Care Home: Woodcote

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What the care home does well The Registered Provider was helpful and insightful during the inspection. The home has received one complaint directly and this was discussed with the Registered Provider on the day of the inspection. Care plans were comprehensive and risk assessments were detailed. The home is a pleasant and well maintained environment in which to live. What has improved since the last inspection? The service has developed their policy on death and dying in the service, and is in the process of redecorating the upstairs bathroom. What the care home could do better: The management arrangements in the home are about to change. The Registered provider must ensure that the home has a Manager who is suitably qualified and applies for registration with the CQC. The Registered Provider should also ensure that the recruitment files of staff are available to view during an inspection. The Registered Provider should revisit and assess individually the practice of waking residents in the night to change incontinence pads Key inspection report Care homes for adults (18-65 years) Name: Address: Woodcote Five Ashes Mayfield East Sussex TN20 6JJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Alexis Reilly     Date: 1 3 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: Woodcote Five Ashes Mayfield East Sussex TN20 6JJ 01825830130 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: ridgewoodcareser@aol.com Ridgewood Care Services care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - LD Date of last inspection Brief description of the care home Woodcote is a care home, which provides personal care and accommodation for up to 6 younger adults with learning disabilities. It was opened in January 2007. The home is owned and run by Ridgewood Care Services who have a well-established sister home for learning disabilities in Uckfield, East Sussex. It is a detached property with accommodation on two floors. Accommodation is provided in 6 single bedrooms all of which have an ensuite facility, either a bath or a shower. There is a large lounge, spacious kitchen a dining room and a well-maintained, secure patio area and large gardens to the rear of the property. The home is well decorated Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 0 6 Brief description of the care home and maintained throughout and has a friendly and homely atmosphere. The home employs a Registered Manager, a deputy manager and a team of care staff, all of whom work a rota, which includes one person working at night on waking duty. A further senior staff member is available on call if needed. (At the time of writing this report the service did not have a Registered Manager in place). The home provides personal care and support to residents who are funded by Social Services. The homes minimum fees are £1200.00 per person per week. Additional costs are charged for hairdressing £6-8 some toiletries (£variable) and holidays (£variable). Prospective residents and their relatives are provided with written information regarding the services and facilities provided at the home prior to admission. A copy of the homes most recent inspection report is available on request from the home. Care Homes for Adults (18-65 years) Page 5 of 25 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The inspection began at 9.30am and lasted for three hours. The inspector saw the residents briefly in the morning and met two of the residents who were part of the case tracking. The inspector looked at the care that two service users received in the home, examining the care plans and the associated documents such as risk assessments and activity plans for these individuals. Other documents examined were copies of notifications, accidents and appointments and evidence of external reviews. The complaints procedure, dates of staff supervision and the plan for staff training were also seen as were a sample of the sheets which record the administration of medication, the duty rota and menus. The inspector spent time with the Registered Provider, and one senior carer. The inspector observed staff interacting in a positive manner with service users during the inspection. Care Homes for Adults (18-65 years) Page 6 of 25 During the inspection the inspector saw residents in the lounge and dining area. The inspector also saw the kitchen, bathroom and the two bedrooms of the service users case tracked. In the report the inspector has included comments from people met on the day of the inspection. Information was also taken from the AQAA which was filled in and returned by the due date. Care Homes for Adults (18-65 years) Page 7 of 25 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 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 Adults (18-65 years) Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 25 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. The Acting Manager has formulated a comprehensive assessment document which is used to ascertain a persons suitability for the service. Evidence was supporting to suggest that in the past comprehensive assessment documents such as learning disability assessments from the community and also CPA documentation have been obtained, therefore ensuring a persons suitability for the service. Evidence: The inspector looked at the care that two service users received in the home, examining the care plans and the associated documents such as risk assessments and activity plans for these individuals. The inspector saw residents briefly in the morning and met with two residents who were part of the case tracking. The inspector spent time with the Registered Provider, and one senior care team member. The inspector also observed staff interacting in a positive manner with service users during the inspection. The home has had one new admission since the last inspection. Comprehensive Care Homes for Adults (18-65 years) Page 10 of 25 Evidence: assessment documents were in place which are used to assess someone referred to the service. Also available to view was collated information with regard to other service users in the home, and their referring documents. This highlighted that the Acting Manager obtains background information and up to date CPA and learning disability assessments prior to offering a prospective resident a place in the home. Care Homes for Adults (18-65 years) Page 11 of 25 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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. Residents have care plans in place which are person centred and are clear documents to work from. Risk assessments are detailed and clear. Residents are able to make their own choices and decisions, and are treated as individuals. Contact with advocacy services is promoted. Evidence: The inspector looked at the care that two service users received in the home, examining the care plans and the associated documents such as risk assessments and activity plans for these individuals. The inspector saw residents briefly in the morning and spent time talking with two residents who were part of the case tracking. The inspector spent time with the Registered Provider, and one senior care team member. The inspector also observed staff interacting in a positive manner with service users during the inspection. Care plans are person centred clear and comprehensive documents to follow. Risk assessments are comprehensive and detailed, with guidance included specifically for Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: helping individuals deal with their behaviour. Referrals to psychology and other relevant services are made appropriately and speedily. Contact with advocacy services is promoted. Through out the documents the inspector saw recorded good examples of practice in relation to risk assessments and a person centred approach to the delivery of care. Care Homes for Adults (18-65 years) Page 13 of 25 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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. Residents do benefit from regular and planned activities. Residents benefit from freedoms and flexible routines, within a structured environment. Residents are consulted and listened to regarding the choice of daily activity. Menus are varied in the home. Evidence: The inspector looked at the care that two service users received in the home, examining the care plans and the associated documents such as risk assessments and activity plans for these individuals. The inspector saw residents briefly in the morning and spent time talking with two residents who were part of the case tracking. The inspector spent time with the Registered Provider, and one senior care team member. The inspector also observed staff interacting in a positive manner with service users during the inspection. Residents have a activity plan in place which is followed in the home. Residents are Care Homes for Adults (18-65 years) Page 14 of 25 Evidence: involved in a variety of activities such as college, swimming and accessing community resources such as evenings out at the local pub. Residents at the home are also involved in cook and taste sessions with staff and meal preparation. Meals in the home are varied. Care Homes for Adults (18-65 years) Page 15 of 25 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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. Residents benefit from a comprehensive plan of care and input from the community learning disability team. The Acting Manager has a good relationship with the general practice and residents health care needs are reviewed and referrals made were appropriate. The procedure for administering medication was found to be in good order Evidence: The inspector looked at the care that two service users received in the home, examining the care plans and the associated documents such as risk assessments and activity plans for these individuals. Other documents examined were copies of notifications, accidents and appointments, and evidence of external reviews. The inspector examined a sample of sheets which record the administration of medication. Medication records were found to be in good order, and these sheets had a photograph of each resident on them. The Acting Manager has a productive relationship with community professionals including social workers and psychologist and this result in all service users being referred appropriately and speedily as and when issues are raised. Through out the Care Homes for Adults (18-65 years) Page 16 of 25 Evidence: care plans and risk assessments there was evidence of good practice, staff are following guidelines and advice with regard to responses to individuals behaviour. No resident self medicates in the service currently. Care Homes for Adults (18-65 years) Page 17 of 25 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. The service records complaints and deals with these effectively; the |Acting Manager has notified the CQC and social services of all significant incidents in the home Evidence: As part of the inspection the inspector examined copies of notifications, and accidents and the record of complaints and the complaints procedure. The inspector spent time with the Registered Provider, and one senior care team member. The Acting Manager has notified the CQC of any significant incidents which have occurred in the home. The home has received one complaint directly, this was investigated by the Registered Provider and the CQC informed. The inspector found evidence throughout the inspection that any relevant issues are passed to the CLDT. The Acting Manager has ensured that any complaints and action taken are recorded and that complaints raised by service users are taken seriously and acted upon. All staff have completed their training in Safeguarding of Vulnerable Adults. Care Homes for Adults (18-65 years) Page 18 of 25 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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. Residents live in a bright and clean home with a large well maintained area of grounds. The Registered Provider has a maintenance schedule in place which is followed. Evidence: During the inspection the inspector saw residents in the lounge and dining area of the home. The inspector also saw the kitchens, bathroom and the two bedrooms of the service users case tracked. The garden is used and tended by the service users in the home and is a well maintained and attractive area. Bedrooms were personalized and well maintained. The service has a maintenance plan in place which is being followed. The kitchen doors are due to be refitted and the upstairs bathroom is currently being re tiled. The home is well maintained, and provides service users with a bright, clean and homely place in which to live. Care Homes for Adults (18-65 years) Page 19 of 25 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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. Staff interact well with residents and have a understanding of the needs through, training and knowledge. Staff are working with person centered care plan documentation and provide a person centered approach to the delivery of care. Evidence: The inspector was unable to view the recruitment files on the day of the inspection and the Registered Provider must ensure that in future all recruitment files are accessible to view. The Registered Provider received and investigated a complaint part of which was in relation to staffing levels in the home. The Registered Provider must ensure they keep under review staffing levels in the home in relation to the needs of the service users placed. Staff attend monthly meetings and supervision is monthly or bi monthly. Existing staff have already achieved NVQ level 2 in care. Members of staff were seen on the day of the inspection interacting positively with residents in an encouraging manner. Care Homes for Adults (18-65 years) Page 20 of 25 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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. The Acting Manager ensures that service users live in a home which is well managed and run in their best interests. However the Registered Provider must ensure that new management arrangements are in line with the national minimum standards and that an application for registration is submitted to the CQC. Residents live in a safe environment where they received person centered care. Evidence: The inspector looked at the care that two service users received in the home, examining the care plans and the associated documents such as risk assessments and activity plans for these individuals. Other documents examined were copies of notifications, accidents and appointments and evidence of external reviews. The complaints procedure, dates of staff supervision and the plan for staff training were also seen as were a sample of the sheets which record the administration of medication the duty rota and menus. The inspector spent time with the Registered Provider, and one senior care team member. The inspector also saw staff interacting in a positive manner with service users during the inspection. Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: The inspector was unable to view the recruitment files on the day of the inspection and the Registered Provider must ensure that in future all recruitment files are accessible to view. The Registered Provider was helpful during the inspection. The Acting Manager was none contactable on the day of the inspection. The management in the home is to shortly change and the Registered Provider must ensure that anyone appointed to manage the home is suitably qualified and submits an application for registration with the CQC. The home has a comprehensive quality assurance policy in place and they send out and collate information which is available to view. Comments from the quality assurance surveys included I am extremely pleased with everything about Xs home its the best place X has ever lived. Care Homes for Adults (18-65 years) Page 22 of 25 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 Adults (18-65 years) Page 23 of 25 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 37 9 A person shall not manage a 01/12/2009 care home unless he is fit to do so. In that any person acting as Manager of the home submits an application for registration to the CQC. 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 Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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. 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