Care Home: Woodlands Innova House CLD

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What the care home does well Everyone likes living at the home. They say they are happy there and it is friendly. One person said they liked the home because they were `independent`.People who live at the home can choose which activities they want to do.The houses are clean and comfortable.Staff are well trained. This means they know what to do if someone is upset or worried. They help them to feel better and sort out problems.Other visitors to the home, such as social workers and nurses, said the home was doing a `lot of good work` and that staff helped people to `settle well`. What has improved since the last inspection? Staff are doing special training to help them understand peoples` needs better. The home hopes to be accredited with the Autism Association. This means it has to do special work to show it understands about autism. What the care home could do better: Care and support plans should have more information on them so staff know how to help people.Support records should be easy to read and understand.Medicine storage and policies should be better.The home must get more information about staff to make sure they are checked properly. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Woodlands Innova House CLD 78 - 86 Forest Road Mansfield Nottingham NG18 4BH two star good service The quality rating for this care home is: 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: Janet Morrow Date: 1 9 0 5 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. They reflect the things that people have said are important to them: 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 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 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. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CQC General public 0870 240 7535 (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. Internet address www.cqc.org.uk Information about the care home Name of care home: Address: Woodlands Innova House CLD 78 - 86 Forest Road Mansfield Nottingham NG18 4BH 01623626252 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) : steve.koban@innova-house.com Innova House Health Care Limited care home 9 Number of places (if applicable): Under 65 Over 65 9 0 learning disability Additional conditions: Innova House Health Care Limited is registered to provide accommodation and personal care at Woodlands Innova House CLD, numbers 78, 80, 82, 84 and 86 Forest Road, Mansfield, Nottinghamshire, for people whose primary care needs falls within the following categories and numbers: 1. Learning disability (LD) 9. 2. The maximum number of people to be accommodated within each of the houses numbered 78, 80, 82, and 84 is 2. The maximum number of people to be accommodated at number 86 is 1. Date of last inspection 2 4 0 5 2 0 0 7 A bit about the care home Woodlands Innova House CLD consists of five houses near Mansfield town centre. Two people share in four of the houses. One person does not share a house. Each house has a bathroom, lounge and kitchen. Everyone has their own bedroom. 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 How we did our inspection: This is what the inspector did when they were at the care home We looked at the information in files for staff on how to support people. These are called support plans. We watched how people spent their day. We looked at some of the policies and procedures in the office. Policies are rules about how to do things. Procedures tell people how to follow the rules. We also talked to staff in the home. We talked to one person who lives at the home. We spoke to visitors to the home by telephone after the visit. We looked at surveys and some information that the manager gave us. What the care home does well Everyone likes living at the home. They say they are happy there and it is friendly. One person said they liked the home because they were independent. People who live at the home can choose which activities they want to do. The houses are clean and comfortable. Staff are well trained. This means they know what to do if someone is upset or worried. They help them to feel better and sort out problems. Other visitors to the home, such as social workers and nurses, said the home was doing a ‘lot of good work’ and that staff helped people to ‘settle well’. What has got better from the last inspection What the care home could do better Care and support plans should have more information on them so staff know how to help people. Support records should be easy to read and understand. Medicine storage and policies should be better. The home must get more information about staff to make sure they are checked properly. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Janet Morrow East Midlands Office CPC1 Capital Business Park Fulbourn Cambridge CB21 5XE 01223 771300 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 - 0870 240 7535 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 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . There was the potential for peoples needs not to be met as the service was not compliant with its registration. Evidence: One persons care file was examined and had a detailed assessment in place. Information from external professionals was available. The written information supplied by the service stated that it offered transition packages to suit individual need. Individual needs were addressed in the file examined. However, the service had also admitted people without a learning disability over the previous twelve months. The manager stated that this was a temporary measure until other accommodation within the overall service was completed. The statement of purpose did not state that this was what the service offered, although the manager amended this on the day of the inspection visit. All three surveys from people living in the home responded that they had received enough information before moving in. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . A lack of detail in care and support plans and risk assessments had the potential to adversely affect how specialist needs were met. Evidence: The written information supplied by the home stated that people were involved in the assessment stage in planning their care provision and their views, needs and choices are then reflected in their individual support plans. However, there was no clear evidence on the file examined on how the person concerned made decisions or what strategies were in place to encourage independence and choice. For example, there was no signature to show the person or their Representative had agreed the care and the care and support records were not in any format to enable comprehension such as pictorial or on tape etc. One person spoken with said they liked being independent and two surveys from people living in the home responded that they always made decisions about what to do each day and one responded that they sometimes did. Observation of routines in the service showed that people were encouraged by staff to make decisions and be as independent as possible. However, the care and support records seen did not support the specialist service provided. For example, the care and support plan policy stated that there were ten areas of need that should be addressed but the record examined contained only seven. These were predominantly about physical aspects of health such as personal hygiene, continence, mobility and eating and drinking. There was no care or support detailed under the headings work/leisure, behavioiur management and personal finance even though the services policy said these areas should be completed and they were relevant to the person concerned. Evidence: Some of the areas detailed in the care and support record were available only on the services computer and not in the individuals house, which meant that staff did not readily have full access to the information. There had been no reviews of care in the file examined between May 2008 and February 2009, although the policy stated that plans should be reviewed monthly. Some of the information in the care and support records was clear and showed that specialist needs had been taken into account; for example, under communication, the records seen stated that staff should give time for the person to process information and indicated what could occur if this was not adhered to. The record also showed that activity undertaken was based on the individuals preferences and designed to encourage independence. There were risk assessments in place for relevant activities such as health and well being and behaviour but there was nothing on the record that indicated they had been recently reviewed, as they were all dated 2007. 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 . Well-managed meals, contacts with the community and activities ensured people lead full lives and grow in independence. Evidence: People living at the home had their own routines as far as possible, choosing either to undertake a range of activities in the home or use community facilities such as colleges, parks, shops and leisure centres. Staff helped people to explore their options with regard to further education and careers and one person spoken with was taking a college foundation course and another had a job. People were also involved in domestic tasks around their home, such as meal preparation, and this was included as part of their personal development and social skill training. The home had an adjacent allotment and those people who chose to be involved participated in growing vegetables. The location of the home on the edge of the town made it easy to use transport and leisure facilities. A range of local amenities were within easy walking distance. People were encouraged to maintain contacts with their families and friends by visits and telephone and one person had regular stays with relatives. One relative spoken with confirmed that they were able to keep in touch and that they couldnt fault the communication from staff. Work around appropriate and safe relationships was undertaken and an example of Evidence: this was discussed with the services autism consultant who was involved in individual work with people. All three surveys received from people living in the home said that they could choose what they wanted to do during the day, in the evening and at weekends. People living at the home were involved in planning their own meals and with shopping. One person spoken with was able to describe what they would eat and the food stocks in their home supported this. Healthy eating was encouraged. 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 . Access to health professionals and clear systems ensured that peoples health and personal care needs were met. Evidence: The written information supplied by the home stated that the home had developed systems with each person to enable them to understand the importance of personal hygiene and how to manage it pro-actively. One persons care and support records were then examined and showed that there were details about individual preferences available and the type of assistance and guidance needed to meet health care needs. For example, it stated that staff should attend hospital appointments with the person. There were also records that showed dental appointments were kept. The service had a specialist autism consultant who was involved in one to one work with individuals where required and provided guidance for staff on each individuals needs.There was also evidence on records seen that multi-disciplinary meetings took place to review the support provided. One relative spoken with said that they had seen a vast improvement in their relative since being at Woodlands and that the staff tried desperately hard to meet their needs. The medication policy was examined and stated that every service user has the right to manage and administer their own medication if they wish. This policy was upheld and the person spoken with managed their own medication. However, the policy made Evidence: no reference to controlled drugs and the storage available for them did not meet recommended guidelines. Medication records were examined and one persons medication administration record (MAR) chart was looked at in detail. This was completed accurately and had the amount of medicines received recorded. However, one medicine had been taken out of sequence in the blister pack. The manager stated that this was due to the medication starting on a different day of the week. Handwritten MAR charts were not being checked and signed by two people to ensure they were accurate. A general check on medication stocks showed that this was satisfactory and those medicines seen were well within expiry dates. 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 . Systems in place ensured that peoples concerns were listened to objectively and that they were safeguarded from abuse. Evidence: There was a clear complaints procedure that said any complaints would addressed within twenty-eight days. The written information supplied by the home stated that two complaints had been received in the last twelve months and both had been addressed within timescale. Issues raised by one person living in the home had been addressed and a written response provided. This showed that the concern had been dealt with objectively and that action had been taken to resolve the issue. There had been no complaints received at the office of the Care Quality Commission (previously the Commission for Social Care Inspection) since the last inspection in May 2007. Two of the three surveys from people living in the home responded that they always knew how to make a complaint and one responded that they sometimes did. The home had the Nottinghamshire Local Authority safeguarding policy and adhered to this as well as having its own whistle blowing policy. All staff were trained during their induction and National Vocational Qualifications (NVQ) in safeguarding adults, and knew what to do if abuse was suspected and were aware of their responsibility to report any allegations. The staff survey received also confirmed that staff knew what to do if anyone had any concerns about the service. One persons financial records were examined. This showed that people were signing for transactions and there were receipts available. The record seen was accurate. 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 . People lived in an environment that was community-based, comfortable, and well maintained. Evidence: Woodlands consists of five houses (four two bedded, and one one-bedded) situated on a quiet residential housing estate a short bus ride away from Mansfield city centre. The houses provided a good standard of accommodation in a community living setting. All had single bedrooms, bathrooms, shower rooms, two toilets, a lounge, kitchens and rear gardens. The houses were clean and tidy and free from odour. The written information stated that the accommodation was soon due to be redecorated and that plans for the next twelve months were to extend and improve the patio areas. One persons bedroom was seen and this had been individualised with their own possessions. The person concerned said they liked their bedroom and had all the things they wanted in it. Two of the three surveys received responded that the home was always fresh and clean and one responded that it sometimes was but qualified this by saying that it depended on myself. 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 were sufficient well-trained staff to ensure peoples needs were met. Evidence: The home provided a consistent staff group to meet the specialist needs of people living there. The written information supplied by the home stated that there was a wide range of experience, age and skill mix within the staff group. Staff were available at key times to ensure that people received the necessary support to maintain a lifestyle of their choosing. Staff spoken with confirmed that there were sufficient staff to enable people and provide the support required and the staff survey received responded that there were usually enough staff to meet peoples individual needs. It also commented that the service offered quality support and care to individuals. Staff spoken with confirmed that mandatory health and safety training was provided as well as training relevant to the service user group. Training certificates seen showed that courses in managing violence and aggression and understanding autism had taken place in 2008. There was also access to the specialist autism consultant who provided guidance to staff on a regular basis regarding individual needs. The staff survey received responded that training relevant to the role was provided, although it commented that a way the service could improve was for staff to work to specific qualifications i.e autistic spectrum disorder. The homes written information also stated that thirteen of twenty-one care staff had achieved a National Vocational Qualification (NVQ) to Level 2. The home was therefore meeting the target of having a minimum of 50 with this qualification. Three staff files were examined and showed that recruitment procedures were generally thorough and most of the information required by the Care Homes Regulations 2001 had been received prior to staff commencing employment. However, one file had only one written reference, one did not have evidence of a qualification Evidence: although the manager stated that this had been seen at interview, and employment histories were not always complete. For example, there was a gap in employment history noted on one file and another included only years of employment and not months. 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 home was well managed, which ensured it was run in peoples best interests. Evidence: The Manager had substantial previous experience in care and the management of care homes. She had achieved the Registered Managers Award, NVQs 3 and 4 in Care, and a Bachelor of Philosophy in Adults with Autism. There was a twenty-four hour on call manager facility. The staff survey received responded favourably on management structures saying that enough support was offered regularly and one of the three service users surveys received commented that they would speak to the management if they were not happy. One visiting professional spoken with said that they felt the service was moving forward and suggested changes had been addressed and another said they discussed any issues with the manager and were confident these would be sorted out. The service was putting all its efforts regarding quality assurance into its work on the Autism Accreditation process. This involved the regular reviews with the specialist autism consultant and identifying areas where more work was needed. There was no formal feedback seen by way of surveys or thank you letters etc on the day of the inspection visit but there were plenty of informal checks on what people living in the service thought about the support provided; for example, the manager stated she spoke regularly to people in the home, there were weekly team leader meetings to discuss any issues and the written information supplied by the home said there was daily contact with staff and service user group by the management team. Staff spoken with confirmed that health and safety training was undertaken in food Evidence: hygiene, moving and handling and fire safety and this was confirmed in the three staff files examined, which showed that this training had taken place as part of the induction process and during 2008. The written information supplied by the home also confirmed that maintenance checks were undertaken regularly; for example, fire fighting equipment and alarms had been tested in December 2008, the electrical wiring in November 2008 and gas safety had been checked in August 2008. It also stated that policies and procedures had been reviewed in January 2009. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action 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 Description 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 Description Timescale for action 1 3 14 The service must ensure that 01/07/2009 peoples needs can be met in accordance with its registration. This is to ensure that people are not admitted to the wrong type of service and that their needs are fully met. 2 6 15 Care and support plans must 03/08/2009 contain sufficient detail in the specialised areas that the service is registered for. This is to ensure staff know how to provide the support and so that the record meets legal requirements. 3 9 13 Risk assessments must be up 03/08/2009 to date. This is to ensure that all areas of risk have been addressed and that people are safe. 4 20 13 03/08/2009 The medication policy must be amended to make specific reference to the procedures regarding controlled medicines. This is to ensure staff know what they must do when administering controlled medicines and to ensure they are dealt with safely in accordance with legal guidelines. 5 20 13 There must be secure storage for controlled drugs that meets recommended guidelines. 01/09/2009 This is to ensure medicines are stored securely and the risk of theft is minimised. 6 34 19 The home must ensure that all the legally required documents are in place before anyone commences employment; this must include two written references and a full employment history. 01/07/2009 This is to ensure that legal requirements are met and that people are supported safely by staff whose suitability has been checked. 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 7 It should be clear on care and support records how decisions are made and that people have been involved in deciding what support they need. Two people should check and sign hand written medication administration record (MAR) charts to ensure they are accurate and to minimise the risk of errors. The home should consider organising specialist qualifications for staff that are relevant to the service user group. The home should endeavour to obtain written feedback from a variety of sources including people using the service, relatives and advocates and visiting professionals. 2 20 3 35 4 39 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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