Care Home: Woodlands Cottage

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What the care home does well The home is clean, comfortable and well maintained. Specialist equipment is provided to meet people`s needs. The home carries out assessments and obtains good information about people`s needs before they are admitted. This helps to ensure their needs can be fully met. The staff team are well trained to meet the individual needs of the people living in the home. The staff team work hard to provide people with opportunities to participate in activities of their choice and to introduce them to new experiences. People are supported to go on holiday each year accompanied by the staff. They are encouraged to make decisions and choices in all areas of their lives. There are clear guidelines for the staff to help ensure individual needs are met in a way each person prefers. People are encouraged and supported to keep in touch with their family and friends. There are good systems in place to help ensure people are listened to, including relatives and staff. This helps ensure the home is run in the best interests of the people who live there. Routines are flexible and good relationships exist between the staff and the people living in the home. A health care professional stated the staff "do an excellent job". A care professional stated "very focused on individual needs. Very dedicated, excellent relationships between staff and service users. What has improved since the last inspection? Person centred care plans are being developed for each person living in the home. The people living in the home and their families have been involved in these to help ensure their wishes and preferences are taken into consideration. The dining room has been redecorated. A new gate has been installed to provide a safer evacuation route if a fire should occur. New wardrobes have been purchased for the bedrooms and a new television has been provided in the lounge. What the care home could do better: The registered provider should ensure that items stored in the sun lounge are removed so it is accessible and safe for the people living in the home at all times. The care plans should be evaluated every month so ensure any changes in people`s needs are fully met. The complaints procedure should be displayed at all times so visitors are aware of how to make a complaint if necessary. Key inspection report Care homes for adults (18-65 years) Name: Address: Woodlands Cottage Fernlea Drive Choppington Northumberland NE62 5SR     The quality rating for this care home is:   two star good 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: Anne Brown     Date: 0 5 0 8 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 Adults (18-65 years) Page 2 of 28 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 Adults (18-65 years) 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 Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Woodlands Cottage Fernlea Drive Choppington Northumberland NE62 5SR 01670828487 01670827525 NTAWNT.Woodlands@nhs.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Northumberland, Tyne & Wear NHS Trust care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category of service only: Care Home only, Code OP. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following category: Learning Disability, Code LD, maximum number of places 4 Date of last inspection Brief description of the care home Woodlands Cottage is a purpose built bungalow for four people who have learning and physical disabilities. The home is situated in the community of Choppington and is close to local amenities. The people who live in the home are provided with single room accommodation and access to a range of aids and adaptations in line with their personal needs. There is a separate dining room, lounge and kitchen. Specialist bathrooms and toilets are provided. The homes furnishings and fittings are of a high standard and the building is well maintained. Attractive garden areas are available. A small car park is provided to the front of the building. The home is not registered to provide nursing care. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 4 Brief description of the care home The fees range from £1319.03p to £1342.47p per week. Inspection reports and information about the home are readily available. Care Homes for Adults (18-65 years) Page 5 of 28 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that the people who may use this service experience good quality outcomes. 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 significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out: Before the visit: We looked at: Care Homes for Adults (18-65 years) Page 6 of 28 Information we have received since the last inspection on 5th September 2007. Any changes to how the home is run. The providers view of how well they will care for people. Surveys returned from people living in the home, the staff and care professionals. An unannounced visit was made on 3rd August 2009. During the visit we: Talked to the manager and staff on duty. Looked at assessment information about the people who may use the service and how well their needs are met. Looked at some policies and procedures. Looked at staff training programmes. Looked at the homes recruitment and selection procedures. Looked around the premises to make sure they were clean, safe and comfortable. We told the manager of the home what we found. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: The registered provider should ensure that items stored in the sun lounge are removed so it is accessible and safe for the people living in the home at all times. Care Homes for Adults (18-65 years) Page 8 of 28 The care plans should be evaluated every month so ensure any changes in peoples needs are fully met. The complaints procedure should be displayed at all times so visitors are aware of how to make a complaint if necessary. 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 Adults (18-65 years) Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 28 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. Thorough assessments are carried out prior to people being admitted to the home to help ensure individual needs are be met. Evidence: The home carries out a thorough assessment prior to people being admitted to the home. This includes obtaining a care management assessment and information from carers, relatives and relevant health care professionals. Copies are available on the individual case files so staff can refer to these to help ensure each persons needs are met. No new admissions have taken place since the last inspection. There was evidence to show that peoples needs are re-assessed on a regular basis and if these have changed appropriate action is taken. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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. Good information is provided to help ensure the staff can deliver care and support according to personal preferences and people are encouraged to make decisions on all aspects of their lives. Evidence: There are care plans in place that give clear guidelines to the staff to help ensure care and support is delivered according to each persons preferences. Guidelines have also been completed by relevant health care professionals to help the staff meet specific needs. Person centred plans are being developed and the people living in the home and their advocates are encouraged to become involved in these to help ensure their wishes and preferences are taken into consideration. The care plans are evaluated on a monthly basis although one was out of date. The manager reviews them every six months to help ensure any changes in peoples needs Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: are met. People are encouraged and supported to take calculated risks if it is felt these will enhance their lifestyles. Risks are assessed and guidelines are in place as to how these will be managed. The manager and the staff encourage people to make decisions about their lives and provide them with information to help them make informed choices. These include menus, what to wear, what places they would like to visit, where to go on holiday and activities they would like to take part in. Meetings are held every month to discuss all aspects of life in the home. These are minuted so any issues can be followed through. A survey returned by a professional who visits the home stated staff were very focused on individual needs. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 people living in the home are given the opportunity to mix with people in the local community and are well supported to participate in activities of their choice. Evidence: People living in the home are supported to choose how they spend their time and decide what activities they wish to participate in. Two people attend day centres two days a week. One person has an enabler from a domiciliary care agency three times a week. They enjoy going shopping, walking and visiting local cafes etc. A music therapist visits the home on a regular basis and was present during the inspection. Some people enjoy aromatherapy sessions and snoozelen equipment. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: Activities include swimming, hydro pool, aerobics, shopping, walking and visiting local places of interest. The home has a vehicle to escort people to various venues. Recent outings have included Holy Island, Seahouses, concerts etc. Trips are being planned to York and Edinburgh. The home have purchased a trampoline which one person really enjoys. Holidays are being arranged for each person living in the home. The staff support people to keep in touch with their family and friends. The staff support one person to have their friend visit the home on a regular basis. One person took a holiday near their sister last year so they could enjoy a day out with her. The manager and staff on duty were interacting with the people living in the home and respecting their privacy and dignity. The menus are based on peoples known likes and dislikes. The staff on duty said they are aware of what people like to eat but also try to introduce new dishes for people to try. Alternatives are always available if people do not want to eat the meals on the menu. Special diets are catered for and specialist advice is sought when necessary. One person has a peg feed and the staff have received training from a specialist nurse to deal with this. Drinks and snacks are served in the home whenever people want them. People are also supported to eat out at local pubs and cafes. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 living in the home are given personal support when they need it and staff monitor and promote their health and well being. Evidence: The people living in the home have individual health care plans and these are monitored on a monthly basis to help ensure any changes are met. They contain clear guidelines to inform the staff how care and personal support should be delivered to each person. Appropriate heath care professionals are consulted for their opinion. Peoples weights are recorded on a regular basis. The manager stated that the home have recently acquired their own scales. The staff confirmed that they have received training on the specialist health care needs of the people living in the home. The medications records were up to date and appropriately signed. An audit is carried out on a daily basis and competency assessments are carried out annually for all staff who administer medications. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: The health and welfare of people living in the home are constantly monitored by the manager and staff. The case files contain details of health checks, hospital appointments, visits to GP, dentist, consultants etc. If there are any concerns about someones health appropriate action is taken. A survey returned by a health care professional stated the staff do an excellent job. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. Complaints are properly dealt with and training on safeguarding vulnerable adults has been provided for the staff which helps to protect people from abuse. Evidence: The home has an appropriate system for dealing with complaints. The complaints procedure is available in various formats, for example easy read, large print, audio etc. The complaints procedure was not on display at the time of the inspection which could mean visitors to the home do not know how to make a complaint if necessary. A complaints book is maintained to record any complaints that are received and the outcome of the investigation. No complaints have been received since the last inspection. The home has a Tell Us policy which helps to support people living in the home to make a complaint if necessary. There is a whistle blowing policy in place which the staff on duty said they were aware of. Training on safeguarding vulnerable adults is part of the mandatory training Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: programme and is provided to staff every year. The people living in the home are not able to manage their own finances so their personal allowances are dealt with by the staff. All transactions were fully recorded and signed. Receipts are kept for any purchases made. Care Homes for Adults (18-65 years) Page 19 of 28 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 home is clean, comfortable and provides people with a pleasant place to live. Specialist equipment is provided to promote their independence. Evidence: All areas of the home were well maintained, clean and comfortable. Specialist equipment has been provided throughout the premises to meet the needs of the people who live there. The building provides ample space, both internally and externally. The people who live in the home have their own bedrooms that are decorated and personalised according to their wishes and tastes. Bedrooms are equipped to ensure the comfort and safety of the individuals and specialist equipment is provided to promote independence. Since the last inspection the dining room has been redecorated. New wardrobes and a new television have been purchased . The gardens are well maintained and accessible to the people living in the home. Tables and chairs are provided. A trampoline has been purchased for one of the Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: people living in the home which they really enjoy. Infection control forms part of the mandatory staff training. Protective clothing is readily available and liquid soap and paper towels are provided to help prevent the spread of infection. Cleaning rotas are in place to help ensure the premises remain clean and tidy. The sun lounge is used as a snoozelen room for the people who live in the home. This facility cannot be used at the present time as it is being used to store swine flu packs for other homes in the area. This means that people living in the home do not have access to this facility which may not promote their well being. As the door does not lock they may have access to items which may compromise their health and safety. Care Homes for Adults (18-65 years) Page 21 of 28 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 are sufficient staff employed in the home who are well trained to meet the individual needs of the people living in the home. Evidence: The staffing rotas showed there were sufficient staff on duty to meet the assessed needs of the people living in the home. The manager stated that they try to ensure three staff members are on duty during the day so people can participate in activities. The manager confirmed that criminal record bureau checks and two written references are received before staff are employed in the home. This helps to protect people from abuse. No staff have been employed since the last inspection. All staff have achieved a National Vocational Qualification (NVQ) Level 2 and six have achieved Level 3. Two staff are in the process of completing NVQ Level 3. There are training programmes in place to ensure staff receive up to date mandatory health and safety training. Specialist training is provided to meet the individual needs of the people living in the home. Formal supervision sessions were up to date. These are carried out by the manager Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: and assistant manager to help ensure people have support to carry out their roles effectively. The staff on duty were well aware of the needs of the people they were caring for. A survey returned by a professional who visits the home stated very dedicated, excellent relationships between the staff and service users. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 cultures and systems in the home help to ensure that the service is led by the needs and wishes of the people who live there, and helps to protect them from harm. Evidence: The manager is supported by the organisation to provide clear leadership throughout the home and the staff demonstrate an awareness of their roles and responsibilities. The manager is registered with the Commission and has experience in working with adults with learning disabilities. She has completed NVQ Level 4 in care and management. The staff on duty said the manager was very approachable and supportive. Monthly meetings are held to discuss any issues that arise and to ensure the home is run in the best interests of the people who live in the home. Minutes are recorded and staff sign to confirm they have read them. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: There are comprehensive policies and procedures in place to safeguard the rights and best interests of the people living in the home. These are well organised and accessible to all staff. The manager confirmed monthly visits are made to the home by senior managers or other home managers. This helps to ensure standards continue to be met and any necessary improvements are made. The staff make every effort to seek the views of the people living in the home. Routines are flexible to help meet the needs of each person. The records showed that fire drills are carried out at appropriate intervals and fire equipment is checked on a regular basis. Fire evacaution guidelines are available on the individual case files. A new gate has been installed to provide a safer evacuation route if a fire should occur. The staff on duty confirmed that they receive up to date health and safety training to help protect their safety and that of the people living in the home. Care Homes for Adults (18-65 years) Page 25 of 28 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 Adults (18-65 years) Page 26 of 28 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 1 24 13 The registered provider must ensure people have access to the sun lounge and any risks are removed. To help ensure the environment is accessible and free from safety hazards. 31/08/2009 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 6 The manager should ensure all care plans are evaluated each month to help ensure any changes in peoples needs are fully met. The manager should ensure the complaints procedure is displayed at all times so visitors to the home are aware of how to make a complaint. 2 22 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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