Care Home: Woodlands

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What the care home does well What has improved since the last inspection? People who live at the home where possible or their relatives sign their care plans to say they have been involved in drawing them up and are in agreement with was has been written in them. This helps to make sure that care is being given to suit people`s individual needs in the way they prefer. A new kitchen has been fitted and both conservatories have been refurbished. This has improved the standard of the living environment with up to date facilities to maintain food and hygiene standards in the kitchen. Personal items such as shaving equipment is now stored in individual bedrooms and not in communal areas. This helps to maintain people`s individuality and dignity. The cat litter tray is stored in a more appropriate area to maintain infection control. Staffing levels have increased at weekends. This helps in making sure that there is always enough staff at all times to meet people`s needs. The owner provides a monthly report of their visits to the home to identify where the home is performing well and areas for improvement. This helps to maintain the good standards of the home and improve people`s quality of life. What the care home could do better: The care plans could include information about whether people have made any advanced plans if they get to a stage where they are unable to make their own decisions or about their wishes in the later stages of their life. This would help in making sure that their wishes are followed.Arrangements could be put in place so that records of controlled drugs that have been administered are clearer and more secure. This will help to reduce the risk of possible medication errors, make the audit trail easier to follow if any discrepancies were to occur and reduce the risk of information going missing. All staff could have updated training on how to protect people from abuse. This will help in making sure that staff respond properly if it was to happen to keep people safe. Further measures could be taken to address an odour problem in one shared bedroom in order to make the bedroom more pleasant and comfortable for the people who are in there. Toilet doors could be fitted with picture signs so that people with confusion can more easily find toilet areas. This will help to maintain people`s independence and dignity. CARE HOMES FOR OLDER PEOPLE Woodlands Woolley Moor House Low Moor Lane Woolley West Yorks WF4 2LW Lead Inspector David White Key Unannounced Inspection 23rd July 2008 08:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodlands Address Woolley Moor House Low Moor Lane Woolley West Yorks WF4 2LW 01924 830234 01924 830019 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) John & Anne Kelly Anne Kelly, John Noel Kelly Mrs Sandra Goodall Care Home 27 Category(ies) of Dementia - over 65 years of age (27), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (27), Old age, not falling within any other category (27), Physical disability over 65 years of age (27) Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th August 2006 Brief Description of the Service: Woodlands is a care home registered for the care for 27 older people some who may have Dementia, Mental Illness, Mental Disorder and Physical Disability. The building is set in the beautiful countryside near the village of Woolley on the outskirts of Wakefield. The views from the home are spectacular. It is a two-storey building, which is accessible by ramp. People who live at the home have access to all areas by ramp or passenger lift. There is a summerhouse where people can sit and enjoy the view. Most rooms are single occupancy and have en-suite facilities. There are four shared bedrooms. People’s health needs are provided by the local health centre and local hospitals. The home has a statement of purpose and service user guide that provides information about their service for people who are thinking about moving to the home and those already living there. The most recent inspection report is available from the manager on request. At the time of the site visit on 23rd July 2008 the range of fees was between £398 and £440 per week. Additional charges are made for chiropody and hairdressing. Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means that people who use the service experience good quality outcomes. The Commission for Social Care Inspection inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.csci.org.uk We went to the home without telling them that we were going to visit. This report follows the visit that took place on the 23rd July 2008. The visit lasted for 5.5 hours. The purpose of the visit was to make sure that the home was operating and being managed in the best interests of people living there. Information has been used from different sources for this report. These sources include: • • • • Reviewing information that has been received about the home since the last inspection. Information provided by the manager on an Annual Quality Assurance Assessment questionnaire. Surveys returned from three health care professionals who visit the home. Information received from two relatives. During the visit time was spent talking to people who live at the home, care staff, catering staff, the maintenance worker, the assistant manager and the manager. We observed staff caring for people in communal areas, looked at various records relating to care, staff, and maintenance, and looked at some parts of the building. The registered manager was available throughout the site visit and the findings were discussed with her at the end of the inspection. Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 6 What the service does well: These are some of the comments of people who use the service: • ‘My relative looked around a number of care homes in the region and decided after visiting Woodlands that this would be the best one. I am delighted with their choice and am very happy here’. • ‘I receive very good care that enables me to carry on doing things I enjoy such as watching sport on television’. • ‘The meals are really nice, they could not be any better’. • ‘I like my bedroom and the views from it. I love living here’. • ‘It is wonderful living here’. • ‘The staff are fantastic, they can not do enough for you’. • ‘I can’t speak highly enough of staff and what they do for you’. • I have confidence that any concerns would be listened to and properly dealt with’. • ‘Staff are very good at attending appointments with you to ease any anxieties’. Relatives of people who live at the home said: • • • • ‘The staff speak and care for people in a kind and patient way’. ‘Staff are friendly and approachable to family and friends’. ‘We are very happy with the care our relative receives’. ‘The care service is especially good at responding to the different needs of individual people, specifically around age and disability’. Health professionals who visit the home made these comments: • • • • • • • ‘The home has a welcoming and friendly environment with long standing staff who are reliable and trustworthy and who treat people with respect’. There is a friendly atmosphere at Woodlands. People who live at the home care about each other and staff are very thoughtful, such as taking care of cleaning glasses and trimming nails’. ‘Medical problems are identified early on. Staff have a good knowledge of people’s medical histories’. ‘They are good at coping with poorly people whose illnesses usually require expert nursing’. ‘There is always a willingness for staff to improve their knowledge and standards of care’. ‘They make you feel welcome when you visit’. ‘I would recommend this service to relatives’. Staff encourage people to make their own choices where this is possible. This helps people to maintain control over their own lives. People living at the home feel that staff are ‘kind and caring’. There is also good interaction and banter between people living at the home and staff and this helps to create a friendly and relaxed atmosphere. Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 7 The home has good links with healthcare services. This helps in making sure that people get the right kind of support promptly and when they need it. Visitors to the home all commented on the welcoming atmosphere. This encourages people to visit the home and maintain involvement with their relatives. The home is clean, homely, comfortable, well maintained and safe for people so making the environment a pleasant place to live. The manager and staff team are committed to providing good standards of care so that people’s quality of life is maintained and improved on and their needs are met. What has improved since the last inspection? What they could do better: The care plans could include information about whether people have made any advanced plans if they get to a stage where they are unable to make their own decisions or about their wishes in the later stages of their life. This would help in making sure that their wishes are followed. Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 8 Arrangements could be put in place so that records of controlled drugs that have been administered are clearer and more secure. This will help to reduce the risk of possible medication errors, make the audit trail easier to follow if any discrepancies were to occur and reduce the risk of information going missing. All staff could have updated training on how to protect people from abuse. This will help in making sure that staff respond properly if it was to happen to keep people safe. Further measures could be taken to address an odour problem in one shared bedroom in order to make the bedroom more pleasant and comfortable for the people who are in there. Toilet doors could be fitted with picture signs so that people with confusion can more easily find toilet areas. This will help to maintain people’s independence and dignity. 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. Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Proper pre-admission procedures are in place and are followed so that people who are thinking about moving into the home can feel confident that their needs will be met. Written information is also available to help people with their decision-making about whether the home can meet their needs. EVIDENCE: The home has a statement of purpose and service user guide that provides information about the care and services on offer. Relatives commented that they had been given enough information about the home before their relative was admitted there. Each person has a contract that they or their relative signs. The contract includes a breakdown of costs of fees and any additional services. Written information is also provided about people’s rights whilst at the home. Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 11 The records showed that the home carries out detailed per-admission assessments when referrals are made to the home. The admission process involves social workers undertaking an initial needs assessment and then making a referral to the home. The manager or the assistant manager then visit people either in hospital of their home environment to carry out the home’s assessment of the person’s needs to see if the person is suitable for the home. Information is also obtained from other people such as relatives to help them decide if they will be able to meet the person’s needs before a place is offered. People who are thinking about moving into the home where appropriate and their relatives are invited to visit the home before any decision is made about moving there. Staff said they are always made aware of a person’s needs before they are admitted into the home. One person who lives at the home said, ‘my relative looked around a number of care homes in the region and decided after visiting Woodlands that this would be the best one. I am delighted with their choice and am very happy here’. The home does not provide intermediate care. Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use the 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’s personal and healthcare needs are well met. One aspect of the medication practices needs to be addressed to ensure medication records are accurately maintained and secure. EVIDENCE: Each person has an individual plan of care detailing people’s needs and the actions that staff need to take to meet these. Further improvements have been made to the quality of the care plans since the last inspection. The care plans are in simple language and are easy to follow and are now more person centred. They explain how people wish to be supported and provide information about people’s family, their life history, personal preferences and their likes and dislikes. There is now written evidence that either the person where possible and/or their relative have been involved in the drawing up and reviews of their care plan. The reviews take place on a regular basis and Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 13 address any changing needs. Handover periods take place between shifts so that information can be passed on. Staff said, ‘we are kept well up to date with information about people’s needs and any changes to these’. A key worker system is in place and staffing levels are good enabling staff to spend individual time with people. The care plans do not contain any information about whether the person has made any advanced plans in the event of them losing the ability to make their own decisions or with regard to their end of life care. The manager said that a policy had been developed about this aspect of care and this was being implemented into care practice in the near future. A relative commented ‘the staff speak and care for people in a kind and patient way’ and observations at the time of the site visit confirmed this. Another relative commented ‘the care service is especially good at responding to the different needs of individual people, specifically around age and disability. We are very happy with the care our relative receives’. Further evidence of this was seen during the visit. One person who is living at the home has visual impairment. The person said, ‘I receive very good support that enables me to carry on doing things I enjoy such as watching sport on television’. The home had arranged for an optician to visit the person at the home. The optician supplied some glasses that magnified images and the person was able to see the television more clearly. The person also receives a monthly magazine from the RNIB (Royal National Institute for the Blind) in large print so that he was aware of any new aids and adaptations that are being introduced. The person also liked books and had a talking book machine so that he could pursue this interest. Each person has a GP (General Practitioner) and has access to chiropody, dental and optical services. The care records showed that medical is sought as soon as it is needed if someone becomes unwell. Staff accompany people to attend appointments and health care records are well maintained so that staff are clear about the reasons for appointments and outcomes from these so that they are clear about how to meet the person’s health needs. One person said, ‘the staff are very good at attending appointments with you to ease any worries you might have’. Another person said, ‘if you need any medical attention, staff are on to this straight away’. A survey returned by a health professional commented ‘there is a friendly atmosphere at Woodlands and you are made to feel welcome when you visit. People who live at the home care about each other and staff are very thoughtful, such as taking care of cleaning glasses and trimming nails’. Another health professional survey said, ‘medical problems are identified early on. Staff have a good knowledge of people’s medical histories’. This helps in making sure that people get the health care support they need promptly. One health professional commented ‘they are good at coping with poorly people Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 14 whose illnesses usually require expert nursing. I would recommend this service to relatives who are looking for a home for their relative’. None of the people were being cared for in bed. One person had developed a small pressure ulcer on their heal and was receiving care and support from the district nurse. One person’s care records showed that the person had diabetes. The care plan was very specific in explaining how staff were to deal with this and information about the person’s dietary needs. A range of risk assessments are in place so that where risk is identified a care plan is put in place to inform staff about what actions they need to take to meet the person’s needs. In the case of one person who was at risk of choking, the risk assessment clearly set out measures that staff were to take to reduce any risks. This included the person needing to have their food blended and catering staff when spoken to were fully aware of this. The risk assessments included information about why decisions have been made where people could be restricted in what they do such as people having their own bedroom key. One person refused to wear glasses and dentures and this was clearly documented. The risk assessments are reviewed regularly so that any changes can be acted on. There are systems in place to make sure that medications are managed safely and the GP carries out periodic medication reviews during their visits. Staff who handle medications on behalf of people are trained to do so. None of the people at the home were able to administer their own medication. However if someone did wish to administer their own medication they would be able to if following a risk assessment it was safe for them to do so. The home has two people who have controlled drugs. These are currently recorded in a notebook. The notebook did not have numbered pages and some of the pages were loose and could potentially fall out. This was discussed with the management who were making immediate arrangements to obtain a bound book so that these medication records were clearer and more secure. Staff were respectful to people and respected their privacy and dignity. People said they feel their privacy and dignity is maintained whilst staff are supporting them with personal cares. A survey returned by a health professional did say that they had to use another person’s room to carry out a medical examination. The manager has since dealt with this and people are now only seen for medical examinations in their own bedroom. People spoken to were able to confirm that this was now happening. Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the 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 have the opportunity to take part in activities and enjoy a lifestyle to suit their needs. EVIDENCE: A range of activities is available for people to join in if they choose to do so and these are displayed for people to see on an activities board. Activities such as the ‘Bamboozle’ quiz, board games and film afternoons are arranged inhouse and an independent person holds a monthly ‘activity motivation class’. Computers have been purchased for one conservatory area and arrangements are being made for someone to visit the home to show people how to use them. People were looking forward to playing card games on the computers once shown how to do this. Outside entertainers occasionally visit the home to perform. There are outings and trips to places of local interest although some people prefer not to take part in these and staff respect this. One person said, ‘I enjoyed a recent trip to the theatre’, another said, ‘we visited a local farm recently which was enjoyable’. A local production company had also performed Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 16 a version of ‘We’ll meet again’ to celebrate the 30th anniversary of the provider’s ownership of Woodlands and this had been well received by people living at the home. People can enjoy each other’s company in the communal lounge or spend time in private in their bedroom if they wish. People’s hobbies, social interests and spiritual needs are recorded in their care plans. One person’s care records that they liked to watch sport. The person said that one of the owners had discussed this with them and as a result of this the person now enjoys watching satellite television in their bedroom. The home encourages family and friends to have as much involvement with the home as possible. Comments from relatives indicated that they are always made to feel welcome. One relative said, ‘staff are friendly and approachable to family and friends’. People said that they sometimes go out with their family. Daily routines are flexible and people can get up and go to bed when they want. Some people are able to verbally express their wishes and needs whilst others have more difficulty with this. In these cases there was evidence that staff had tried to obtain information about their wishes through other sources such as relatives. In one case pictures were being used to help communicate with one person who has communication difficulties. People said that they enjoy the meals that are on offer at the home. One person said, ‘the meals are really nice, they could not be any better’, another commented ‘I put nearly two stone on in weight when I first moved here because the food was so good’. The home employs three cooks. They have recently introduced food from different cultures onto the menu. Records from the residents meeting book showed that people had been asked to provide comments about these meals and their preferences had been acted on. There is always a choice of meal, healthy eating options are considered and specialist diets are catered for. The home has links with dietary services if advice is needed. One cook said that they are provided with a good supply of fresh produce. Mealtimes are flexible and people could be seen eating their meals in a relaxed and unhurried environment. Those who required assistance were given this in a dignified way. Snacks and drinks are offered between mealtimes. One member of kitchen staff said, ‘the kitchen is always open’. On the day of the site visit people could be seen enjoying fish and chips from the local fish shop. An alternative meal was provided for those who did not want fish and chips. People’s weights are regularly monitored so that any health needs can be addressed. Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the 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’s concerns are listened to and acted on. Systems are in place to safeguard people from abuse. EVIDENCE: The home has a complaints procedure that is on display. The complaints procedure is also summarised in other information such as the statement of purpose and service user guide. The manager said that since the previous inspection the home’s complaints procedure has been brought to the attention of relatives and other visitors and information received from relatives confirmed that they knew how to make a complaint if they needed to do so. Since the previous inspection, the Commission has not received any complaints about the home. The manager said that any complaints would be logged and investigated and the complainant would be informed of the outcome of any investigation. The training records showed that most staff have had training on abuse. The majority of staff have completed NVQ (National Vocational Qualification) and this includes training on abuse awareness. The manager was aware that some staff needed updated training in this area and said that she would be arranging Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 18 this. Staff spoken to knew of their responsibilities in reporting suspected or incidents of abuse to the management without delay. One person who lives at the home said, ‘I am totally confident that any matters of concern would be dealt with quickly and properly by the manager’. Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the 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 clean, very well maintained, homely and safe environment. Improvements to two aspects of the home’s environment would help to maintain people’s comfort. EVIDENCE: The accommodation is over two floors and can be accessed by a ramp or passenger lift so is suitable for people who have mobility problems. There are communal lounges where people can sit and watch television and enjoy each other’s company. The home has two conservatories that have recently been refurbished, one where people can smoke if they choose to do so. Since the last inspection a new kitchen has been fitted. There are very well maintained gardens where people can sit out. Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 20 People commented on how much they like living at the home. One said, ‘I like my bedroom and the views from it. I love living here’. Other people said, ‘it is wonderful living here’. Bedrooms were clean, comfortable and personalised. Most of the bedrooms are single, however, there are four shared bedrooms. The manager said that people are made aware before their admission if they may have to share a bedroom with another person and the person already occupying the bedroom is consulted about this beforehand. All shared bedrooms have screening to offer privacy to people living in there. One shared bedroom did have an odour despite a number of measures having already been put in place to try and address this. The manager agreed to look into this issue further. Some people living in the home have confusion and difficulty with their orientation. It is recommended that communal toilet doors should have picture signs on them to assist people to be able to recognise and access toilet areas. Since the previous inspection the cat litter tray has been located to a more appropriate area to maintain infection control. People’s personal items such as shaving equipment are now stored in individual bedrooms and not in communal areas. The home was clean and tidy throughout and there is an ongoing maintenance programme for the upkeep of furniture and fittings. There is a separate laundry area where people’s personal clothing and bedding are attended to. People looked smartly dressed and their clothes were clean. Infection control procedures are followed and staff receive training on this. A health professional did comment ‘alcohol gel could be provided in appropriate areas’. The manager said this had been tried but following guidance from environmental health the home is now using hand gel to maintain hygiene practices. Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the 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 receive good care from a settled staff team who are well supported in developing their skills and knowledge to meet people’s needs. EVIDENCE: The home has a very settled and experienced staff team and there is minimal staff turnover, which helps people to receive consistent care from staff who know them well. A health professional survey commented ‘the home has long standing staff who are reliable and trustworthy and who treat people with respect’. The duty rotas show that there are sufficient staffing numbers at all times and since the previous inspection improvements have been made to increase the staffing numbers on a weekend. The home also employs catering and cleaning staff and a laundry assistant to help maintain food and hygiene standards and a maintenance worker is employed to maintain health and safety. People spoken to were complimentary about the staff team and the care they receive. One person said, ‘the staff are fantastic, they can not do enough for you’, another said, ‘I can’t speak highly enough of staff and what they do for you’. Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 22 From our observations it was evident that there is good interaction and banter between people who live at the home and staff and this created a good atmosphere. Over half the staff have completed NVQ and there is an ongoing NVQ programme. This helps in making sure that people are receiving care from staff with the right skills and knowledge to meet their needs. The home has not employed any new staff since the previous inspection visit. However, in the past proper pre-employment checks have been carried out before new staff started in post. This helped in making sure that only suitable people are employed to work at the home. New staff have a formal induction before they are expected to carry out any tasks they may be unsure of. All the staff receive a range of training on different aspects of care. A survey returned by a health professional said, ‘there is a willingness for staff to improve their knowledge and standards of care’. Staff said they receive ‘good training’. This includes training that is specialist to the needs of people who use the service such as dementia training. Staff spoken to had a good understanding of the needs of the people who live at the home and throughout the visit staff displayed good attitudes towards the people they were supporting. One staff member said, ‘I couldn’t work in a better place. The welfare of the residents is paramount in everything we do’. Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use the 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 well managed in the best interests of people who live there and proper attention is given to their health and safety. EVIDENCE: The registered manager is experienced in running the home and has completed management qualifications to develop her management skills. There is also an assistant manager who is very experienced and supports the manager in the leadership of the home. Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 24 People who live at the home and staff said that they found the manager to be ‘approachable and supportive’. People said they would feel confident that any concerns would be dealt with properly. One member of staff said, ‘we work together as a team and can always go to management for support’. There are systems in place to monitor the performance of the home. Meetings are held with people living in the home to seek their views about the care and services they receive. The records from these meetings showed that people’s views had been listened to and acted on. Care plan reviews are held and this gives relatives and professionals an opportunity to discuss the care at the home. The owner makes regular visits to the home and is now making a report of their findings and any actions that are to be taken from these. Staff receive supervision to provide them with support to meet people’s needs. Staff meetings are also held and staff said they are encouraged to voice their views about the running of the home within these meetings. The home does not attend to people’s personal finances although a small amount of money was being held on behalf of one person. Records are made of any incoming and outgoing monies for this person and are signed by two members of staff. Records and receipts are kept of any transactions so that money can be easily accounted for. Those health and safety certificates that were seen were up to date. All staff receive fire and health and safety training and this is regularly updated to make sure staff are providing care in a safe way. Fire safety checks are routinely carried out. The maintenance worker is responsible for the health and safety checks and keeps good records of these. A problem had been identified with the water pressures the day prior to the site visit and a plumber had been immediately notified to rectify the problem. Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 (2) Requirement Controlled drugs must be recorded in a bound book with numbered pages. This will help to make sure that people get their right medication, will provide a better audit trail if any discrepancies occur and will make the medication records more secure. Timescale for action 23/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations Each person’s care plan should include information about whether the person has made advance plans in the event of them losing their capacity to make their own decisions or/and their end of life care. All staff should receive up to date training on how to safeguard adults from abuse. This will help in making sure that staff understand abuse and respond to it appropriately to keep people safe. 2. OP18 Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 27 3. 4. OP19 OP19 Measures should be put in place to more effectively deal with the odour problem in a shared room that was identified at the time of the site visit. Communal toilet areas should have picture signs on the doors to help people with disorientation to find them. This will help to reduce confusion and maintain people’s independence, comfort and dignity. Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Woodlands DS0000006241.V368603.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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