Care Home: Woodlands Nursing Home

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What the care home does well There has been a regular staff team and people are receiving support from staff that they know and who know them. The staff team have received a lot of training and also good support from the management team. The service is very well-managed and staff are clear as to what is expected of them. There is a very relaxed atmosphere in the home and people receive good care from a committed staff team and it is evident that the home is operated for the benefit of the people living there. One person commented: "I have no complaints and am lucky to live here. It is friendly and the staff care for me very well. My family are pleased with the care as well." The manager and staff are very aware of promoting issues of equality and diversity and the respect of individual`s beliefs and cultures, There is a relaxed atmosphere throughout the home and people appeared unhurried and are given sufficient time and support in their everyday activities. Health care professionals said: "they provide loving care with dignity and respect. They listen and are very aware of people`s needs". A relative said: "My father-in-law would like you to know that he is very happy with the care at Woodlands. The carers are indeed very caring and he is extremely well cared for on all levels. We for our part can sleep at night knowing that he is safe". What has improved since the last inspection? The home has recently undergone a lot of refurbishment and redecoration. The double rooms have now been converted to single rooms, the laundry has been extended, more storage provided in the kitchen, one of the showers and toilet has been relocated and upgraded. In addition the dining area and lounge have been made open plan. The new dining area part can be partitioned off with curtains and it is hoped that sliding doors with fitted in the future. This area is also used for activities. All of the bedrooms and communal areas have been decorated. The building is bright and comfortable and is much nicer environment for the people living there. In addition the single rooms mean that people will have their own private space. The home has received a five star rating for food and hygiene and therefore people can be sure that their meals are prepared appropriately and safely. Pictorial menus have been introduced to help people choose what they want to eat. The organisation has employed a permanent trainer to provide staff with the training that they need. What the care home could do better: The planned improvements to the garden will make this area a nicer space for people to use.More detailed protocols for the administration of PRN (as required) medication will mean that staff will be clear as to when and how to administer this medication. Key inspection report Care homes for older people Name: Address: Woodlands Nursing Home Gordon Road Ilford Essex IG1 1SN     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: Jackie Date     Date: 1 7 1 1 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 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 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 28 Information about the care home Name of care home: Address: Woodlands Nursing Home Gordon Road Ilford Essex IG1 1SN 02085532841 02085532946 enquiry@woodlandstotalcarenursinghome.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Woodlands Total Care Nursing Home Limited care home 30 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: 30 The Registered Person may provide the following categories of service only: Care home with Nursing - Code N 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 Dementia - Code DE (maximum number of places: 30) (of the following age range: 55 years and above) Date of last inspection Brief description of the care home Woodlands Nursing Home is registered to provide nursing care for up to 30 older people, including people who have a diagnosis of dementia. The large converted property is situated in a residential area of Ilford in the London Borough of Redbridge. There are good transport links and the home is close to shops and other amenities and community facilities. All rooms are singles and some have en suite facilities. The bedrooms are located on three levels with access by lift to all floors. The home is able Care Homes for Older People Page 4 of 28 Over 65 0 30 30 0 Brief description of the care home to accommodate people from different cultural and religious groups. The manager and some of the staff team have the ability to speak a variety of languages, and key words are taught to staff to facilitate care for people whose first language is not English. The home is able to meet a range of cultural dietary needs. The home employs an activity co-ordinator, catering, laundry, domestic and maintenance staff. The range of fees for the home was between 612 pounds and 673 pounds per week. Copies of the homes Statement of Purpose, service user guide and most recent inspection report are available in the main entrance hall, together with other information about the home. In addition there is a copy of the service user guide in each bedroom. Care Homes for Older People 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: 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: The last inspection of this service was on 16th November 2007. This inspection was unannounced and took place over two days. There was a few weeks gap in between the two visits to allow for the refurbishment work to be completed. This was a key inspection and all of the key standards were tested. Staff were asked about the care that people using the service receive, and were also observed carrying out their duties. People using the service were asked to give their view on the service and their experience of living in the home. All of the shared areas were seen and some of the individual bedrooms. Staff, care and other records were checked. Feedback questionnaires were sent to people who use the service, staff and other professionals. Completed forms were received from, or on behalf of, two people who use the service and three healthcare professionals. In addition people who use the service, visiting relatives and the community matron provided verbal feedback during the course of the inspection. Services are now required to complete an AQAA (Annual Care Homes for Older People Page 6 of 28 Quality Assurance Assessment) and the completed form was received in September 2009. Information provided in this document also formed part of the overall assessment. We would like to thank the people living at Woodlands, their relatives and staff for their input during the inspection. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: The planned improvements to the garden will make this area a nicer space for people to use. Care Homes for Older People Page 8 of 28 More detailed protocols for the administration of PRN (as required) medication will mean that staff will be clear as to when and how to administer this medication. 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 28 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 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 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. Full information is gathered prior to people being admitted to the home and therefore staff have sufficient information to fully meet peoples needs. People can therefore have confidence that the service will be able to meet their needs. Evidence: Standards 3 & 4 were detested. Individual records are kept for each person and a number of files were examined. All records examined had assessment information recorded and the information had been used to continue assessment following admission to the home. The records showed that where possible the person concerned and their relatives/ representatives had been involved in the assessment process. Information provided by the placing authority and other healthcare professionals was also included. From the records, observations and discussions with the manager, staff and people Care Homes for Older People Page 11 of 28 Evidence: living at Woodlands it was evident that people are referred to any appropriate specialist services and that staff receive the necessary training to meet the nursing and care needs of these people. The section on health care later in this report gives more details on this. This is a very multicultural home both in terms of the staff and the people living there. There is great awareness of different cultures and peoples cultural needs and a strong commitment to meet cultural and religious needs. The service does not provide intermediate care. Care Homes for Older People Page 12 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are identified and staff have clear information about how to meet these. People receive good personal care, excellent healthcare and end of life care that meets their individual needs and preferences. The principles of respect, dignity and privacy are put into practice. Evidence: Standards 7, 8, 9, 10 & 11 were tested. Each person has a detailed care plan that gives staff clear information on a persons needs and how to meet them. The care plans seen had been reviewed and were up to date. The care plans cover all the necessary areas. The risk assessments seen were appropriate to the individual and include moving and handling assessments, dependency assessments, bedrail assessments and nutritional assessments. The staff have now started doing individual family histories for each person. This includes, how I live my life and how I would like to continue doing this. Information seen was very detailed and included peoples preferences for a bath or shower, preferred clothing, Care Homes for Older People Page 13 of 28 Evidence: skin products, creams and lotions, make up and foot care. These show that staff know people very well and that they do pay attention to the details of the personal care that people receive. Feedback received on the day was that care and attention is excellent. A health care professional said, they provide loving care with dignity and respect. All the people living at Woodlands are registered with a local doctor and specialist help is received when needed. For example the dietician, the diabetes nurse, speech and language therapist and occupational therapist. Records are kept of medical appointments and these show that people also have checks from the optician, dentist and chiropodist. Daily reports include any nursing interventions that people have had and people also have nursing needs care plans that are reviewed monthly to ensure that they are up-to-date. Each person has a transfer letter that gives details of their needs and medication to be used in the event of them needing to be taken to hospital. The service is proactive in maintaining peoples health. For example monthly monitoring for urine infections and also changes in blood pressure. A relative said that if there any concern over a persons health the doctor is called. A healthcare professional said, staff listen and are very aware of peoples needs. There is a very stable staff team and there has not been any need to use agency staff for a very long time. Therefore people receive their care, including their health care, from staff that know them well and are very aware of their needs and how to meet them. Staff have received the training that they need to do this and details of this are in the section on staffing later in the report. It was evident that people living at Woodlands receive very good healthcare from the staff team and that staff support people to access other healthcare services as and when needed. Medication is administered by the nurses. All staff including the nurses receive medication training. This is to ensure good practice and also that care staff are aware of the issues that may present when people are taking different medications. Medication is stored in two appropriate trolleys. Some medication is in a monitored dosage system and this is stored in one trolley and any other medication in the other. The medication was clearly labelled and the trolleys were neatly organised. Opening dates were recorded on creams and eye drops and confirmed that these were in date. The nurse in charge of the shift keeps the keys to the medication. There is also a medication fridge and temperatures for this and the room the medication is stored in are checked regularly. Appropriate controlled drugs storage facilities and a record book are available but at the time of the visit none of the people living at Woodlands were prescribed any controlled drugs. This is a supply of homely remedies available and the doctor has signed these specific to individuals where required. Some people are prescribed PRN (as required) medication and clearer protocols must be in place for Care Homes for Older People Page 14 of 28 Evidence: the administration of these. This must include the dosage of the medication, the circumstances under which it is to be administered, the frequency/minimum period before repeating a dose, the maximum number of doses in a time span, and the action to be taken in the event of the persons symptoms inadequately responding to the medication. This will help to ensure that staff are clear about when, how and why to administer this medication. Medication Administration Records (MAR) were appropriately kept and up-to-date. These also contained photographs of each individual and any allergies that they might have. There was also a record of the signatures of staff that administer medication. These are all good practice as they lessen the risk of error and provide an appropriate record of what medication people have been given by whom. Overall the administration of medication is robust and in line with good practice and legal requirements. It was apparent in discussions with the manager and staff that they are able to care for people at the end of their life and that they would treat people with care and dignity. Also that staff are aware of the different needs and wishes of different cultures and religions at this time. Care Homes for Older People Page 15 of 28 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. Family contact and contact with the local community is encouraged and visitors are welcomed at the home. The manager and staff are very aware of promoting issues of equality and diversity and the respect of individuals beliefs and cultures. There is a general programme of activities available, which is varied to suit individual interests, preferences and capabilities. The attitude and practice of the staff working in the home, promotes opportunities for people to remain independent, exercise choice and express their wishes and needs. People are provided with food that meets their preferences, nutritional, cultural and health needs. Evidence: Standards 12, 13, 14 & 15 were tested. There is a part time activity co-ordinator who works three days a week. As recommended in the previous inspection she has completed the National Association for Providers of Activities for Older People (NAPA) training. This is specific to the provision of activities for people living with dementia. There is a programme of Care Homes for Older People Page 16 of 28 Evidence: activities and entertainments within the home, including celebration of all important festivals from different cultural and religious groups. This includes Diwali, Eid, Christmas, St Patricks Day and Valentines Day. Consideration is given to providing a range of activities that support peoples individuality and their social preferences. One person expressed a desire to go to Lourdes. So the manager made contact with a local church. People from the church visited and took the person to church. Subsequently he travelled to Lourdes. Activities include a variety of large, small and one to one activities such as karaoke, bingo, card games, hand massage, manicures and regular visits by professional entertainers. Relatives and friends are encouraged and welcomed to be involved in special events in the home, so that people are able to maintain contact with them. A group of people went on a trip to Southend in the summer. The home occasionally holds afternoon tea sessions to raise money for different charities. At Christmas local school children visit for carol singing and approximately 10 people will be going to the local high school for a Christmas Party. The manager and staff are very aware of promoting issues of equality and diversity and they respect individuals beliefs and cultures. When a new person is admitted to the home whose first language is not English, the manager ensures that all staff are aware of how to greet them in their own language and know some key cultural sayings and translations in respect of individuals daily needs. Diets specific to individuals culture and religion are clearly recorded and provided for accordingly, for example Halal and vegetarian diets. A visit was made to the kitchen and the inspector was able to discuss the storage and preparation of food with the cook. She is fully aware of those people requiring special therapeutic diets and other diets/foods such as Halal and vegetarian. There is a separate Asian menu and a vegetarian option each day. The cook was able to demonstrate a good knowledge and understanding of the importance of well balanced and well presented meals and had information available from about individuals specific needs. It was obvious that the cook and others in the kitchen know people living at Woodlands well and are aware of their needs. Fresh fruit is provided daily and is available on request. The use of full cream milk, butter and cream is used wherever possible to supplement the diets of those with reduced food intake/diminished appetite. At lunchtime it was noted that people had a variety of different meals according to there needs and preferences. Staff were observed to sit with people who needed assistance to eat. These people were supported sensitively and patiently. The new how I lived my life and would like to continue to do so, contained information about what people like to drink and how they take their drinks. Also what they prefer for breakfast and where they like to have this. Therefore people can be sure that they will receive good quality food that meets their needs and preferences. Care Homes for Older People Page 17 of 28 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 living at Woodlands are safeguarded by the working practices and support of the staff team. In addition their rights are actively promoted. Evidence: Standards 16, 17 & 18 were tested. The home has a written complaints policy and procedure for dealing with complaints, and staff spoken to were aware of the complaints procedure and how to deal with complaints or concerns made to them. The complaints procedure is also produced in three Asian languages i.e. Gujarati, Punjabi and Hindi and is displayed in the reception area. One complaint was received by the Commission since the last inspection and this was dealt with under the safeguarding procedure. This complaint was not substantiated. The home has policies and procedures for safeguarding people from abuse. Staff have had safeguarding training and are aware of safeguarding issues and their responsibilities. Staff also talked about MCA (Mental Capacity Act) and DOL (Deprivation of Liberty) training and were also aware of those issues and its impact on their work. IMCA (Independent Mental Capacity Advocates) have been contacted to advocate when people have not been able to express their wishes. The manager is very clear about individual rights and responsibilities and advocates for people. Care Homes for Older People Page 18 of 28 Evidence: The section on staffing later in this report gives information that confirms that there is an appropriate recruitment procedure and this also helps to safeguard people living in the home. The home does not deal with peoples overall finances, but some people have small cash amounts held in safekeeping . The section on management and administration gives more details on this and confirms that systems are in place to safeguard people from financial abuse. Care Homes for Older People 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, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean and comfortable home that is suitable for their needs. Evidence: Standards 19, 20, 21, 22, 23, 24, 25 and 26 were tested. Woodlands Nursing Home is a large converted property situated in a residential area of Ilford in the London Borough of Redbridge. There are good transport links and the home is close to shops and other amenities and community facilities. The home has recently been refurbished. The refurbishment included building works and decoration. The laundry was extended and storage improved in the kitchen. The two shared rooms were converted into four single rooms and a toilet and shower relocated. Alterations were made to give an open plan lounge and dining area. One part of this can be sectioned off for a quiet area or for activities. It can be divided with curtains and the manager said that in the future they are hoping that theyll be able to have some sliding doors there. A new nurses station has been constructed and all of the rooms and corridors have been repainted. The home was found to be well-lit, clean, pleasant and hygienic with no offensive odours. Specialist equipment such as hoists were evident, and any other equipment would be provided to enable people to maintain independence. There is a mixture of suitable baths and showers, which gives people a choice. Pressure relieving Care Homes for Older People Page 20 of 28 Evidence: mattresses and profiling beds are used. Each person now has a single bedroom and five of these are ensuite. The bedrooms have been personalised to suit the individuals likes, wishes and culture. Overall the environment was clean, bright and comfortable. Care Homes for Older People 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 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. People are supported and protected by the recruitment practices of the service. People are supported by a caring, competent and well trained staff team. Evidence: Standards 27, 28, 29 & 30 were tested. Staff rotas were inspected and the staffing level and skill mix of qualified nurses and care staff was sufficient to meet the assessed nursing and personal care needs of the people living there. The home has retained a stable workforce and effective team working was observed throughout the inspection. Care workers were being effectively deployed throughout the home to ensure that people, who remain in their bedrooms, either by choice or for health reasons, were being cared for appropriately. The organisation has a designated trainer. A record is maintained of staff training and records showed that staff have undertaken training in essential areas such as manual handling, basic food hygiene, first aid, infection control and fire safety. Other training undertaken has included equality and diversity, dental care, malnutrition, safeguarding, deprivation of liberty, mental capacity act, dementia, palliative care and preventing slips and trips. Most of the care staff have achieved NVQ level II and half NVQ level III. In addition some staff have achieved NVQ level IV. Feedback from staff Care Homes for Older People Page 22 of 28 Evidence: was that they receive lots of training and that it is renewed and updated regularly. Staff therefore have the training and qualifications needed to meet the needs of the people living there. A random sample of three staff files were checked and these contained recruitment, training and supervision records. Files seen had CRB (Criminal records Bureau) checks, application forms, references and confirmation of identification. The manager had a record of nurses PIN numbers and confirmation that the appropriate checks had been carried out for this. Therefore a robust recruitment process is in place and this helps to safeguard the people at Woodlands. The registered organisation employs a workforce from diverse cultures and backgrounds and all staff have undertaken training in equality and diversity. This ensures that the spiritual, dietary, cultural, sexual and any other diverse need of people living at Woodlands is understood and appropriately met, wherever possible. Staff are able to demonstrate a good understanding of the particular needs of individuals and can therefore deliver meaningful person centred care. Observations at the time of the inspection were that staff were patient and kind to the people in their care and there was a calm, welcoming and relaxed atmosphere. Feedback from people living at Woodlands was: they answer very quickly when I use my buzzer. They are really wonderful and nothing I need is any trouble. I feel really secure and very well cared for. I have no complaints and am lucky to live here. It is friendly and the staff care for me very well. Feedback from a healthcare professional was: they provide loving care with dignity and respect. They listen and are very aware of peoples needs. Care Homes for Older People Page 23 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Woodlands benefit from a home that is very well managed and organised and where their rights and well being are actively promoted. They live in a safe home. Evidence: Standards 31, 32, 33, 35, 36, 37 & 38 were tested. The manager has the qualifications and experience to manage the home and is able to demonstrate a clear understanding of the peoples needs. Equality and diversity and person centred thinking are a priority. She is very user focused and works continuously to improve the service and provide an increased quality of life for the people living at Woodlands with the support of a committed staff team. Staff said that the manager was very supportive. Feedback from a relative was that the home is well run. A system of formal supervision is in place and records are kept of staff supervision. Care Homes for Older People Page 24 of 28 Evidence: Evidence of this was seen in the staff files examined. Staff spoken to confirmed that they received regular supervision and very good support. Also that staff meetings are held. Therefore staff have the opportunity both collectively and individually to discuss work practice, any concerns and the development of the service. A representative of the organisation carries out monthly monitoring visits to monitor and report on the quality of the service being provided in the home. Copies of these reports were available at the home. The reports seen were detailed and also confirmed that feedback is sought from staff, relatives and the people living at Woodlands. The manager does not act as an appointed agent for any of the people living at Woodlands. Their financial affairs are managed by their relatives/representatives. The home holds small amounts of personal money which is used for such things as newspapers, hairdressing and chiropody. The money is stored in separate wallets in the safe. The cash held for four people was checked and amounts recorded tallied with cash held. Peoples monies are securely stored and systems are in place to protect them from financial abuse. The necessary health and safety checks are carried out and records are kept of these checks. These records were up to date and accurate. A safe environment is maintained for the people living, working and visiting Woodlands. Care Homes for Older People 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 Older People 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 1 9 20 Clearer protocols must be in 31/12/2009 place for the administration of PRN (as required) medication. This must include the dosage of the medication, the circumstances under which it is to be administered, the frequency/minimum period before repeating a dose, the maximum number of doses in a time span, and the action to be taken in the event of the persons symptoms inadequately responding to the medication. This will help to ensure that staff are clear about when, how and why to administer this medication. Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 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. If you would like a summary in a different format or language please contact our helpline or go to our website. 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. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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