident that they will be cared for by competent and experienced staff. Evidence: The Manager confirmed that they have a full complement of staff at Woodbury Court and there are no vacancies. Staffing rotas were viewed and these contained details of the staff members name, job title, day, dates and times worked. It was noted that in the foyer of the home there was a signing in sheet, which staff signed when they arrived and when their shift started. It was confirmed that present staffing at Woodbury Court consisted of one Care Team Manager and seven carers on both floors in the morning and one Care Team Manager and six carers on both floors in the afternoon. At night time there are three carers on both floors. The Manager is supernumerary to the staffing numbers and there is also a receptionist, administrator, laundry staff, domestic staff, Cook, Cooks assistant, two activity coordinators and a maintenance man. When residents were asked whether staff were available when needed, all four stated usually. One added when the buzzer is pressed it takes a long while to get help. The Manager confirmed that any recruitment of staff from over seas would be completed by Head Office, but she has the responsibility of recruiting and interviewing Care Homes for Older People Page 23 of 31 Evidence: any other new staff. The files of two recently recruited staff were viewed and these showed that correct recruitment practices had been followed. Files contained three written references, proof of identity, full employment history, medical history, details of any criminal offences and Criminal record checks. One file also contained copies of certificates relating to relevant training and qualifications. Files inspected had copies of terms and conditions, and the Manager stated that these are given out at the start of the employment. Those staff who returned questionnaires confirmed that their employer carried out recruitment checks before they started working at Woodbury Court. The Manager confirmed that the induction was in line with Skills for Care guidance and all new staff complete this in the first 12 weeks and then proceeded to their NVQ two. Both files viewed contained documentation that showed they had received a local induction to the home. Those staff who returned questionnaires stated their their induction covered everything they needed to know to enable them to be a carer. The Manager provided a copy of a training matrix, which included details of staff and dates of when they had completed certain training. She added that some of the staff on the matrix had now left, so it did not provide an accurate reflection of the training within the home. The company have internal trainers who provide all training to staff and this is organised at different homes throughout the year. Training consists of moving and handling, health and safety, fire, medication, safeguarding adults, dementia, first aid, infection control, care plans and food hygiene. From looking at the staffing matrix for training it was apparent that some staff needed updates in moving and handling training. There was a training board in the foyer with details of a health and safety course and vulnerable adult course, which were to take place at the end of August. Those staff spoken with during the inspection confirmed they had been offered regular training. Staff who returned questionnaires confirmed that they are offered training, which is relevant to their role as a carer. One staff member spoken with stated they had been given training, which included NVQ two and food hygiene and they also attend updates every year. On discussion with the Manager she advised that 34 staff had now completed their NVQ 2 and three their NVQ 3. The Manager stated that staff are encouraged to do the NVQ two after completing their induction, it was confirmed that a different company provide NVQ training, but the manager has an assessor qualification which has been used in the past. Care Homes for Older People Page 24 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this 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 live in a home that is run and managed efficiently and effectively. Evidence: Woodbury Court has a Manager who has 25 year experience in nursing and care and has completed her Registered Managers Award and A1 NVQ assessors course. Other courses that she has completed to keep her knowledge updated includes dementia awareness, psychiatric nursing, psychology, supervision of nurses, management of aggression, and management of difficult people. There were clear lines of accountability within the home and the Manager confirms that she also receives support from upper management within the company. On discussion with the Manager she was aware of her responsibilities under the Care Home Regulations and National Minimum Standards. Staff and residents spoken with during the inspection reported that the Manager was approachable and offered regular support. One staff member spoken with added that Care Homes for Older People Page 25 of 31 Evidence: they were happy with the Manager and found her very supportive. It was noted whilst looking through the compliment folder that many members of staff had received a number of compliments in connection to their approach and care provided to the individual residents. Feedback from the staff questionnaires included I have found the home to be very well organised and the residents needs met, The Manager is good at communicating with the staff, good management and good administration, I think communication among the staff needs to improve in order to work better as a team. This would help to improve most things about the service. It was noted that there is a staff surgery held every week and this is advertised in the Foyer and staff room. Documentation seen showed that staff meetings had been held with different members of staff. On viewing the staffing matrix for supervision it was apparent that staff had received some form of supervision, but this varied from being seen once to five times since January 09. This was discussed with the Manager and it was agreed this was an area that needed to be developed further. Woodbury Court has systems in place to monitor the quality of the service it provides. Residents and relatives views are gained through sending out questionnaires and there is also a suggestion box in the foyer for comments. An internal quality report is also completed, which is quiet comprehensive and highlights any areas the home needs to improve on. The Manager confirmed that Regulation 26 reports are also completed every month by a senior member of the management team. Residents meetings had also occurred and minutes of the meetings were made available. Details the quality assurance process at the home could be found in the Service Users Guide. The Manager confirmed that there are systems in place for those residents who require assistance with their finances, but some do have assistance from family members. Three residents finances were checked and found to be in order. Earlier in the year there was a safeguarding referral in connection to possible mismanagement of a residents finances, but this was investigated and appropriate action taken. Records were well organised and systems had been put in place to enable the Manager to provide the evidence to show that the National Minimum Standards and Regulations had been met. Checks had been made on the fire extinguishers, fire drills had been organised and documentation seen showed that weekly fire alarm checks had been completed. Regular checks had been carried out on the gas safety certificate, electricity, PAT testing, water temperatures and the lift. The certificate of insurance was viewed and this was valid until 19 August 2009 (which was the date of the inspection). It was confirmed that they were waiting for the new one to be sent out. There was a health Care Homes for Older People Page 26 of 31 Evidence: and safety poster in the staff room, which had been completed. Care Homes for Older People Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 18 13 Training must be provided to 01/12/2009 all staff on safeguarding adults to help prevent residents being harmed or suffering any form of abuse. Training must be provided to staff to ensure they are aware of the safeguarding process and can identify forms of abuse and keep residents safe. 2 26 13 Training and systems must be in place to ensure the prevention of infection. Suitable arrangements and training must be in place to prevent the spread of inspection within the home. 01/01/2010 3 36 18 Staff working at the home must be appropriately supervised. This is to ensure staff are supported in their role as a care worker and are competent. 01/11/2009 Care Homes for Older People Page 29 of 31 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 The information in the Service User Guide and Statement of Purpose needs to be updated to include the new details of the CQC office in Newcastle. It presently states in the Service User Guide that the home is inspected by CQC twice a year. This needs to be changed to reflect the correct practice. Ensure staff assisting with medication are aware of good practice with regard to hand washing. Ensure that the complaints information in the Service User Guide and Statement of Purpose has the correct address and phone number of the Care Quality Commission. It is recommended some form of surface is introduced to the laundry room to assist staff when folding clothing/laundry. It is recommended that staff are supervised at least 6 times a year. 2 1 3 4 9 16 5 26 6 36 Care Homes for Older People Page 30 of 31 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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