Care Home: Woodlands

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What the care home does well The people who live at Woodlands get good support to maintain and monitor their health and their personal care. Staff have a good understanding of people needs and choices in this area and receive training in basic and more specialist areas of care so that they can meet people`s individual needs. Clear systems are in place for raising and dealing with any concerns or allegations that arise. People living at the home and their relatives are aware of how to raise any concerns and these are listened to and acted upon. This helps to ensure the people living at Woodlands feel safe. All areas of the home are accessible to people who have physical disability and there are a number of aids and adaptation available to support people with their mobility and their personal care. Everyone has their own bedroom andthese are decorated and furnished in a way that meets both their support needs and their choices. The manager is clear about her role in supporting the people who live at Woodlands and staff. She has a sound knowledge of how the service operates and plans for future improvements that will benefit those who live there. What has improved since the last inspection? One evening a week, the evening meal is being prepared at Woodlands rather than being delivered from the main kitchen on the site. This is working well and providing people with an opportunity to be involved in or aware of food preparation and cooking. With plans in place to provide a more accessible kitchen and cook all meals at Woodlands this will further support people in living as ordinary a domestic lifestyle as possible. Recent building work at Woodlands has resulted in everyone having their own bedroom and an accessible shower room being provided. This work is to a high standard and means that nobody has to share a bedroom. It also provides people with the choice of having a bath or a shower, which was not previously available. People are receiving more support to get out and about in their local community. This has included joining local facilities such as the library as well as community groups such as a women`s group for people with learning disabilities. This provides people with more interest in their life and opportunities to meet new people. What the care home could do better: Support plans should be written in plain English following current good practice guidelines. This will help to ensure that everyone can understand as much as possible about the plan and therefore the person`s needs and choices. A clear system for monitoring when safety checks are due to be carried out, and ensuring these occur, should be put into place. This will help to ensure all checks are carried out in a timely manner and that the building is as safe as possible for people to live and work in. People`s care plans should be expanded to include planning and reviewing all of the support they are offered with their daily live and chosen lifestyles. This will help to ensure that people get support to do the things they enjoy as well as support to remain healthy and well. CARE HOME ADULTS 18-65 Woodlands Blundell Avenue Freshfield Formby Merseyside L37 1PH Lead Inspector Ms Lorraine Farrar Unannounced Inspection 5 August 2008 02.40 Woodlands DS0000063026.V369540.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 Woodlands DS0000063026.V369540.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. Woodlands DS0000063026.V369540.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodlands Address Blundell Avenue Freshfield Formby Merseyside L37 1PH 01704 872179 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) woodlandsunit@yahoo.co.uk www.ftf.org.uk Frances Taylor Foundation Diane Ellis Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Woodlands DS0000063026.V369540.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1 The registered person may provide the following categories 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: Learning disability - Code LD The maximum number of service users who can be accommodated is: 12 Date of last inspection 17th October 2007 Brief Description of the Service: Woodlands is owned and operated by the Francis Taylor Foundation. They are a national organisation that provides services for people with a variety of support needs. Located in the middle of Formby Pinewoods, Woodlands shares a site with two other registered care homes, a day centre for 65 people and a convent. All the services are for adults who have a learning disability. The services share main kitchen facilities, extensive grounds and a hydrotherapy pool. Woodlands provides accommodation and support with nursing for 12 adults who have a learning disability. Many of the people living there also have physical disabilities and the service provides aids and adaptations to meet their needs. There are staff available twenty four hours a day to support people when needed. Everyone living at Woodlands has their own bedroom and toilet, adapted to their individual needs. There is a dining room, several lounges, bathrooms and a small kitchen within the home and a small, private, courtyard outside for people to share. The fee for living at Woodlands is based on people’s individual support needs, with a basic cost of £950 per week. Woodlands DS0000063026.V369540.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 the people who use this service experience good quality outcomes. We gathered information for this inspection in a number of different ways. We carried out an unannounced visit to the home on 5 August 2008. This took place over six hours and included reading records and looking at the building. We spent time looking at the support the people living at Woodlands receive. This included looking at the support they get with their daily lives, care plans, medication, money, activities and environment. We met and talked with some of the people living at Woodlands and some of the staff working there. We also spent time observing daily life and the support people receive in their everyday lives. Any information the Commission for Social Care Inspection (CSCI) has received about the home since the last big inspection of Woodlands in October 2007 is also taken into account in writing this report. The manager completed a questionnaire we sent her before our visit to get up to date information about the service. Information from this was again used by us to plan this inspection and in writing this report. An easy to understand summary of this report is available. If you would like to see a copy please ask staff working at Woodlands. What the service does well: The people who live at Woodlands get good support to maintain and monitor their health and their personal care. Staff have a good understanding of people needs and choices in this area and receive training in basic and more specialist areas of care so that they can meet people’s individual needs. Clear systems are in place for raising and dealing with any concerns or allegations that arise. People living at the home and their relatives are aware of how to raise any concerns and these are listened to and acted upon. This helps to ensure the people living at Woodlands feel safe. All areas of the home are accessible to people who have physical disability and there are a number of aids and adaptation available to support people with their mobility and their personal care. Everyone has their own bedroom and Woodlands DS0000063026.V369540.R01.S.doc Version 5.2 Page 6 these are decorated and furnished in a way that meets both their support needs and their choices. The manager is clear about her role in supporting the people who live at Woodlands and staff. She has a sound knowledge of how the service operates and plans for future improvements that will benefit those who live there. What has improved since the last inspection? What they could do better: Support plans should be written in plain English following current good practice guidelines. This will help to ensure that everyone can understand as much as possible about the plan and therefore the person’s needs and choices. A clear system for monitoring when safety checks are due to be carried out, and ensuring these occur, should be put into place. This will help to ensure all checks are carried out in a timely manner and that the building is as safe as possible for people to live and work in. People’s care plans should be expanded to include planning and reviewing all of the support they are offered with their daily live and chosen lifestyles. This will help to ensure that people get support to do the things they enjoy as well as support to remain healthy and well. Woodlands DS0000063026.V369540.R01.S.doc Version 5.2 Page 7 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 DS0000063026.V369540.R01.S.doc Version 5.2 Page 8 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 Woodlands DS0000063026.V369540.R01.S.doc Version 5.2 Page 9 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): 2 People who use this service experience good outcomes in this area. We have made this judgment using available evidence including a visit to this service. Sufficient information is obtained about and provided to people considering moving into Woodlands. This helps everyone to decide if it is the right place for the person to live. EVIDENCE: Nobody new has moved into Woodlands in the past twelve months, therefore we were not able to practically assess the support that the home would offer to anyone considering moving in. There is a policy in place that states before anyone is offered a place to live, a full assessment of their needs will be carried out. This will include obtaining information from the person, family and any professionals involved in supporting them. People are encouraged to visit the service and stay overnight, before they make a decision about moving into the home. They and their family are also given information about both Woodlands and the Francis Taylor Foundation. This information is made available in an easy read picture format, which helps people to understand as much as possible about the information they are given. This helps everyone to decide of Woodlands is the right place for the person to live and if it can meet both their needs and choices. Woodlands DS0000063026.V369540.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 & 9 People who use this service experience adequate outcomes in this area. We have made this judgment using available evidence including a visit to this service. The people living at Woodlands are supported by a staff team who understand their needs and choices. However a lack of complete lifestyle planning may lead to all of a person’s choices not being consistently met. EVIDENCE: Individual care plans are in place for all of the people who live at Woodlands. These are reviewed regularly and contain clear information and guidance on how to meet the person’s personal care and health needs. This helps to ensure people get the right support and that any changes to their support needs can be quickly noted and acted upon. Plans also contain some information about the person’s lifestyle choices. However, this is limited and does not provide as much information about how staff are meeting people’s needs in this area. For example, one plan identified Woodlands DS0000063026.V369540.R01.S.doc Version 5.2 Page 11 that the person may like to use public swimming baths but there was no evidence that any planning had taken place to support them with this. As attending the on-site day centre is included in fees for living at Woodlands then the activities people are supported with there should be recorded within their plan. This will help staff to gain an overall picture of each person’s day and plan with them how they may wish to spend the rest of their time. The organisation is in the process of changing their care planning systems to using person centred planning documents. Some of these have started to be completed at Woodlands and they give a clear picture of the person as an individual and their choices as well as support needs. The manager explained that she intends each plan to be put onto DVD so that new staff can sit with the person and watch it. This is good practice as it helps to involve and inform people as much as possible. A sample DVD was seen and provided good, clear information. However some of the language used was over complicated, which could lessen the opportunities for the person, their relatives and staff to understand the contents fully. Everybody’s care plan contained a series of risk assessments about them. These covered areas such as their environment, going out and personal care. Information was recorded about the identified risk and the actions that needed to be taken to lessen that risk. These had been reviewed regularly and were up to date. Staff were able to explain to us how people show their decisions based upon their non verbal communication and during our inspection staff were seen to take time to speak with people and understand what they were communicating. Woodlands DS0000063026.V369540.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, 14, 15, 16 & 17 People who use this service experience good outcomes in this area. We have made this judgment using available evidence including a visit to this service. The people living at Woodlands receive support from staff who are aware of their choices and are providing increasing opportunities so people can take part in more activities of their choice. EVIDENCE: There are a number of facilities on the overall site that the people living at Woodlands use. These include a modern day service that provides seven different groups people can join depending on their needs and choices. Whilst at the day centre people are also supported to go out and about. The day centre is also attended by people who have a learning disability and live in the wider community, providing an opportunity to meet new people. There is a hydrotherapy pool and ‘beauty rooms’ on site that are used for aromatherapy and reflexology. These facilities are decorated and equipped to Woodlands DS0000063026.V369540.R01.S.doc Version 5.2 Page 13 an extremely high standard and provide a relaxing environment for people. The organisation has qualified therapists and some staff from Woodlands have training in the use of the pool so people can access this facility outside as well as within the hours the day service operates. In addition a café, partly run by volunteers, opens on the site 3 days a week. This provides people with the opportunity to socialise in smaller groups and if possible help out with the café. There is a chapel on site, which has Catholic services every Sunday, and Church of England services every two months. In addition services are held at the day centre at Christmas and Harvest Festival and are lead by ministers from the United Reform, Methodist, Roman Catholic and Church of England faiths. Relatives and members of the public are also able to attend the Sunday service, which again provides people with the opportunity to meet others. A note was up in Woodlands stating “all service users to be taken to mass on a Sunday morning if anyone is unable to go please document why”. The manager told us that people are only supported to go to the service if they wish to do so and the note was more of a reminder. However this should be re-worded so that staff are aware people have a choice and do not have to attend. Support for people to get out and about in their local community is increasing with people using community facilities such as the local concert arena. One lady told us she has joined a local women’s group where she is learning, about “hygiene and things” and the manager explained they have also supported people to go to a local disco and join the local library. People are supported to go on an annual holiday each year. They are also supported to see their family and friends whenever they wish. Routines are flexible depending on people’s plans for the day. We observed that in the evening people are supported with different things depending on their choices. Staff supported people to sit together or in their room and watch TV or listen to their chosen music and were seen to respond quickly to a non verbal request from one of the people living there to change her TV programme. A central kitchen provides the main meals for all of the services on site. There is also a small kitchen at Woodlands, which can be used to prepare breakfast, drinks and snacks. In addition the home staff have recently started cooking the evening meal one day a week. Staff explained that some of the people living there go shopping and help as much as possible with the preparation. The organisation is currently planning to alter the kitchen facilities at Woodlands so that all meals can be cooked and prepared there. This will offer people the opportunity to become more involved in the daily running of their home, such as shopping for food. It will also offer them the opportunity to live Woodlands DS0000063026.V369540.R01.S.doc Version 5.2 Page 14 a more domestic lifestyle and gain awareness of how food is obtained, prepared and cooked. A choice of meals is provided each mealtime and the cook was able to explain the different diets that people require. The evening meal was served on a hot trolley and we observed that special diet requirements had been catered for. One of the ladies living there told us that she gets different meals and thinks they are generally “okay” whilst another lady told us that she likes the meals, particularly “ the roast”. Many of the people living at Woodlands need 1-1 support with their meals and staff were seen to provide this is an unhurried manner, taking time to chat with people as well as provide support. Due to the support required the meal can take some time and therefore people are supported in different ‘sittings’ so that they are not sat around waiting. Tables are nicely laid, people have adapted cutlery if needed and where possible their own teapot; this helps to make the meal a social occasion. However as there is a hatch to the small kitchen there was some noise and staff conversation apparent. In addition the dining room also has a lounge area and the TV was playing whilst people were being supported with their meal. These could all provide a distraction for people. Woodlands DS0000063026.V369540.R01.S.doc Version 5.2 Page 15 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 & 20 People who use this service experience good outcomes in this area. We have made this judgment using available evidence including a visit to this service. The people living at Woodlands receive support from a staff team with the necessary skills so they can meet their health and personal care needs and choices. EVIDENCE: In meeting the people who live at Woodlands it was evident that they had received support to maintain their personal appearance in a way that ensured they were both comfortable and dressed in accordance with their age and choices. Records also showed that people are supported to get up or go to bed at times suitable to their plans for the day and that they choose. This was confirmed in discussion with one of the people who lives there who told us she sometimes enjoys a “lie in”. There are a number of aids and adaptations at Woodlands that support people with their personal care. This includes adapted baths, a fully accessible shower and overhead tracking. This helps to ensure people can be supported safely. Woodlands DS0000063026.V369540.R01.S.doc Version 5.2 Page 16 Staff were seen to offer discreet support to people with their personal care needs throughout our visit. Health files are in place for all of the people living at Woodlands and we looked at a sample of these. Assessments of different areas of the person’s health, such as their weight, risk of pressure sores and moving and handling needs are regularly carried out. These assessments help to ensure that any changes to the person’s support needs or their health can be quickly noted and acted upon. Care plans are in place for supporting people with their individual health care needs and any medical conditions they may have. These are clear and had been regularly reviewed. These plans help to ensure that staff have the information available so they can support people safely and well and quickly deal with any issues that arise. Records showed that people receive support to access a range of health professionals. This includes regular appointments such as the optician as well as more specialist appointments such as the dietician and tissue viability nurse. In working with other health professionals and seeking advice the home are supporting the people living there to remain as healthy as possible. Discussions with staff showed that they have a good understanding of people’s health and personal care needs and their role in meeting these. Records also showed that staff are observant of people’s health and take action. For example recent notes showed that one person appeared to have cold feet at night and staff took care to ensure they wore warm bed socks. Good practice was noted in that where a person needs a regular injection staff record where this is given so that a different injection site is always used. This helps to prevent the person becoming sore or the area inflamed. There is a separate room to store medication at Woodlands and this was seen to be clean and tidy. Care plans contain information about the support people require with their medication. Where it is given with their food this is clearly documented, agreed by relevant people and the reasons why are clearly recorded. This helps to ensure the process is clear and people are given their medication in a way that meets their health needs and also respects their rights. Records of medication given to people and received into the home are clearly recorded and audit system is in place. Staff receive training in dealing with medication. This all helps to minimise the risk of errors occurring and ensures that any issues are quickly noted so that they can be dealt with. We checked samples of medication and records. These had been fully completed, were stored correctly and stocks of medication tallied with the home’s internal recording systems. Woodlands DS0000063026.V369540.R01.S.doc Version 5.2 Page 17 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 & 23 People who use this service experience good outcomes in this area. We have made this judgment using available evidence including a visit to this service. The people living at Woodlands and their relatives are confident that any concerns they have will be listened to and acted upon. This helps to ensure Woodlands is a safe place for people to live. EVIDENCE: Information about how to raise concerns is made freely available to the people living there and their relatives and friends via the home’s service user guide. Relatives of the people living at Woodlands have previously told us that they know how to raise any concerns they may have. This was further confirmed in a survey carried out by the home in February 2008, to which seven relatives responded, all confirming that they were aware of how to raise any concerns that they may have. During our visit one of the people living at the home explained that they would tell staff if they were not happy and were confident that staff would “help”. This has been recently confirmed when the manager took appropriate action in dealing with concerns raised with her. Staff receive training in recognising and dealing with any adult protection issues that may arise. In our discussions with staff it was clear that they had a good understanding of adult protection and their role in reporting and dealing with any issues that may occur. Woodlands DS0000063026.V369540.R01.S.doc Version 5.2 Page 18 Clear systems are in place for supporting people to manage their money. Records and receipts are kept of purchases made, a sample of which were checked and tallied. The system in place helps to ensure that any discrepancies that occurred would be quickly noted and could be acted upon. This open approach to concerns helps to ensure that people can feel confident they will be listened to and any concerns they have will be acted upon. Woodlands DS0000063026.V369540.R01.S.doc Version 5.2 Page 19 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, 26, 27, 29 & 30 People who use this service experience good outcomes in this area. We have made this judgment using available evidence including a visit to this service. Woodlands provides a comfortable home for people to live and has been adapted well so people’s needs and choices are met. EVIDENCE: Woodlands is based in the middle of Formby Pinewoods, near to the National Trust Park. Its location means that it is not directly part of the wider community; however there is a local train station, shops and facilities approximately 20 minutes walk away. The location of Woodlands means that it has scenic views and there are nearby walks within local areas of interest. It also has several gardens within the larger grounds that people can access, as well as an enclosed courtyard with seating, that is directly accessed via the home. Due to the layout of both Woodlands and the site, all areas are accessible for people with physical disabilities, with wide corridors and doorways and all areas at ground level. Woodlands DS0000063026.V369540.R01.S.doc Version 5.2 Page 20 It was identified at our previous inspection that the small kitchen on Woodlands is not accessible for people with mobility difficulties. However the organisation now has plans in place to replace this kitchen and the manager advised that some adaptations will be incorporated into the new design. Recent building work at Woodlands has resulted in everyone living there having their own bedroom, with nobody having to share a room. This helps to provide people with more privacy and a private space to enjoy their personal hobbies and interests. Bedrooms are very well decorated and furnished in accordance with people’s needs and choices. For example in one of the bedrooms we visited the person had a double bed, whilst another was equipped with a settee and mini fridge so they could use the room as a lounge as well as a bedroom. Staff and relatives support people to personalise their rooms with photos, posters, music and TVs as they prefer and people were seen to enjoy spending time in their room engaged in their preferred activities. There are several adapted bathrooms in Woodlands and the recent building work has resulted in a fully accessible shower room being available to people. Some of the bathrooms are quite clinical in appearance with few storage facilities. For example we saw a hoist and urine bottles stored in one bathroom. This can make the rooms appear clinical and may not provide as relaxing an atmosphere as possible for people to enjoy their bath. Communal rooms have been decorated and furnished so that they are as homely and comfortable as possible. During our visit we saw the people living there using all areas of the home, including the dining room, lounges and their bedrooms to engage in different activities, as they preferred. There are a number of aids and adaptations within Woodlands that support people with their mobility. Everyone has a designated en-suite or nearby toilet that is adapted for their needs and decorated to meet their choices. In addition there is overhead tracking, hoists, grab rails and electric beds available. These aids mean that it is as easy as possible for people to get around and to receive support with their personal care. There is a designated laundry room, which is well equipped to meet the needs of the people living there and has a clear system and equipment in place for preventing any cross infection occurring. All areas of the home seen during our visit were warm, clean and tidy. Woodlands DS0000063026.V369540.R01.S.doc Version 5.2 Page 21 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, 34 & 35 People who use this service experience good outcomes in this area. We have made this judgment using available evidence including a visit to this service. The people who live at Woodlands are supported by a staff team who are skilled at recognizing and meeting their needs and choices so they can provide the support that people need in the way they prefer. EVIDENCE: During our discussions with some of the staff who work at Woodlands and our observations during our visit to the home, it was evident that staff have a good understanding of the needs and choices of the people who live there. As many of the people who live at Woodlands do not use recognised forms of communication, staff have developed the skills and knowledge to understand what people are telling them and to understand their different support needs and lifestyle choices. One member of staff explained that she observes how people are behaving as this informs her about how they are feeling and the things that they may need or want. We observed that staff take time to support people on a 1-1 basis and to chat with them as well as meeting their basic health and personal care needs. Staff also took time to meet some of people’s lifestyle choices, for example by Woodlands DS0000063026.V369540.R01.S.doc Version 5.2 Page 22 supporting them to sit where they wish and listen to music or watch a TV programme of their choice. Records showed that before anyone starts work at Woodlands a series of checks are carried out. These include a set interview process, obtaining written references and checking with the Criminal Records Bureau (CRB) and register of people unsuited to work with vulnerable adults. These checks help to ensure staff are suitable to work with people who may be vulnerable. Records and discussions with staff showed that they have undertaken a number of training courses to help them in their work and in supporting those who live at Woodlands. These range from basic training in areas of care such as moving and handling people, equality and diversity and dealing with medication to more specialist areas such as using a peg feed, use of the hydrotherapy pool and the depravation of liberty act. In addition over half of the staff team have obtained a nationally recognised qualification in care (NVQ). The range of training available to staff helps to ensure that they can meet the needs and choices of the people living at Woodlands. Woodlands DS0000063026.V369540.R01.S.doc Version 5.2 Page 23 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 & 42 People who use this service experience good outcomes in this area. We have made this judgment using available evidence including a visit to this service. Woodlands is well managed so it is run in the best interests of the people who live there. EVIDENCE: Mrs Diane Ellis is the manager of Woodlands; she is experienced in a management role within a care setting, is a registered general nurse and has undertaken a course in supporting adults who have learning disabilities. Records showed that she takes part in regular training courses to ensure her knowledge is up to date. During our visit the manager showed she had a good knowledge of the individual needs and choices of the people living at the home, a sound knowledge of her role and was clear about plans for future developments Woodlands DS0000063026.V369540.R01.S.doc Version 5.2 Page 24 within the home. Staff we spoke with told us that advice is always available and that they find the manager approachable. There are several systems in place within Woodlands for checking the quality of the service they provide and planning improvements. These include regular checks on medication and reviewing of care plans. This helps to ensure that any errors or changes to people’s needs and choices can be quickly noted and acted upon. In addition, a senior manager from the organisation visits regularly and provides a report of their visits along with any areas that need action taking. In February of 2008 the home carried out a survey of relatives of the people living at Woodlands. As many of the people living at Woodlands cannot fully express their views, this provides an opportunity for their relatives to become involved in future planning for the home by raising any concerns they may have or making suggestions for future improvements. In addition the manager has completed a quality assurance review this year that is based on national minimum standards for care homes. This gives the home the opportunity to look in depth at the service they are providing and plan future improvements. Records and certificates showed that regular checks are generally carried out on the environment and equipment to ensure they are safe to use. This includes checks on the fire precautions and safety system, moving and handling equipment and the mains electrics. However the gas certificate for the home was due to be renewed in March 2008 and had not been. Following the inspection we were given evidence that a gas safety inspection was booked to take place within two weeks but leaving it overdue for several months could put people in the home at risk. Woodlands DS0000063026.V369540.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 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 X 2 3 3 X 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 2 25 X 26 3 27 3 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 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 2 X Woodlands DS0000063026.V369540.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 YA42 Regulation 13(4)(a) Requirement A system must be set up for monitoring safety checks on equipment throughout the building to make sure they are renewed when they are due and the home continues to be a safe place to for people to live. Timescale for action 15/09/08 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 2 Refer to Standard YA6 YA6 Good Practice Recommendations Care plans should be written in plan English. This will provide as much opportunity as possible for everyone to understand the contents. Care plans should include clear planning around people’s social choices. They should also record the activities people are supported with at the day centre. This will ensure that staff can and are supporting people with their preferred lifestyles. The noise levels and distractions are meal times should be monitored. This will help to ensure that mealtimes are a relaxed and sociable occasion for people. 3 YA17 Woodlands DS0000063026.V369540.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North West Region Unit 1, Level 3 Tustin Court Port Way Preston PR2 2YQ 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. 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