Care Home: Woodland Way, 60

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What the care home does well Woodland Way provides a homely and safe environment for people to live in. People have personalised their bedrooms and are involved in keeping the home clean and tidy. Medication is well managed and people`s health care needs are well documented and met. People who use the service make choices about their day-to-day life including meals, activities, outings and holidays. People who use the service say they are `happy here`, `staff treat me well` and `I like the food`. Staff feel they offer people a good quality of life, treat people who use the service as individuals, try to meet peoples diverse needs and `work well together`. Other people involved with the service feel people are well looked after and that there are good lines of communication with outside professionals. What has improved since the last inspection? The kitchen units have been replaced, providing a better environment for people who use the service. The manager has registered with the CSCI, complying with previous requirements. Person centred plans have been developed with all people who use the service. The manager reported that they have developed links with specialist health professionals to help meet individuals needs. What the care home could do better: People who use the service didn`t think anything could be done better. Staff said they need more staff to be able to offer people a better service to meet all of their needs. Staff also said that they wanted more support when dealing with challenging behaviour and more appraisals focusing on what they are doing well rather than what needs to improve. The manager said that they will be working with people who use the service on self advocacy, to improve their lives. They will also be redecorating bedrooms to keep the home at a good standard for everyone who lives there. CARE HOME ADULTS 18-65 Woodland Way, 60 Mitcham Surrey CR4 2DY Lead Inspector Emma Dove Key Unannounced Inspection 7th and 13th May 2008 11:30 Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodland Way, 60 Address Mitcham Surrey CR4 2DY Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8687 2376 020 8687 2376 woodland.way@unitedresponse.org.uk www.unitedresponse.org.uk United Response Caroline Teresa Kyriacou Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 6 12th September 2007 Date of last inspection Brief Description of the Service: 60, Woodland Way is a registered care home, providing personal care and accommodation for up to six adults with learning disabilities. Six people are currently living there. 60, Woodland Way is owned by a housing association and is managed by the voluntary organisation, United Response. The home is in a residential area on the borders of Mitcham and Tooting, close to public transport, local shops and leisure facilities. Accommodation is provided over two floors with three single bedrooms, a bathroom with toilet, separate toilet and staff sleep-in room on the first floor. The remaining three single bedrooms, an assisted bathroom, separate toilet, lounge, kitchen/dining room, office and laundry room are on the ground floor. People who use the service have access to a garden. A lift serves both floors. The home is staffed twenty-four hours a day. The current fees are from £1,101 per week, depending on peoples assessed needs. Inspection reports are available at the home and details of the CSCI are included in the Statement of Purpose and Service Users Guide. Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means people who use this service experience good quality outcomes. This unannounced inspection took place over five hours on the 7th May and four hours on the 13th May 2008. One regulation inspector visited, looked at records, spoke with people who use the service, the manager and four members of staff. Questionnaires were sent to people who use the service and their relatives, placing social workers, health professionals and staff. We received four completed questionnaires, comments from these are included throughout this report. The manager completed an Annual Quality Assurance Assessment, which contained good information that is included in this report. The service has notified the CSCI of relevant issues since the last inspection. What the service does well: What has improved since the last inspection? The kitchen units have been replaced, providing a better environment for people who use the service. The manager has registered with the CSCI, complying with previous requirements. Person centred plans have been developed with all people who use the service. The manager reported that they have developed links with specialist health professionals to help meet individuals needs. Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The home understands the importance of having sufficient information when choosing a care home and has developed a Statement of Purpose and Service Users Guide to help people make a decision about moving in. Assessments are completed before admission, to ensure the home are confident that they can meet the needs of an individual. People are invited to visit, look around, meet people living there and staff as a part of the admission process. EVIDENCE: The Statement of Purpose includes information about the aims and objectives of the service, the accommodation available, staffing, the admission process and the activities in the home and in the local community. A Service Users Guide has been developed which provides information about the service, the key work system and how to make a complaint. These booklets need updating to reflect the new contact details for the CSCI. A detailed induction programme is developed with people planning to move into the service, to ensure they are fully involved and to help them understand the service and to help staff get to know them and their needs. This can include short visits to the home, overnight stays and visits to the person’s Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 9 current home, allowing individuals to meet other people using the service, staff and to familiarise themselves with the building. We saw assessments by placing social workers and staff from the service in case files, which include details of the support and assistance individuals need. Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who use the service are involved in developing person centred care plans which include goals. Staff understand the importance of people being supported to take control of their lives and make their own decisions and choices. Risk assessments are in place and kept up to date, ensuring that people are protected. EVIDENCE: We saw information in case files covering assessments of what people can do and the areas they need support and assistance from staff. Person centred plans have been developed which include goals people want to achieve. We saw that people have achieved some of their goals and have added more things they want to achieve. We saw reviews taking place on a regular (annual) basis with all people involved in an individual’s care invited to discuss progress and changes in Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 11 need. With more regular meetings being held for two individuals during times of change in their lives. The service operates a key work system, which allows staff to work on an individual basis with people who use the service. This supports the development of person centred plans, and provides time for people to achieve their goals. People who use the service confirmed that they meet with their key worker and do things they want to do. One member of staff said they ‘always’ and two staff said they ‘usually’ have up to date information about the needs of people who use the service. We saw up to date appropriate risk assessments in place. The manager and staff are aware of the balance between risk and people living fulfilled lives. Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People are involved in meaningful daytime activities of their choice, to meet their individual needs, ability and interests. The service has a strong commitment to enabling people who use the service to maintain and develop social, emotional, communication and daily living skills. People who use the service have the opportunity to maintain and develop important family and personal relationships. The staff team help with communication skills, within the service and in the community, helping people participate fully in daily living activities. EVIDENCE: We saw people who use the service return from day centres, go out shopping, go to classes and out for meals during our visits. People also told us that they go out to Church on a Sunday, which is very important to them. The manager and staff said that they are looking for more community based activities with Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 13 individuals and that they hope to have more choice of activity and occupation for people over the next few months. We saw that relatives and friends are welcome to visit and people who use the service are supported by staff to maintain important family relationships. Staff said people who use the service choose the menu for the week and are involved in shopping and meal preparation if they wish. Two people who use the service confirmed that they choose the food and are happy with the meals they have. The menu is varied and takes into account people’s dietary and medical needs. We saw mealtimes to be pleasant social occasions with people generally sitting at the table in the kitchen. Staff provided help in a discrete, appropriate and dignified manner. Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People receive personal and healthcare support using a person centred approach with support based on dignity, equality and respect. Personal healthcare needs are clearly recorded in case files, so staff are able to meet individuals specific needs. Staff support people who sue the service to attend healthcare appointments and document any issues, concerns or actions. Appropriate medication policies and procedures are in place. Medication is well managed with records up to date and signed by staff. EVIDENCE: We saw good records of GP, hospital and other health related appointments in case files. Staff monitor peoples weight on a regular basis and take appropriate actions if any significant loss and help individuals with healthy eating. Staff are aware of privacy and dignity issues and speak with individuals in private. We saw people who use the service out of the room at staff handover, Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 15 when information about individuals is discussed. One person said the service ‘always’ respects peoples privacy and dignity. Appropriate medication policies and procedures are in place. We saw good practices with staff following the policy when administering medication. Medication is appropriately stored. Medication Administration Record Sheets were up to date and signed by staff. Staff complete training in the administration of medication. Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure that is clearly written and easy to understand. People who use the service and their representatives are happy with the service provided and feel safe and supported by staff. EVIDENCE: The complaints procedure is available in pictorial format which is more accessible to people who use the service. The manager said they regularly ask people who use the service if they have any complaints or worries. We saw evidence of this in house meeting records. The manager said they have not received any complaints since the last inspection. We have not received any complaints or concerns about the service in the last year. Three members of staff were aware of how to respond to concerns raised by people who use the service or their representatives. One person said the service ‘always’ responds appropriately to concerns. Appropriate safeguarding policies are in place. The manager reported that all staff complete training in the protection of vulnerable adults as a part of their induction to the organisation. Staff confirmed that they have completed training in protection and are aware of their responsibilities. The manager also said that she plans to contact the local authority to access more safeguarding training, so all staff are aware of the protocols in the local area. Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28, 29 and 30 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The home provides a physical environment that is appropriate to the specific needs of people who use the service. Specialist aids and equipment are available to meet individuals needs. Bedrooms are single and have been personalised to individuals taste and choice. All areas of the home were well lit, clean and tidy. EVIDENCE: People have access to a kitchen/dining room and lounge on the ground floor. A small paved garden is available to the rear of the home with a seat and garden furniture. We saw that the garden needs more attention to keep it clear and pleasant for people who use the service. Bedrooms are single and have been personalised to individuals taste. People said they have everything they need in their rooms. Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 18 The kitchen has been refurbished with new cabinets and work surfaces, providing a better environment for people who use the service. Appropriate furniture is provided in the lounge, as one person said ‘making it comfy for me to sit in’. A large shower room with toilet and a separate toilet are available on the ground floor with a bathroom and toilet and separate toilet on the first floor. All areas of the home were clean and tidy. Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 35 and 36 People who use this service receive excellent quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The staff team support each other and share skills and knowledge to provide a good service to people. Staff roles and responsibilities are clearly defined. Good staff recruitment practices are in place, ensuring people who use the service are protected. Staff have access to relevant training to keep up to date with good practice and to meet the individuals specific needs. Staff receive regular supervision and support from the manager and deputy. EVIDENCE: Two members of staff are on duty during the day with the manager in addition on some weekdays. One member of staff is awake and one member of staff is asleep but on call at the home at night. These staff levels were seen to be sufficient to meet peoples needs. However three members of staff said there is ‘usually’ enough staff to meet peoples needs but as peoples needs increase, having more staff would enable them to provide a better service. Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 20 We saw good interactions between people who use the service and staff. Staff demonstrated a good knowledge and understanding of individuals needs. We saw people who use the service to be comfortable and relaxed with staff. We saw good policies and practice for recruiting staff. Staff files contain a copy of the application form, two written references, a Criminal Records Bureau check and proof of the individual’s identity. Three members of staff confirmed that they had the appropriate checks before they started work at the home. Two members of staff said their induction ‘mostly covered’ and one member of staff said their induction covered everything they needed to know ‘very well’. Staff have access to regular training relevant to their role. Three members of staff confirmed that they have good training opportunities with courses that help them improve their practice and do their job well. The manager said staff have regular supervision. Three members of staff confirmed that they get supervision. One member of staff felt that more appraisals, focussing on what staff do well would be beneficial. Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The manager has the experience to run the home. The manager is aware of the organisation’s planning systems and where the service ‘fits’ with other similar services. The manager has a clear understanding of the key principles of the home and is aware of equality and diversity needs. The manager and staff operate in a person centred way. The AQAA contains clear, relevant information about the service which is supported by evidence. The AQAA has let us know about changes and plans to develop the service in the future. EVIDENCE: The manager has been at the home for over two years and has previous experience in a similar service. The manager is registered with the CSCI and Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 22 is in the process of completing NVQ Level 4 and the Registered Managers Award. We saw that ‘house meetings’ are held every month. The manager said that everyone who lives at the home is asked their opinion about the services provided, given the opportunity to raise any concerns and plan any outings, activities, events and holidays for the future. This was confirmed by people who use the service, records and staff. We saw records of monthly staff meetings, staff are given the opportunity to discuss practice issues, given information about training, updated on changes to people who use the service and changes within the organisation. We receive copies of reports from visits made to the home every month to check on the services being provided. The manager said that questionnaires have been sent to relatives and other people with an interest in the home, to seek their opinions and see if any changes to the service are required. The responses are being analysed and will be used to develop the service. We saw good health and safety policies, practices and records of daily, weekly, monthly and annual checks are up to date. The fire alarm has been serviced and tested as required, regular monthly fire drills take place to ensure that people who use the service are familiar with the actions they need to take. Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 4 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Woodland Way, 60 DS0000027215.V363111.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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