Care Home: Woodlands

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What the care home does well This was not assessed on this occasion. What the care home could do better: Controlled drugs must be stored correctly and safely to prevent unauthorised access and inappropriate use of these medicines. When medicines are given at a different time to that printed on the medication form, the actual time it is given must be recorded to prevent medicines be given too closely together. The temperature of areas where medicines are stored should be monitored and recorded to suer they are of a suitable quality.Changes or amendments to medication instructions should be confirmed in writing by the prescriber. Signage and orientation aids indicating where key areas such as the lounge and dining room are should be placed around the home to help people find their way about. Staff must undertake all mandatory training to their role so they have the knowledge and skills to look after residents properly. In particular staff must have up to date moving and handling, health and safety and COSHH (control of substances hazardous to health). Prospective employees should receive a job description and person specification so they know what their job entails and whether or not they have the right skills for it. Supervision for staff continues to be poor, and although some are now receiving it, more must be done to ensure that all staff receive it at least 6 times a year. Overall there has been some improvement in the service the home provides since we last inspected, however the provider must be mindful of the legal timescales we set, and ensure these are met, otherwise we may consider enforcement action. Random inspection report Care homes for older people Name: Address: Woodlands 50 High Street Earith, Huntingdon Cambridgeshire PE28 3PP one star adequate service 30/06/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Janie Buchanan Date: 2 5 0 5 2 0 1 0 Information about the care home Name of care home: Address: Woodlands 50 High Street Earith, Huntingdon Cambridgeshire PE28 3PP 01487841404 F/P01487841404 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Pamela Ellis Type of registration: Number of places registered: Conditions of registration: Category(ies) : Farrington Care Homes Ltd care home 24 Number of places (if applicable): Under 65 Over 65 24 24 dementia old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home 0 0 2 3 1 2 2 0 0 9 Woodlands provides care, accommodation and support for up to 24 older people, some who have a degree of confusion or a form of dementia. The home is situated in the village of Earith, which is approximately 6 miles from the market town of St. Ives; from the rear of the home are good views across the River Great Ouse. Residents accommodation is on two floors, the upper floor being accessed via a shaft lift. The home has 18 single and 3 double rooms, but would only be used to accommodate a couple if the need arises. Sixteen of the single rooms have en-suite toilets, and 4 rooms also have baths. There are 4 toilets, one specialist bath, and a level access Care Homes for Older People Page 2 of 11 Brief description of the care home shower. Communal areas include 2 lounges, a dining area, and a large conservatory, all of which are available for residents use. A pleasant garden area leading down to the river is provided outside. Residents are supported by a team of care staff; the premises are looked after by domiciliary staff and a maintenance person. A copy of the latest CQC inspection report can be requested from the home or downloaded from www.cqc.org.uk Charges vary between £363 and £563 per week. Care Homes for Older People Page 3 of 11 What we found: We,(The care Quality Commission), undertook this inspection to check that the requirements and recommendations we had made at the previous inspection of 23/12/2010 had been complied with. We visited the home and talked with staff and the manager. We checked medication storage and a sample of medication administration records. We toured the building and checked some of the homes polices and documents. CARE PLANS At our last inspection we made a requirement that residents must be involved in planning and reviewing their care where possible. We checked the care plans for three residents, two of which showed some involvement from residents. Each resident had completed a questionnaire that asked them how they wished to be assisted, how they could maintain their personal hygiene, and how they could be helped to make choices. Two residents had signed this, showing us they had actively been involved in and consulted about their care. Staff told us they now sit with residents, where appropriate, and go through their care plans with them. We consider this requirement to have been met. We made a recommendation that residents wishes concerning their end of life should be fully documented in their care plans. Care plans we viewed contained good information about residents specific wishes in this matter. MEDICATION We looked at the practices and procedures for the safe storage, handling, use and recording of medicines. Medicines are stored securely for the protection of residents but the temperature of the area where medicines are stored is not monitored or recorded regularly. It is important to demonstrate that medicines are stored under the recommended storage conditions as this could affect the quality of medicines in use. This also applies to the fridge used to store medicines in the kitchen. The cupboard used to store controlled drugs is not of a construction, or fixed to the wall, in a way which complies with the relevant regulations. The cupboard also contained items which should not be stored there. We have made a requirement about this. We looked at the medication and medication records for several people in the home. Records are made when medicines are received into the home, when they are given to people and when they are disposed of. These records were generally in good order and provide a good account of all medicines in use and demonstrate that people receive the medicines prescribed for them. But when medicines are given at a different time to that printed on the medication record form, the actual time it is given must be recorded. This will prevent medicines being given too close together. We saw that for one person who has their medication injection given by district nurses, the homes records did not indicate that the medication was given and in what dose, although the district nursing records did so. At the last inspection we made a requirement that records made when medicines are given to people must be accurate and complete. Given the improvement in the accuracy of records, we consider this requirement has been met. We also made are requirement that medication must only be given in line with the Care Homes for Older People Page 4 of 11 prescribed instructions. We consider this requirement has been met as we found no evidence to suggest it is not. We looked at the care plans for people prescribed medicines on a when required or variable dose basis and could not find any guidance for staff on the circumstances these medicines were to be used or what dose was to be administered. We expect this to be managed by the home rather than make a requirement on this occasion. We saw that the dose of some peoples medication had been changed but there was no written confirmation of this, the change being made by telephone conversation. It is strongly recommended that such changes are confirmed in writing by the prescriber and this retained in the residents care notes. Residents are only given their medication by staff authorised to do so but we could not find any evidence of recent training on the safe use of medicines and staff had not had an assessment that they were competent to do so. We expect the home to manage this rather than make a requirement on this occasion. STAFF TRAINING We made a requirement at out last inspection that staff must receive training in safeguarding vulnerable adults. We checked the training files for 4 staff which showed us they had attended a course recently. Staff we spoke to also confirmed this, although their knowledge about other agencies involved in protecting vulnerable adults and proper reporting guidelines was limited. We made a requirement at out last inspection that domestic staff must receive training in health and safety, infection control, moving and handling, and COSHH. We checked the training files for two domestic members of staff and, although they had recently received recent training in moving and handling, and food hygiene, they had not received any in health and safety, fire, infection control and COSHH. We checked the training files for two night staff and noted that their training in fire safety and first aid was out of date. PRIVACY SCREENS We made a requirement at our last inspection that screens must be provided in all shared bedrooms to maintain residents privacy and dignity. We checked 3 double bedrooms and noted only two contained screening. However the manager told us she was about to organise screening from the ceiling in this room and therefore we will not take further enforcement action on this occasion. BEDROOM DOORS We made a requirement at out last inspection that residents must be able to lock their bedrooms doors for security and privacy. We toured the building and noted 6 bedrooms that could still not be locked. Although this requirement has not been met within the legal timescale given we will not take further enforcement action on this occasion as the locksmith was due out on the day of our visit. COMPLAINTS Care Homes for Older People Page 5 of 11 We made a recommendation at out last inspection that information about how to raise concerns and also how to report any adult protection issues should be made available around the home so that residents and their visitors know who to contact. We viewed information about these matters on the main notice board in the dining room (although these could be put in large print to make them more accessible to people with visual impairments). The manager stated that a copy of the complaints procedure had been placed in each residents bedroom. SUPERVISION At our last inspection we made a requirement that all staff must receive supervision. We checked the files for four members of staff and only two of them had received supervision recently. One member of staff we spoke to told us she had never received any formal supervision, despite working at the homes for over six years. The manager stated that only eight members of staff had received supervision in total. This requirement had not been met and we may take further enforcement action. SIGNAGE At our last inspection we made a recommendation that that better signage and orientation aids should be provided around the home to help people find their way about. During this inspection we noted that residents names had been placed on their bedroom doors. However signage helping people find their way to key areas such as the lounge and dining room was still absent making them difficult to find. RECRUITMENT CHECKS At our last inspection we made a recommendation that staff should not commence employment at the home until a full CRB check had been received. We checked the personnel files for two recently recruited members of staff and noted appropriate CRB checks in place. We consider this requirement to have been met. We also noted that notes from interviews with prospective employees were now being recorded. However we noted that a recent employee had not received any job description or person specification. What the care home does well: What they could do better: Controlled drugs must be stored correctly and safely to prevent unauthorised access and inappropriate use of these medicines. When medicines are given at a different time to that printed on the medication form, the actual time it is given must be recorded to prevent medicines be given too closely together. The temperature of areas where medicines are stored should be monitored and recorded to suer they are of a suitable quality. Care Homes for Older People Page 6 of 11 Changes or amendments to medication instructions should be confirmed in writing by the prescriber. Signage and orientation aids indicating where key areas such as the lounge and dining room are should be placed around the home to help people find their way about. Staff must undertake all mandatory training to their role so they have the knowledge and skills to look after residents properly. In particular staff must have up to date moving and handling, health and safety and COSHH (control of substances hazardous to health). Prospective employees should receive a job description and person specification so they know what their job entails and whether or not they have the right skills for it. Supervision for staff continues to be poor, and although some are now receiving it, more must be done to ensure that all staff receive it at least 6 times a year. Overall there has been some improvement in the service the home provides since we last inspected, however the provider must be mindful of the legal timescales we set, and ensure these are met, otherwise we may consider enforcement action. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 7 of 11 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 24 12 Residents must be able to lock their bedrooms doors. You must do this so that residents can maintain privacy and security. 01/03/2010 2 30 18 Domestic staff must receive 01/02/2010 training in health and safety, infection control, moving and handling, and COSHH. You must do this to ensure they have the knowledge and skills to do their job safely 3 36 18 All staff must receive formal supervision You must do this so that staff have their working practices reviewed, their training needs identified and so they are supported. 01/03/2010 Care Homes for Older People Page 8 of 11 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Medicines controlled under 31/08/2010 the Misuse of Drugs Act 1971 must be stored in accordance with the Act and associated unauthorised access and inappropriate use of these medicines. You must do this to prevent unauthorised access and inappropriate use of these medicines 2 9 13 When medicines are given at 30/06/2010 a different time to that printed on the medication record form, the actual time it is given must be recorded. You must do this so residents are protected from harm by preventing medicines being given too close together 3 24 12 Residents must be able to lock their bedroom doors. You must do this for their privacy and security. Previous timescale of 01/02/2010 not met 30/06/2010 Care Homes for Older People Page 9 of 11 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 4 30 18 Staff must receive all mandatory training for their role. In particular first aid, fire, infection control and health and safety, You must do this to ensure they have the skills and knowledge to do their job. 31/05/2010 5 36 18 All staff must receive formal supervision. You must do this so that staff have their working practices reviewed, their training needs identified and so they feel supported. Previous timescale of 01/03/2010 not met. 31/07/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 The temperatures of the areas where medicines are stored should be monitored and recorded regularly to ensure medicines are of suitable quality. Changes or amendments to medication instructions should be confirmed in writing by the prescriber and this retained in the residents care notes. Better signage and orientation aids should be provided around the home to help residents find their way about. In Prospective employees should be given a job description and person specification so they know what the job entails. 2 9 3 4 19 29 Care Homes for Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 11 of 11 - 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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