Care Home: Woodlands Care Home

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What the care home does well Thorough assessments are carried out before people are admitted so that the home can be sure it can meet their needs. The staff of the home work well with health and social professionals throughout this process. Comprehensive care plans are put in place following consultation with service users and their representatives. Staff work in a `person centred` way, which means each person is seen as an individual with individual needs, which staff word hard to support. Staff are well trained about dementia and show great understanding of this condition and how it affects people. A social worker who completed a survey said they had seen staff with "excellent people skills" and that they "look at the personal needs and history of service users when delivering services". Two social workers and a general practitioner who completed surveys said the staff usually managed medication well and respected people`s privacy and dignity. Service users made positive comments and one said, "this is a good place to live". The home has had extensive changes made to it, so it now provides a range of comfortable sitting and dining areas. Seating is arranged in small groups but service users can spend time alone or with staff if they prefer. Some service users were occasionally asleep but more often they were taking an interest in what was going on around them, or doing an activity or chatting to staff or other service users. There was a pleasant hum of conversation and activity around the lounges. Service users have the opportunity to enjoy a wide range of activites and get out and about in the community with support from staff. It is also recognised that some service users prefer one to one support from staff, rather than join groups and their needs are catered for also. The cook prepares good nutritious food and meets the needs of service users with special or individual dietary requirements. Choices are available at all mealtimes and substantial snacks inbetween meals. Family and friends are welcomed into the home. A social worker, who completed a survey, said, "Woodlands make a friendly and welcoming environment to professionals and visitors. On many occasions they offer visitors meals". The recent refurbishment has provided most service users with an en-suite bedroom. Lounge and dining areas have been redesigned to provide plenty of choice of pleasant sitting and eating areas. Chairs are placed in small groups. Good staffing levels are maintained and staff have time to support service users in one to one activities or in group activities. They receive good training particularly about the needs of people with dementia. Robust vetting checks are carried out before people are employed, which helps to protect service users. A social worker who completed a survey said the staff have "excellent people skills" and "the staff approach is very professional".The home is managed to a high standard by Mrs Linda Gallon, who has implemented many improvements since she became manager. In particular, she has worked with staff to help them become more skilled and knowledgeable about caring for people with dementia. This has led to better care and quality of life for service users living here. A member of staff said, "the manager is very supportive with all the staff and is very much involved with residents. She is not a manager who sits in the office 9 to 5. This is an excellent company to work for and I am proud to be part of an organisation that is recognised throughout the area for great care". A service user also commented that the manager worked hard and was often to be seen in the home up to 10 pm. What has improved since the last inspection? The home has been extensively improved to provide ensuite bedrooms, improved toilet and bathing facilities and better designed lounges and eating areas. Improvements are now being made to the garden and remaining areas of the home. Improvements have continued to be made in care planning and record keeping. Requirements made at the last inspection have been addressed. What the care home could do better: When people return to the home after a spell in hospital, the discharge notes from the hospital should be checked immediately to ensure any change to their medication is acted on straight away. This ensures they get the right medication when they need it. If any service user is prescribed medication in a varying dosage or to be used `when required`, guidance outlining the circumstances when the medication should be given, shouold be placed with the administration record. This helps to ensure that staff are aware of when and how much medication they should give and avoids the medication being given routinely or unnecessarily. When staff open short life medication, such as eye drops, they should note the date of opening on the medication container. This helps ensure the medication is not used when it is past its best. There are generally good arrangements in place for the protection of the people living here but some staff need a better understanding of the Whistle Blowing policy. This helps ensure they will feel comfortable about raising any concerns they may have. Key inspection report Care homes for older people Name: Address: Woodlands Care Home Great North Road Wideopen Newcastle Upon Tyne NE13 6PL     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Janine Smith     Date: 3 0 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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 30 Information about the care home Name of care home: Address: Woodlands Care Home Great North Road Wideopen Newcastle Upon Tyne NE13 6PL 01912170090 01912364165 Linda@woodlandsc.plus.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: North East Care Homes Ltd care home 42 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 42 The registered person may provide the following category of service only: Care home only - Code 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 - Code OP, maximum number of places: 42 Dementia - Code DE, maximum number of places: 42 Date of last inspection Brief description of the care home Woodlands is a purpose built home that provides personal care and support for 42 elderly people. The home is in a residential area of Wideopen close to shops, churches and local amenities. There is a bus route that passes the home. Residents who need care because of age, physical frailty and/or memory loss including Care Homes for Older People Page 4 of 30 Over 65 0 42 42 0 Brief description of the care home dementia type illnesses are supported by good levels of staff. As well as the registered manager, administrator and care team the home has an activities co-ordinator, six kitchen staff, a housekeeper and laundry assistant. One of the care team is a qualified hairdresser who runs the homes hairdressing salon. There are bedrooms at first and second floor levels. A passenger lift helps residents to get around the home. The home has been extensively improved which has provided 34 bedrooms with ensuite facilities. Fees for privately funded service users range from £441.63 to £457.78 per week. The fees do not include charges for hairdressing, private chiropody, toiletries, transport and costs for outings. Information about the service, including inspection reports, are available. The home also produces a monthly newsletter to keep people up to date with what is going on. Care Homes for Older People Page 5 of 30 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: Before this visit we looked at information we have received since the last visit on 5th July 2007; how the service dealt with any complaints and concerns since the last visit; any changes to how the home is run; the providers view of how well they care for people; the views of people who use the service and the staff. An unannounced visit was made on 30th June 2009. During the visit we talked with people who use the service, staff and the manager. We looked at information about the people who use the service and how well their needs are met. We looked at other records which must be kept and checked that the staff had the knowledge, skills and training to meet the needs of the people they care for. We looked around parts of the building to make sure it was clean, safe and comfortable. We also checked what improvements had been made since the last visit. We told the manager what we found. Care Homes for Older People Page 6 of 30 We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at signficant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 30 What the care home does well: Thorough assessments are carried out before people are admitted so that the home can be sure it can meet their needs. The staff of the home work well with health and social professionals throughout this process. Comprehensive care plans are put in place following consultation with service users and their representatives. Staff work in a person centred way, which means each person is seen as an individual with individual needs, which staff word hard to support. Staff are well trained about dementia and show great understanding of this condition and how it affects people. A social worker who completed a survey said they had seen staff with excellent people skills and that they look at the personal needs and history of service users when delivering services. Two social workers and a general practitioner who completed surveys said the staff usually managed medication well and respected peoples privacy and dignity. Service users made positive comments and one said, this is a good place to live. The home has had extensive changes made to it, so it now provides a range of comfortable sitting and dining areas. Seating is arranged in small groups but service users can spend time alone or with staff if they prefer. Some service users were occasionally asleep but more often they were taking an interest in what was going on around them, or doing an activity or chatting to staff or other service users. There was a pleasant hum of conversation and activity around the lounges. Service users have the opportunity to enjoy a wide range of activites and get out and about in the community with support from staff. It is also recognised that some service users prefer one to one support from staff, rather than join groups and their needs are catered for also. The cook prepares good nutritious food and meets the needs of service users with special or individual dietary requirements. Choices are available at all mealtimes and substantial snacks inbetween meals. Family and friends are welcomed into the home. A social worker, who completed a survey, said, Woodlands make a friendly and welcoming environment to professionals and visitors. On many occasions they offer visitors meals. The recent refurbishment has provided most service users with an en-suite bedroom. Lounge and dining areas have been redesigned to provide plenty of choice of pleasant sitting and eating areas. Chairs are placed in small groups. Good staffing levels are maintained and staff have time to support service users in one to one activities or in group activities. They receive good training particularly about the needs of people with dementia. Robust vetting checks are carried out before people are employed, which helps to protect service users. A social worker who completed a survey said the staff have excellent people skills and the staff approach is very professional. Care Homes for Older People Page 8 of 30 The home is managed to a high standard by Mrs Linda Gallon, who has implemented many improvements since she became manager. In particular, she has worked with staff to help them become more skilled and knowledgeable about caring for people with dementia. This has led to better care and quality of life for service users living here. A member of staff said, the manager is very supportive with all the staff and is very much involved with residents. She is not a manager who sits in the office 9 to 5. This is an excellent company to work for and I am proud to be part of an organisation that is recognised throughout the area for great care. A service user also commented that the manager worked hard and was often to be seen in the home up to 10 pm. 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 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 0870 240 7535. Care Homes for Older People Page 9 of 30 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 10 of 30 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 may use the service and their representatives have the information needed to make sure that the home can meet their needs. Evidence: The Service Users guide was readily available in the home. Two social workers, who completed surveys, said that the homes assessment arrangements always ensured that accurate information is gathered and the right service planned for people. They also said that service users social and health care needs were always properly monitored, reviewed and met by the home. The care record of someone recently admitted was looked at. A comprehensive assessment had been carried out to make sure that the home would be able to meet their needs. A welcome notice was placed in their bedroom and a photo of their keyworker. Their next of kin had been involved in helping to draw up their plan of Care Homes for Older People Page 11 of 30 Evidence: care. Care Homes for Older People Page 12 of 30 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. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put in practice. Evidence: The care three people received was looked at in detail to form a view of how well their needs were being met. Their care records were up to date and comprehensive. A full range of up to date assessments had been carried out in each case, including Clifton, dental, continence, risk of falls, nutrition, pressure sore and infection risk, manual handling needs and self-medication. These assessments help inform carers about the extent to which they need help with day to day tasks or life in general. An assessment of their strengths had been documented. The care plans were very personalised, reflecting the persons wishes and what they did and did not like. Service users or their representatives had been involved in drawing them up. The recordings were very positive and person centred. As many service users have dementia, the quality of information held is very important so that carers are well informed about the needs and wishes of each person they care for. The information held was very clear and showed that staff had understanding of the needs of people with dementia. For Care Homes for Older People Page 13 of 30 Evidence: instance, one plan clearly described behaviours shown by a service user, and the action staff should take and emphasised that the behaviour displayed was the way a service user communicated her feelings. The care records showed that service users had had contact with their general practitioners, community nurses, or hospital when necessary and routine check ups from the chiropodist, dentist and optician were carried out. Their weight was monitored regularly. Advice had been sought from the Challenging Behaviour team where appropriate or other health care professionals. For instance, a service user has a swallow problem and has to have a pureed diet. Advice had been sought from the speech therapist. Risk assessments had been put in place where appropriate. Five surveys were received from staff, who stated that they are always given up to date information about the needs of the people they care for. They also said they usually or always have the right skills and experience to meet the needs of service users. A survey was received from a general practitioner who stated the staff always manage medication appropriately, respect peoples privacy and dignity and help them live the life they choose. Two surveys were received from social workers, who state that the home always or usually supports people appropriately with medication, respects their privacy and dignity, and supports them to live the life they choose. One added, observed excellent people skills and added, looks at personal needs and history of service user when delivering services. The manager and care staff are a happy staff group and this is reflected in the service users provision of care. The other said, At times communication from staff to staff could be improved. When the manager is not around it is noticeable. They also said that service users social and health care needs were always properly monitored, reviewed and met by the home. Each service user has a key worker, a member of staff who is a link who provides particular support to them. Each room has a photograph identifying who their key worker is. One service user said Woodlands was a good place to live and she enjoyed the staff, home, activities and food. Another service, who has lived here many years, continues to enjoy it. Her bedroom has been adapted specifically for her to help her manage her physical disabilities. Care Homes for Older People Page 14 of 30 Evidence: Another service user said, This is a good place to be. Time was spent sitting quietly in a lounge observing to get a flavour of what it was like. Some service users were occasionally asleep, but often they were taking an interest in what was going on around, or chatting to each other or the carers, or doing an activity such as reading or listening to music. Seating is arranged in small groups, so that there are plenty of places service users can choose to spend their time. Staff are trained before handling medication, which was confirmed by a senior carer. As well as training from an outside agency, the manager assesses the workers competency to handle medication, which is a detailed assessment which establishes how well they understand what they need to do. Evidence of this training and testing was seen for one member of staff. The manager also carries out regular audits of the medication system to help ensure it is being handled appropriately. A member of staff recently failed to follow safe procedures when handling medication, but this was quickly identified and reported within the home and dealt with by the manager. A senior carer described the processes followed when ordering, administering and handling medication which were appropriate. The medication and a sample of records were looked at. It was noted that a service user had been discharged from hospital the previous night but staff had not noticed that the hospital discharge summary showed a change in the prescribed dosage of one of her medications and the old prescription had been followed during the day. One person was prescribed a variable dosage of one medication and staff were usually giving the higher dose. Written guidance should be placed alongside the medication administration record to advise staff how to decide how much and when to give this medication to ensure that it does not become routine to give a higher dose. A bottle of eye drops were not marked with the date of opening. Other aspects of medication were fine. Care Homes for Older People Page 15 of 30 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. People who live here are able to make choices about their lifestyle and are supported to enjoy as active and fulfilling life as they wish. Evidence: Carers were observed throughout the day spending time with service users, chatting or doing activities like knitting. Staff described the type of social activities carried out. These included one to one support for some individuals to go out for walks to improve mobility and wellbeing. Other group activities included exercise sessions, arts and crafts activities, baking in the kitchen. They also do one to one with those people who dont like groups. Some like doing colouring in or using a memory book. One lady was observed reading a reminiscence book. There is a knitting and sewing circle. Three ladies are making a proggy mat. They have reminiscence sessions and entertainers come in twice a month at least. They have musical bingo sessions and give us a clue. Some service users are said to enjoy music and they have sing-a-longs. After the evening meal, they put dance music on and service users often dance with the carers. Some service users enjoy walks locally, looking at gardens, the park or doing some shopping. They visit garden centres. They have a gardening group and have planted bulbs in the courtyard garden. They plan to make wind chimes and butterflies for the front when it is landscaped. Care Homes for Older People Page 16 of 30 Evidence: Three of the male service users enjoy bowls and they will be organising visits to local parks to watch or play, if possible. They are also trying out poetry and geordie joke sessions, which are popular. They are planning a garden party at the end of July. Some service users enjoy one to ones in the kitchen where they make buns, biscuits and cakes and there were photographs showing them enjoying this activity. Some service users set the tables, do dusting, peel vegetables in the kitchen. Some like flower arranging or watering the plants. They have lots of plants around and get fresh flowers every day. They have been in touch with the local authority about using lunch clubs. Some service users have been to a tea dance. They use taxis for transport. Two local churches visit twice a month. Service users are asked every week if they would like to go to church. A carer said they are also making life story books with some service users. They can then use these to have talks with individual service users about their lives. They are also making scrap books and photo collages of old and new service users. The activities organiser also works a late evening once a week, which is good practice, as she can be available at times when people with dementia can tend to be more active. Bedrooms contained copies of the homes newsletter. The communal areas were nicely decorated with pictures. There was lots of reading matter around, such as magazines, newspapers and books about past times. Residents were seen making use of these. A service user said her family came in to see her. She also goes out with staff regularly, which she enjoys. A social worker, who completed a survey, said Woodlands make a friendly and welcoming environment to professionals and visitors. On many occasions, they offer visitors meals. There was evidence in care plans to show that service users were assisted to make choices about their day to day lives, such as giving people the support to manage their own financial affairs. Service users can get up and go to bed when they prefer and meal times are flexible. Fresh juice was available in the lounges and there is a machine to provide fresh water. As there are four dining areas, staff can ensure that service users who need more support get this. The cook baked scones, which were served mid afternoon, when there was a pleasant hum of conversation from service users. Care Homes for Older People Page 17 of 30 Evidence: The manager said that they had tried to assist servicer users to make choices at mealtimes by showing them photographs of the meals on offer. However, by the time the meal was served, many changed their minds. They now offer two plated meals at the time of serving to ensure that they get the choice they want at the time they make it. This is good practice. The cook prepares a good range of substantial snacks for between meals. She also prepares a platter of prepared fruit. Some service users have an individual menu, due to health reasons or preferences. Their preferred likes and dislikes are taken account of when drawing up menu plans for them. The cook said she was informed if any service users are not eating well or losing weight. She then prepares enriched, high protein snacks, such as bananas, ice cream, milkshakes. For anyone needing a pureed diet, the individual foodstuffs are prepared and served separately, which helps make the meal colourful and appetising. One person needs a special diet due to a health problem. The cook has guidance and has also done her own research on the computer about this and knows what she can eat. A care plan was in place for this and advice had been sought from health professionals. Care Homes for Older People Page 18 of 30 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. People who stay here are able to express their concerns and have access to a robust, effective complaints procedure. They are protected from abuse, but further steps should be taken to ensure that all staff understand what the whistleblowing policy is about and the protection it gives employees, who report concerns. Evidence: There is a complaints procedure in place, if anyone has concerns. A general practitioner and two social workers, who completed surveys, said that the service always responded appropriately to any concerns. All five staff who completed surveys, said they knew what to do if someone had concerns. A service user said she would readily raise any concerns if she had them and knew the manager and owner well. The manager has had extensive training about the protection of vulnerable adults (pova) and assists North Tyneside Council in carrying out training. A carer spoken to showed their understanding of the homes whistle blowing policy and confirmed they had had training about the protection of vulnerable adults. Another recently employed carer confirmed they had received pova training but could not explain what the whistle blowing policy was about or give examples of the type of abuse which could occur. This may have been due to nervousness. She was, however, clear that she would report any concerns to the manager. Another was also not sure what whistle blowing meant. However, they had had training and could give examples Care Homes for Older People Page 19 of 30 Evidence: of abuse and knew what to do if they had concerns. Care Homes for Older People Page 20 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home has been much improved to create comfortable, good quality individual and shared living spaces. Consideration has also been given to the needs of some service users to ensure that their bedroom and bathing facilities meet their individual needs. Evidence: A tour of the home, including a sample of bedrooms, was made. Access to and from the building is good. Bedrooms are homely and well maintained. They have all been recently refurbished and most fitted with ensuite toilets. Attention has also been paid to the individual needs of service users, for example, one room has been equipped to meet the specific needs of a service user with mobility problems. The washbasin is designed for her to use from a wheelchair. Attractive photos of service users have been attached to their bedroom doors in nice frames, to help people with dementia identify their own bedroom. The communal areas have been redesigned to create four attractive lounge dining rooms. Fresh flowers are provided every day and there were attractive large plants. The television lounge also houses two budgies. Bathrooms and a shower room are also being or have been refurbished. Good signage was fixed to the doors to help service users identify toilets and bathrooms. A sensory Care Homes for Older People Page 21 of 30 Evidence: therapy bathroom has also been created, which has candle type lighting effects and music, so service users can enjoy a relaxing bath. A longstanding senior carer, who was previously a hairdresser, has used his own money to fully equip one room as a hairdressing salon, complete with hairdressing sinks, dryers, sterilising equipment, lighting effects, music system and a nail bar. This looked delightful and a good place to go for a natter. A new snoozelum room has been created using a donation from a former service users family. This has special lighting and sound effects, such as bird song and tinkling water and provides a relaxing space for people to use. The home has a passenger lift to the first floor, which was in working order. Radiators are safeguarded. The home had hoisting equipment and sit on weighing scales. A sample of window restrictors were checked and found to be in working order. Staff responded quickly when the call system sounded. A social worker who completed a survey, said The entrance of Woodlands could be made more welcoming. It is rather bare. Prospective carers of service users have been put off by the dingy entrance. There are large garden areas and work has started on landscaping these. The manager said she was going to Stirling University, a centre of expertise on dementia, to get ideas for creating a sensory garden. A small courtyard area provides a space where service users can do some gardening. A garden club has been started. A small covered area has been created for service users who smoke. Improvements are being made to the flooring in the laundry area. They use protective clothing and protective bags when dealing with soiled laundry. The staff have handwashing facilities. There was a system for the labelling and identification of clothing. The home was clean and fresh smelling, apart from an odour in one bedroom. Staff were observed working hard to keep the home clean throughout the inspection. A service user commented that there were never any unpleasant smells. Staff spoken to confirmed that they received training in infection control and had ready access to protective clothing. Their staff records provided evidence of this training. Care Homes for Older People Page 22 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service. Evidence: There were six care staff on duty between 8 am and 8 pm. Four care staff were on duty between 8 pm to 10 pm and three waking carers through the night until 8 am. An activities organiser worked between 10 am to 5 pm on some days and also on one evening. Ancillary staff were also employed. The rota and staff spoken to confirmed the staffing levels maintained. They said that, although it was busy, they had time to spend with service users, for instance, going for a walk, playing dominos. All five staff, who completed a survey, said that there were always or usually enough staff to meet the individual needs of service users. One added, The only thing that is a problem at times is a shortage of staff but thats not as a general rule. Five staff said in their survey that they were vetted before they started work. They all stated their induction training covered everything they needed to know and that they had received ongoing training about the individual needs of people, health care and medication. Ancillary staff have also been given training about dementia, which is good practice. Care Homes for Older People Page 23 of 30 Evidence: The records of two established carers showed that they had had training in dementia care and both had achieved a National Vocational Qualification at Level 2. One had completed essential health and safety training and update training was planned for the other. One of these staff plus another were also spoken to and they confirmed the training they had had. The record of a carer employed a few weeks earlier showed that three references had been taking up, a declaration about any offences or cautions obtained and a satisfactory check had been made with the Criminal Records Bureau, which included a check of the Protection of Vulnerable Adults list. A record had been kept of her interview to show the areas discussed and opinions drawn. She had been issued with an employment handbook and given induction training, which she confirmed. She had also received essential health and safety training and updates were planned. She had already achieved a NVQ2, but was receiving further in house training about dementia. Surveys were received from two social workers and a general practitioner, who all said the staff always or usually had the right skills and experience needed to support the people they cared for. One said they had observed excellent people skills and another said, the staff approach is very professional. Care Homes for Older People Page 24 of 30 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 management and administration of the home is based on openness and respect, has effective quality assurance systems, developed by a qualified, skilled manager. Evidence: The registered manager, Mrs Linda Gallon, has managed Woodlands for the past couple of years. During that time she has implemented and overseen many improvements, which have led to better quality of care of the service users living here. In particular, she has worked with staff to help them understand and work with service users in a person centred way. This means that they always see each person as an individual with individual needs rather than providing the same service to all, regardless of need. She has set high standards for the staff team and shown strong leadership. She acts quickly and decisively if issues need to be addressed. A service user said she knew Mrs Gallon well, who she said worked hard and was often to be seen working in Woodlands until 10 at night. She also sees the owner about the home regularly and knows him. Care Homes for Older People Page 25 of 30 Evidence: Five surveys were received from staff, who all confirmed they received regular supervision from their manager. One said, I feel that the home does very well in most aspects of the management and care of service users. Another said, the manager is very supportive with all the staff and is very much involved with the residents. She is not a manager who sits in the office 9 to 5. This is an excellent company to work for and I am proud to be part of an organisation that is recognised throughout the area for great care. Another said, I dont feel that the home could do anything more. I feel that the manager is running a fantastic home here. Another carer, spoken to during the inspection, said the manager was alright and that she tries all the time to improve. She is fair to residents and staff. The home had a quality assurance system in place, which included using surveys to obtain feedback from service users, relatives, staff and outside agencies who visit. There was evidence they acted on feedback, for instance, improvements were being made to the garden. The system for handling service users personal monies was looked at. Appropriate records were kept and receipts held for items purchased on their behalf. A check was made of two balances held which were accurate. Auditing procedures are said to be in place. Records were kept of fees charged and personal allowances processed on behalf of service users. Staff spoken to and staff records showed that they were systems in place to provide essential training in moving and handling skills, food hygiene, first aid, fire safety, infection control and health and safety. A sample of maintenance and servicing records were looked at for the fire extinguishers, hoists, electrical wiring and appliances, which were up to date. Care Homes for Older People Page 26 of 30 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 27 of 30 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 1 9 Ensure that hospital discharge summaries are checked carefully, so that any changes to a service users medication, are actioned immediately. This helps ensure that service users receive the medication prescribed by their doctor as soon as possible and helps ensure that mistakes are not made. Where service users are prescribed medications, which may be taken as and when necessary or in a varying dose, guidance should be placed in the medication administration records to advise staff when they should give this medication. This helps ensure that such medication is not given routinely, which may not be good for the service user in the long term. The container of short life medications, such as eye drops, should be marked with the date they were opened. This helps ensure that the medication is not used after the period of time advised by the manufacturer. 2 18 Ensure that all staff fully understand the Whistle Blowing Policy, and in particular the protection it provides to staff who report concerns in good faith. This helps to ensure that Page 28 of 30 Care Homes for Older People 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 staff are not afraid to report bad practice it they come across it, and means service users can be protected from abuse. Care Homes for Older People Page 29 of 30 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. 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