Care Home: Woodcross Mental Nursing Home (Highfields)

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What the care home does well The home is pleasantly decorated and does offer a comfortable place for people to live. People are encouraged to take part in activities and to stay active. The home has a dedicated activity coordinator that organises events for people to enjoy. We were told "I love the parties we have here". Those people who are able to do so, are supported with daily living skills such as cooking and doing their own laundry. We were told "the home is always clean and tidy". There are sufficient staff on duty to meet the needs of the people living in the home. People told us "this is the best home, the staff are very good". What has improved since the last inspection? The home has made improvements to the care planning systems in place. People`s need are clearly recorded in their care plans. It is evident that people are included in this process. Medication systems have been improved, there are care plans in place for the use of "as required, PRN" medication. This will mean that nursing staff will be very clear about the circumstances for administration and prevent the over use of such medication. Recruitment procedures have been improved upon. The home is now making sure that people are recruited in a manner that prevents unsuitable people from working with vulnerable adults. What the care home could do better: We have made no requirements as a result of this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: Woodcross Mental Nursing Home (Highfields) 23 Reeves Street Bloxwich Walsall West Midlands WS3 2DQ     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: Mandy Beck     Date: 2 9 1 0 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 27 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 27 Information about the care home Name of care home: Address: Woodcross Mental Nursing Home (Highfields) 23 Reeves Street Bloxwich Walsall West Midlands WS3 2DQ 01922497394 01922497395 woodcross@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Southern Cross Healthcare Centres Limited care home 44 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 44 The registered person may provide the following category of service only: Care Home with Nursing (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia (MD) 44 Date of last inspection Brief description of the care home Woodcross Nursing Home is registered to accommodate 44 adults with enduring mental health issues and associated conditions. A small number of people have a physical disability, although this is not their primary need. The home is a purpose built two-storey building. On the ground floor there are three lounge areas, one being a smoking room. There is a large dining area with a serving hatch to the kitchen. The home has toilets and bathrooms situated throughout. There are two sluice areas and professional laundry facilities. The home has single and shared bedrooms, none of Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 44 2 0 1 0 2 0 0 8 Brief description of the care home which have en-suite facilities. There is an enclosed garden at the side of the home, with a patio ara and barbeque facilities. The home has a minibus for use by people who use the service. The home is located near the centre of Bloxwich with local bus services, shops and other amenities close by. The Service User Guide did not reflect information relating to the fees in the home as required. The reader may wish to approach the care provider for up to date details of the fees payable. Care Homes for Adults (18-65 years) Page 5 of 27 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: This was an unannounced visit to the home, they were given no prior notice. One inspector completed this inspection over a period of one day. We looked at all the information that we have received, or asked for, since the last key inspection. This included, The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Information we have about how the service has managed any complaints. Care Homes for Adults (18-65 years) Page 6 of 27 What the service has told us about this that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. Relevant information from other organisations. We also spent time talking to the people who use the service and to the staff who support them. We looked at the care of four people who use this service in depth. This is part of our case tracking process and helps us make judgements about the homes abilities to meet peoples needs. Care Homes for Adults (18-65 years) Page 7 of 27 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 27 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 27 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. People can be assured their needs will be assessed in full prior to their admission. People can expect to be fully involved in this process. Evidence: We looked at the care of two people in depth as part of our case tracking process. When we looked at the assessment details we found the homes own assessment had been completed in full. The home also takes steps to obtain copies of the care managers assessment and the Care Programme Approach (CPA) documentation. The information in these sets of documents did provide enough information for staff to be able to plan care with people. People who answered our surveys told us they had been given enough information about the home prior to their admission and that they had been consulted about their needs. Care Homes for Adults (18-65 years) Page 10 of 27 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. People using this service can expect to be included in planning their own care and the service will manage risks to people appropriately. Evidence: Since our last inspection the home has maintained its approach to care planning and managing risk for people. We saw that care plans and risk assessments were more person centred in their approach and did give an overall picture of peoples needs. People we spoke to said they were involved in the planning of their own care and felt that the staff supported them when they needed it. They told us I am happy for the staff to look after me, they know when I am not well because sometimes I dont know this. We saw risk assessments in place for reducing the risk of falls, pressure sore development, malnutrition and road safety. There were also risk assessments from the Care Programme Approach that manages peoples specific risks associated with their mental health problems. These risk assessments were detailed and included any Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: limitations placed upon the person as a result of this. Care Homes for Adults (18-65 years) Page 12 of 27 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. People using this service will be encouraged to take part in activities and to lead an active life. Evidence: People are supported by the home to lead active and independent lives. At this time there are no people living at the home attending college or further education. The home has told us that it would support people to do this should they choose to do so. We spoke to people about how they felt the home supported them they told us they felt staff understood their needs and helped them with activity. People told us they were particularly fond of the parties and the close encounters of the furry kind. This activity gave people the chance to see animals such as meerkats, mountain cats and a kookaburra bird. One person said it was great, the home also had photographs of this event and it was evident people had enjoyed it. Another person said the parties Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: are fantastic, I love the Halloween one the best, they helped me make my costume, its great isnt it. Other people said that they had the choice about participation in activity but preferred to stay in their room. People also told us they enjoyed the line dancing that takes place once a week. At the time of this inspection the home had been decorated for Halloween and people were planning a Halloween party. People can choose where they want to eat their meals, the majority of people choose to have their meals in the dining room. People told us the food is good and there is alot of choice. Food is freshly prepared on the premises and the home is able to meet specialist dietary requirements when necessary. People who answered our surveys told us the food is very good and tasty, we have plenty of choice, if you dont like it they always make you something else. Care Homes for Adults (18-65 years) Page 14 of 27 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. Peoples health care needs will be met and medication is managed safely. Evidence: There are appropriate arrangements in place to ensure that people have the health and personal care that they need. We saw evidence that people are seen by other professionals such as psychiatrists, community mental health nurses, doctors, chiropodists, dentists and opticians depending on their needs. We were also able to see that staff support people to take responsibility for their health care needs such as hospital appointments and collecting and ordering medication. There are support plans in place to manage specific health care needs for some people. We did look at one care plan and moving and handling risk assessment for one person. It was evident that staff have problems at times managing the persons needs in relation to movement in bed and transfer to and from the bed. The staff have identified that a profiling bed may offer better protection and be more suitable for the person. This was in April 2009 and no profiling bed has yet been supplied. The home should consider providing this for the person. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: We spoke to people about how the home supports them when they are not well or in need of medical attention. They told us the staff know before me that I need help, they recognise very quickly. We spoke to staff about how they recognise peoples relapse signatures in relation to their mental health. It was very evident that all of the staff know and understand the needs of all of the people living in the home. The home has a policy and procedure for the safe handling of medication including self medication. All staff receive training prior to taking any responsibility for peoples medication. We looked at the systems in place for the safe storage and administration of medication and found them to be satisfactory. Care Homes for Adults (18-65 years) Page 16 of 27 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. People using this service can be sure their concerns will be listened to and acted upon. Staff have the knowledge and skills to protect vulnerable people living in this home. Evidence: The home has not received any complaints since our last inspection. People who responded to our surveys told us, they were aware of who to speak to if they were unhappy about anything and they felt confident about making complaints as they needed. People we spoke to said Roger is the best manager we have had here, he will always help me to sort things out, I have no complaints at all this is the best home ever, another person said I am very happy here the staff are support me, they are the best. The home includes a copy of the complaints policy and procedure inside the Service User Guide. Each person has their own copy this. People are protected from harm whilst living here. Staff have received training in safeguarding vulnerable adults and were clear about what to do if an allegation or incident were made known to them. We also spoke to staff about their knowledge of the Mental Capacity Act 2005 and deprivation of liberty safeguards. It was encouraging to hear that staff knew about this legislation and how to support those people in their care who may not have the capacity to consent to their treatment and care. The home has also arranged for more training so that all staff can take part and Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: understand their role in supporting people under this legislation. There have been no safguarding referrals since our last visit to the home. The home also makes sure that when it is recruiting new staff it carries out the required safety checks against the Protection of Vulnerable Adults list (PoVA) and Criminal Records Bureau disclosure (CRB). These checks will help stop unsuitable people from working with vulnerable adults. The home has a member of staff who is trained to deliver training in non violent physical crisis interventions. He plans to provide training for all staff in this area so that they will be more aware of the strategies available to them when diffusing difficult situations. There are no other methods of restraint in use at the home at this time. Care Homes for Adults (18-65 years) Page 18 of 27 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. People live in a well maintained home they find comfortable and meets their needs. Evidence: We were shown around the home by the staff and the some of the people who live there. The home is comfortable and a safe environment for people to live. People told us they liked living at Woodcross. They said my room is the best I have a flat screen telly with freeview and anything I want, another person said I share a bedroom with my partner, its just like one big family here. There are ample communal areas for people to make use of. The large lounge by the dining room appears to be a popular place for people to meet and socialise. The home provides smoking facilities for people both indoors and outside in the garden. The occupational therapy room provides space for people to cook their own meals and to take part in activity should they choose to do so. We were told I like it here very much and it helps that there is a smoking room because alot of us do it. Others told us I like what the staff have done with the place like choosing some lovely ornaments. There is a games/recreational room with pool table, sofas and televisions for people to enjoy. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: The home has a large patio area with plenty of seating and tables for people to use. People are encouraged to do their own cleaning wherever possible, there are laundry facilities in the home to support people doing this. Staff have access to protective clothing such as gloves and aprons, there is also hand gel and hand wash for people to use. These measures will help reduce the risk of cross infection in the home. Care Homes for Adults (18-65 years) Page 20 of 27 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. There are appropriate numbers of staff on duty to meet peoples needs. Staff are trained and have the knowledge and understanding to meet peoples needs. Evidence: The home has a skill mix of both trained nurses and care workers on duty to meet peoples needs. In addition to the care staff there are housekeeping, kitchen, laundry and maintenance workers all working hard to keep the home running smoothly. One person said The staff are wonderful there is never anything that is too much trouble. The home supports all care staff through training in National Vocational Qualifications. Staff we spoke to confirmed that they had completed both their level 2 and 3 NVQ training in Health and Social Care. This means that staff have the knowledge and understanding to be able to meet the peoples needs who live in the home. We looked at the recruitment processes in the home. We saw the staff files of four people. All of them contained the required information and security checks such as previously mentioned Protection of Vulnerable Adults (PoVA)first, and CRBs. This means the home has systems in place to prevent unsuitable people from working with vulnerable adults. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: We looked at the training records for some staff. The home has supplied us with information of training that has been arranged. It is clear that staff will be trained as required. We spoke to several staff on duty during the inspection who confirmed they regularly take part in training and keep their knowledge and skills up to date. New workers are supported through an induction that meets the Skills for Care common induction standards. This induction will provide staff with the basic skills needed for completed their NVQ training. Care Homes for Adults (18-65 years) Page 22 of 27 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 home is managed well and run in the best interests of the people living there. Evidence: The home continues to be managed by Mr Roger Low he has both the necessary skill and qualifications to run the home. He is aware of the need to keep up to date with practise and continuous development of management skills. And has responsibility for reviewing home policies and procedures and making sure they are kept up to date with current best practise. The quality assurance systems in place involve the manager completing audits. These audits include care planning, medication, home environment and accidents. In addition to this the organisation also has a visiting manager complete an inspection of the home. The home has recently been audited in this way. We noticed the organisation is reviewing the home against the National Minimum Standards for older people rather than the National Minimum Standards for younger adults. The organisation may wish to consider reviewing this. People living at the home are also invited to comment about the service through regular meetings. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: As part of the homes self assessment they also completed the AQAA, the information contained in the AQAA gave us a reasonable picture of the service the home provides. There was also some evidence to support some of the comments made but more would have been useful to illustrate what the home has done in the last year or how it is planning to improve. The homes health and safety systems are satisfactory. Staff have a rolling programme of health and safety training provided by the home. This will make sure that their knowledge of current best practise is kept up to date. We checked some safety certificates and service records for equipment used in the home and found them to be up to date. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 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 2 18 39 The home should consider providing a profiling bed for those people who need one. The home should consider reviewing the key outcomes audit tool so that is appropriate to the National Minimum Standards for Younger Adults. Care Homes for Adults (18-65 years) Page 26 of 27 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). 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