Care Home: Woodlands

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What the care home does well People who are interested in living at the home are given clear information to help them make a decision. People are asked what support they need and how they would like this to be done. People told us they like living at the home as it is a relaxed and homely atmosphere. They are treated with respect and are supported to make decisions for themselves. They are helped to remain as independent as possible following support needs and risk management assessments. They say the staff are always friendly and attentive and they feel safe living at the home. There are plenty of things for people to do to keep them occupied. People feel they are listened to and some changes have been made as a result. People are helped to stay in good health. What has improved since the last inspection? The home has increased the amount and variety of information available to people who are interested in living there. Staff training has increased and includes specialist areas so people can be better supported. People on the waiting list are kept in touch by the home newsletter. There is an increased use of volunteers form the community to help with activities. What the care home could do better: There were no requirements or recommendations identified at this visit. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Woodlands 176 Reading Road South Church Crookham Hampshire GU52 6AE     The quality rating for this care home is:   three star excellent service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Geoffrey Senior     Date: 1 3 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Woodlands 176 Reading Road South Church Crookham Hampshire GU52 6AE 01252613880 01252613880 Jean@woodlands-hillbrow.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Woodlands and Hill Brow Ltd care home 40 Number of places (if applicable): Under 65 Over 65 0 40 dementia old age, not falling within any other category Additional conditions: 40 0 The maximum number of service users to be accommodated is 40. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Dementia (DE). Date of last inspection Brief description of the care home Woodlands Care Home provides accommodation for forty people who are within the category of older people. The home endeavours to provide a homely and relaxed environment for residents. The home is owned and operated by Woodlands and Hill Brow Ltd a family business who also have a second home in the area. The home is situated between the towns of Farnham and Fleet and is located in a residential street in Church Crookham. The home is set within its own grounds. Accommodation is provided on two floors, with lifts and stairs providing access to each floor. Residents are accommodated in single rooms with en-suite facilities. Residents also have access to a large lounge with television, a smaller quiet lounge and a dining room. The home Care Homes for Older People Page 4 of 25 Brief description of the care home has a pleasant garden that is accessible to all residents, including those who use wheelchairs. Information received stated that fees for the home ranged from £480 to £610 per week. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This visit to Woodlands was an unannounced Key Inspection. We arrived at the home about 10 oclock and stayed for about four and a half hours. We sat with the Manager in her office for a while; talking about how the service is doing and looking at some of the records and documents. We also spoke with the two deputy managers before walking round the home and looking at the accommodation with the Provider. We met and spoke with a number of the service users, some in private. We also met and spoke with members of staff and observed them as they went about their work. In addition to the information collected on the day we also looked at the Annual Quality Assurance Assessment, (AQAA). And information we have received about the service Care Homes for Older People Page 6 of 25 since the last inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –03000 616161. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are interested in living at the home are given clear information to help them make a decision. People are asked what support they need and how they would like this to be done Evidence: People who are interested in living at the home are invited first of all, to visit or join as a day resident. They may use the opportunity to meet and spend time with the existing residents and staff, view the accommodation and find out about the lifestyle and routine they could expect to experience at Woodlands. Written information about the home its facilities and services, and a variety of other relevant and related issues such as; care fee planning,social services funding, the Mental Capacity Act, and deailing with people with dementia is available to prospective service users and their families or representatives. The home keeps in touch with those on the waiting list by sending them resident newsletters and regular telephone updates. Prior to any Care Homes for Older People Page 10 of 25 Evidence: admission to the home the management undertakes a full assessment that explores all the relevant areas of care including social needs, medical history, mobility and mental cognition to determine suitability for living at the home. Information is gathered from hospital staff, care managers and relatives. All the information is brought together to decide whether or not the home will be able to meet the service users assessed needs and that the placement will be mutually beneficial. This then forms the basis for developing the care support plan. The home tries to avoid emergency admissions. There is a good mix of youth and experience in the staff team who have the skills, knowledge and experience to meet the assessed needs of the service users . Staff were seen to communicate well with the service users and the atmosphere was relaxed. The service users spoken with were happy and content with the home and felt that their needs were being met. One said that she had been able to visit the home and had viewed the room before making a decision about taking the place that was offered. Another said that they were happy to have left it to their family to make all the arrangements and were delighted with the choice. Specialist services are available to any of the service users as the need arises Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are involved in their care planning, their healthcare needs are being met and they are treated with kindness and respect. The arrangement for managing medication are satisfactory. Evidence: People who live at Woodlands say the Managers and care workers offer them all the assistance that they need. Each person has an individual plan of care and personal support. These are important documents because they are one of the ways that people can have a say in what sort of support they want and how they want it to be done. The plans give information to staff so they know what to do when assisting the service users. Staff said that the care plans and risk assessments are clear and understandable and help them to know what needs to be done, how and why. The staff make daily notes on each of the service users and report on any changes to make sure that the plans are up to date and accurate. The management regularly review the care plans. They check with the person concerned, with their relatives and care workers how things are going and what might need to be changed. Service users said Care Homes for Older People Page 12 of 25 Evidence: that they felt they were always listened to and that staff were happy to accommodate changes if they could. If they want, service users are helped to record, or have written down for them, things about their personal history and particular memories they may have so that staff have a better understanding of what is important to them. Steps are taken to try to ensure that people do not have any avoidable accidents. These are recorded in the care plans as risk assessments. Some people may , for example, be unsteady on their feet so they will be accompanied by staff, or have special rails fitted if they worry about rolling out of bed. People are helped to stay well. Staff keep an eye out for any signs of illness or changes to peoples condition so that a doctor can be contacted without delay. Alocal GP holds fortnightly surgeries in the home so every resident has adequate independent medical support. Any visits to or from the local GP, physiotherapist, community nurse or other health care professionals are written down and the care plans updated as necessary. The homes fees include 5 weekly chiropody care. The home has clear procedures in place for dealing with medicines. Service users can manage their own medication when it is safe for them to do so. No one chooses to do so at the moment. The home uses a monitored dose system for administering medication. We watched a member of staff giving out some tablets at lunchtime. She checked that the medication was the right one for the person concerned then, having given it, she recorded what had been done. We looked at the records and storage for medication and found them to be satisfactory and up to date. One of the staff is trained to be a trainer for medication and checks on the competency of staff. The Manager also does spot checks to make sure safe and proper procedures are followed. People said that staff are always friendly, helpful and attentive and that nothing is too much trouble for them. Staff are respectful of peoples privacy and we saw them knocking on doors before entering private rooms. There was a relaxed, informal and unhurried atmosphere in the home with people being quietly and discreetly assisted. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are interesting things for people to do if they choose. People may to receive visitors and spend the day as they wish. Service users are offered a variety of good quality meals. Evidence: People said that there was a social gathering or event that they can join in with on most days. They do have a choice however and no one is jollied into doing things they do not want. Staff are aware of peoples interests and background history through the care plans as well as talking to them on a daily basis. Each person is given a schedule relating to the weekly activities in the home. Relatives and friends are invited to become involved in what is going on. We saw one group meeting in the dining room to read poetry and another sat round the table discussing the newspaper and keeping up to date with current affairs. The Manager is in the process of a research project to look at the relationship between social life and dementia in the home setting. She hopes this will improve the homes understanding and skills when supporting people with this condition. Care Homes for Older People Page 14 of 25 Evidence: People are helped to keep in touch with their family and friends if this is what they want. People are welcome to call at the home at any reasonable time. Staff keep in touch with them to keep them up to date and inform them of any significant changes or events. A newsletter is also sent out to relatives and people on the homes waiting list. We were told that although there were no particular matters arising at the moment, any social, cultural or religious issues would be given every consideration and appropriately supported. We asked about the menus and food people are offered to eat. Service users said that they have really nice meals and there is always enough to eat. They are informed about what is on offer for each meal and can, if they wish have an alternative. We were told that there is a good balance of meals with fish, meat and vegetables always available. People can choose where they take their meals and although the dining room at lunchtime was relaxed and unhurried, a number preferred to dine in the privacy of their rooms. Snacks and drinks are available throughout the day and night so people do not have to go too long without refreshment. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a complaints procedure. There are arrangements to make sure complaints are dealt with properly. Evidence: People said that they feel safe living at Woodlands. They knew who to go to and would be quite happy to talk to them about any concerns, complaints or if anything was worrying them. They knew of the information about making a complaint that is in the homes brochure but would probably go straight to staff or relatives. The home keeps a complaints and action book which details any and every issue raised, the action taken and the outcome. Staff have received training in the protection of vulnerable adults and have guidelines available for further reference. There are staff members who are trained to present abuse training to other staff members. All staff are required to attend abuse training at least every six months. The home aims to protect residents when recruiting new staff by undertaking thorough background checks and references before they are allowed to start work. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Woodlands provides a clean and homely environment for all who live, work and visit there. Evidence: Woodlands is a large detached house. The living areas and bedrooms are spread over two floors. These are accessible by stairs or one of 3 passenger lifts. Every one has their own room with en-suite facilities. The people we spoke with like their rooms and those we saw were well decorated and homely with lots of personal possessions and ornaments on display. People can have their own key if they wish. Everyone has a call alarm in their room to attract staff attention if they need help or assistance. The ground floor lounges and dining room have been moved around at the suggestion of the residents and patio windows fitted to give direct access to the extensive gardens. There are paths around the garden so people can access, sit and enjoy the tranquil spaces. There are smaller communal areas where people can sit quietly without the TV and read or write letters. Everywhere we saw appeared to be tidy and smelt fresh and clean. There is an ongoing programme of redecoration and repair so some areas showed some signs of wear and tear but not neglect. Care Homes for Older People Page 17 of 25 Evidence: Information sent to us by the home before the visit told us that the maintenance of equipment is up to date and satisfactory. The provider confirmed that the inspection of the electrical installation was nearing expiry but had been booked for the 24th February 2009. There are measures in place for the control of infection and the safe handling of substances hazardous to health. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are well trained staff in sufficient numbers to care for and support the service users at all times. Evidence: We were told that there are always five care support staff and three of the management team on duty in the morning, four carers plus one manager in the afternoon and evening and three care staff at night. This is so that there are enough people around to support the service users fully and to give staff time to sit and chat with residents in a relaxed manner. People said that they never feel rushed and someone always comes quickly if they need assistance. Before people are employed as staff at the home the Registered provider completes a number of checks. This is to confirm their identity, take references and do a police check. We looked at the records of two staff and saw that these had been done. We were told that there is a low staff turnover and the home does not need to use agency staff so everyone on duty is familiar to the residents. The Providers want staff to see their job as a long term, skilled and caring profession. To this end they offer staff introductory training before they work on their own and then encourage them to make use of the training opportunities that are offered. A Care Homes for Older People Page 19 of 25 Evidence: number of staff are in house trainers for mandatory courses and four are NVQ assessors. NVQs aim to help people deliver good quality residential care services. 14 of the 26 staff have attained NVQ to at least level 2 and 3 of the management team have the registered manager award. Staff told us that they are able to attend additional training on specialised subject and discuss their development and training needs during regular supervision sessions. The staff training programme includes; stroke awareness, Parkinsons and sensory loss. 10 staff have undertaken palliative care training during the past year. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is reliably managed. People are listened to when asked what they think about the home and the service it offers and improvements made as a result. Peoples health and safety is promoted. Evidence: The manager has worked at the home for fifteen years and has managed it for seven. She has a management qualification designed to help her ensure high quality support is provided. She is also undertaking degree level study of Dementia. She is supported by two deputies also with the registered manager award and has two senior staff with level 4 NVQ qualification. The staff said that there is a good team spirit and morale is high. The handover meetings at the beginning and end of each shift ensure everyone knows what is going on and the service users get consistent and informed support. Care Homes for Older People Page 21 of 25 Evidence: Service users told us that they are constantly asked for their opinions about how the house is run and any ideas for improvement or change. Formal meetings are held for residents and relatives to have their say. They are also invited to participate in training events. Some service users have been invited to sit in on interviews for new staff and voice their opinions. The minutes of the meetings and the results of the surveys are published in the homes service user guide. The registered provider visits most days and is a familiar face to everyone. She oversees the management of the home and ensures her standards and expectations are maintained. She also looks at key records and documents. The AQAA (Annual Quality Assurance Assessment) was completed and returned to us on time. It contains thorough and detailed information that is supported by other appropriate evidence. It demonstrates a good level of self awareness and is used in conjunction with other quality assurance measures in the planning and further development of the service. Record keeping was of a consistently high standard. The records are securely stored but Service users may have access them to know what they contain and to contribute to them if they wish. Staff have received training for the health and safety of people living and working in the home. The management undertake regular health, safety and maintenance checks to safeguard the well being of residents, staff and visitors. The home recently attained an excellent rating from the local Authority Environmental Health Inspection. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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