Care Home: Woodlands Nursing Home The

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What the care home does well This home provides an adequate level of nursing care in a homely and comfortable setting. Care is based on a thorough knowledge of each person, good assessments and plans of care which are regularly reviewed. Good risk assessments help people to be as independent as possible. People are assisted with their health care in a caring and friendly manner. Complaints are quickly dealt with and people are protected from harm by well trained staff. The home is clean and well maintained. There is a good ratio of staff to people, and staff are well recruited. The home consults people about practice and makes sure suggestions are acted upon. People made positive comments about Woodlands Care Home. One person wrote: `I believe that staff at Woodlands Home now `get it right` ..patients are happy.` Another person said: `My mother is happy, therefore so am I.` Another person wrote: `Staff are always available to assist the less able.` What has improved since the last inspection? At the last inspection the manager was reminded to ensure that only appropriate admissions were made to the home. Some people had dementia needs and this was felt to be the main care need. The home does not have a registration for dementia care. Now the primary need of each person at the home is that of nursing care, which is appropriate as the home is registered to care for people with a nursing need. Assessments and care plans have improved to give detailed instructions to nurses and care staff, and these are kept up to date. The internal decor of the home has improved and there have been some improvements to the garden. The home protects the welfare of people living at the home, through better staff training. Staff receive better training across the board in all required areas of care. The home is better managed and people are kept safe by good up to date policies and prodecures. One person wrote: `I wanted to write and tell you of the great improvement I have seen in the Woodlands Nursing Home. I have seen a great change in the staff`s attitude towards the patients. The staff are so patient and kind.` A member of staff said: `I think people have a lovely life here, and it is a better place to work now.` What the care home could do better: The home could provide more individualised activities for people. Some people commented that they had not seen activities for some time. There were a small number of recorded temperatures of discharged water up to 52 degrees. This is too hot and could put people at risk of scalding. Since the inspection, CQC has received notification that the hot water problem has been remedied by the installation of a new boiler. Hot water must continue to be discharged at a safe temperature to protect people from the risk of scalding. All training records should be available for inspection at the home and organised so that evidence can be seen of staff training in all required areas. The home has a quality assurance system in place and the manager uses information from surveys and internal auditing to plan improvements. The home has an acting manager. The provider is reminded that the home must have a manager registered with CQC. Key inspection report Care homes for older people Name: Address: Woodlands Nursing Home The 8-14 Primrose Valley Road Filey North Yorkshire YO14 9QR     The quality rating for this care home is:   one star adequate 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: Karen Ritson     Date: 0 8 1 2 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 23 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 23 Information about the care home Name of care home: Address: Woodlands Nursing Home The 8-14 Primrose Valley Road Filey North Yorkshire YO14 9QR 01723513545 F/P01723513545 judyannelucas@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Hexon Limited care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 34 The registered person may provide the following category of service only: Care Home only - Code PC, To service users of the following gender: Either, Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP, maximum number of places 34 Date of last inspection Brief description of the care home The Woodlands is a large detached property set in secluded gardens approximately 2 miles from the seaside town of Filey and 8 miles from Bridlington. The home is a short walk from a bus route. It is registered to provide personal and nursing care for up to 34 older people. The property is on three floors and there is a passenger lift providing access to all areas. The building is separated into two wings, Oak wing and Chestnut wing. The majority of bedrooms provided are single with en suite facilities. Basic information about the home and what services are offered is provided in the homes Statement of Purpose. Prospective service users and their families are given a copy of this document when they express an interest to live at Woodlands. Fees range from Care Homes for Older People Page 4 of 23 Over 65 34 0 2 6 1 1 2 0 0 8 Brief description of the care home £498 to £570 per week. Care Homes for Older People Page 5 of 23 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: one star adequate 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 inspection for this service took twelve hours. This includes time spent gathering information and examining documentation before and after a site visit and in writing the report. The site visit took place on 8th December between 9.30 and 15.30. Information for this inspection was gathered from the following: A tour of the premises, observations of care throughout the day of the site visit, speaking with people, case tracking people on the day of the site visit, examining policies, procedures and records kept at the home, examining information regarding the home on the file kept by CQC, considering comments made by relatives, health care and social services staff. 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. Care Homes for Older People Page 6 of 23 In future, if a requirement is repeated, it is likely that enforcement action will be taken. All key standards were looked at during this inspection. The manager was available throughout the day of the site visit. Care Homes for Older People Page 7 of 23 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 23 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 23 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 23 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. Peoples needs are well assessed. This ensures people can receive the care they need Evidence: Admissions are not made to the home until a full needs assessment has been undertaken. A pre-admission assessment takes place and risk assessments are put in place to ensure peoples needs are well understood and that they receive the care they need. These include such areas as tissue vulnerability, nutrition, moving and handling, bed rails and mental capacity. The risk assessments are detailed and specific to each individual. The home is clear about the range of needs it can cater for and explains this to prospective residents. This ensures that people are not admitted to the home whose needs cannot be met. Information about the home is available to people before they are admitted to the home. This ensures people can make an informed decision about admission. Care Homes for Older People Page 11 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their health and care needs well met. They are protected by staff who handle medication safely. Evidence: A care plan for each person is drawn up, based on the assessment of needs. All specialist requirements are included in this plan, including medical and health needs. This ensures that peoples needs are considered so that they can be met. All care plans are reviewed monthly with the person involved where this is possible. The review covers each area of the care plan. This ensures that the home is responsive to the changing care needs of those living there. Three care plans were examined and these contained information on care needs and how these would be met. The range of care needs covered in each care plan is detailed. One member of staff said: We understand each person very well here. We take the time to get to know what each person needs. Risk assessments are in place for all appropriate areas of care to ensure people live in a safe environment. However, people are not discouraged from taking part in activities which may have a level of acceptable risk. Notes are written on each persons care after every shift, which means staff have up to Care Homes for Older People Page 12 of 23 Evidence: date information to help them provide appropriate care. Health care professional visits are recorded separately so that the management and staff can easily see the medication and health history of each person. The home administers medication correctly. Recording was accurate with no discrepancies seen on the records sampled. The home has changed the pharmacy provider to ensure continuity of medication provision for the people living at the home and there is now only one system of medication in place. This ensures that people get the medication they require and reduces the risk of mistakes in administration. The pharmacy has provided equipment for the safe storage of medication and the medication storage room is secure. Staff who administer medication have received training to do so. This ensures that people are protected as far as their medication is concerned. Throughout the day of inspection staff were observed taking care and consideration in their duties with people. Privacy and dignity were well respected. Feedback from people living at the home confirmed that the staff treat each individual with respect. One person said: All the staff are kind and very helpful. They seem to have more time now. This means people experience being respected as individuals. Care Homes for Older People Page 13 of 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their leisure and social needs partially met, visitors are welcome and people have a varied and nourishing diet they enjoy. Evidence: The home assesses the leisure and social needs of each person on admission. Activities take place after lunch time and may be skittles, ball games, quizzes or jigsaw puzzles. In the warmer months the staff have time to take people who want to go out for a walk down to the nearby Lake, or for a trip into Filey , which is not far away. Some people go out on trips with their relatives. There are a number of highly dependent people at the home, who would find it difficult to get out, but staff say they have time to sit and chat after lunch in their rooms or in the lounges and to do one to one activities with them of their choice. One person wrote: Staff pop in for a chat and provide company. Excellent. However, some comments from people suggest more activities would be appreciated. One person wrote: Social activities are pretty well non existent. Another person wrote: I have not seen any social activities for a long time. Visitors are encouraged to call at any reasonable hour and are made welcome. One person said: We have always been welcomed in a friendly cheerful manner. Care Homes for Older People Page 14 of 23 Evidence: Menus are on a rolling programme with seasonal choices. A midday meal was observed, and the food was of a good quality. One person said: The food is very good. Another said; I like the meals. Theyll do something different for you if you ask. Another person wrote: The food looks and smells delicious. Specialist diets can be catered for if required. This ensures people have a varied diet they enjoy. Care Homes for Older People Page 15 of 23 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 have their complaints listened to and dealt with and they are protected from harm. Evidence: The home has a complaints procedure and policy. People spoken to said they knew who they would complain to if there was a problem and were confident things would be sorted out quickly. One person said: The manager or any of the staff would help, they are all helpful. This ensures people are listened to and their complaints are taken seriously. Some staff have received safeguarding of adults training and dementia awareness training is planned. Staff all receive Criminal Records Bureau (CRB) checks prior to commencing work, or have a Protection of Vulnerable Adults (POVA) first check and are shadowed until the CRB comes through. This is acceptable practice and protects people from staff who are unsuitable to work with vulnerable people. Care Homes for Older People Page 16 of 23 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 well maintained environment. Evidence: The home is kept clean and the interior decor has been upgraded to a good standard. New carpets have been laid in corridors and dining areas and the home has purchased new dining chairs. Some bedrooms have new carpets fitted. This provides a pleasant environment for people to live in. One of the lifts in the home is disused, but there are plans for this to be brought back into use. On a small number of occasions the discharged water temperature was recorded at up to 52 degrees, which is too high and must be remedied, (see standard 38). All internal doors have coded panels to ensure people are kept safe from harm. The home complies with the local fire service and environmental health authority to ensure peoples welfare is protected. The home has a separate laundry room away from the kitchen and there were no reported problems with the laundry. Care Homes for Older People Page 17 of 23 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 receive good care from staff who are well recruited, trained and who are on duty in sufficient numbers. Evidence: The home is well staffed and has recruited more nurses, so that the home now has 24 hour nursing care. People said that the home had good staff. One comment was: They are not only professional, but very nice caring people. At least 50 of care staff have National Vocational Qualifications (NVQ) at level 2 or above. Staff are recruited according to procedure. Two references are kept on file, and each member of staff has a Protection of Vulnerable Adults(POVA) and CRB check as a matter of routine. (In future such POVA checks will be carried out by the Independent Safeguarding Authority.) When staff were questioned it was clear that they spent a considerable amount of time shadowing more experienced staff who took them through a practical induction into the role. Staff said they had learnt about the way to treat people, the principles and values of good care, abuse awareness, privacy and dignity, infection control , moving and handling and general health and safety. Each member of staff completes skills for care induction training and then foundation training. Some training records were seen on file, however, some were missing and the provider telephoned after the inspection to inform us of further training which had taken place. All training should be clearly recorded and evidence available at the home so that this may be checked during an inspection. Care Homes for Older People Page 18 of 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home does not have a consistent record of good management as the new acting manager has not been in post for long. Peoples opinions about the service are taken into account and influence what happens in the home. Peoples money is safely managed. Hot water temperatures must remain within acceptable levels to protect peoples safety. Evidence: The home is managed by Tom Griffin, who has taken up his post since the last inspection. He has a background in nursing care within a hospital setting. Staff said he was very supportive and approachable. Mr Griffin is not yet registered with the Care Quality Commission. The provider is reminded that there must be a registered manager for the home. The home keeps the personal allowance of several people living at the home. The money for one person was checked against records and there were no discrepancies. Care Homes for Older People Page 19 of 23 Evidence: The home has a quality assurance system, where questionnaires are given to people living at the home and to relatives and others visiting the home. The results of these questionnaires are collated and any problems are addressed directly. People are kept safe by general environmental and COSHH risk assessments and by regular maintainance of equipment and systems. The home has a fire risk assessment and staff are well trained in fire safety. The home has up to date policies and procedures. The record of the temperature of hot water as it is discharged from taps was examined. There were a number of recordings of a temperature which was too high, in some cases up to 52 degrees centigrade. This is too hot and places people living at the home at risk of scalding. The acting manager said that all bathing was supervised and that each bathroom had a thermometer. The temperature of water in the bath was always checked prior to bathing taking place. However, the risk remained to people who may wander into bathrooms and turn on the hot water tap. Mr Griffin said he was aware there was a problem with the hot water and had arranged for a plumber to attend to this. We received notification after the inspection that a new boiler had been fitted which means that water is constantly discharged at a temperature around 43 degrees centigrade. Discharged water temperatures must be maintained at a safe level to ensure people are kept safe from the risk of scalding. Care Homes for Older People Page 20 of 23 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 21 of 23 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 37 12 Water temperatures must be 24/12/2009 maintained at a safe level close to 43 degrees. To avoid the risk of scalding. 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 12 More activities tailored to individual interests would help people to live an interesting life at Woodlands and improve their quality of life. All training records should be available at the home to provide evidence that staff have received the appropriate training to offer good care. 2 30 Care Homes for Older People Page 22 of 23 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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