Care Home: Woodlands Rest Home

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What the care home does well Residents have a full assessment carried out before they are offered a place at the service .This means they can be confident the service is aware of their needs and can meet them. There is good access to the community health team including doctors and district nurses. Residents feel they have control over the care they receive and are listened to by the manager and staff. Catering arrangements are good and residents receive nutritious meals. Activities are provided at times which suit residents preferences and choices. Residents rights are upheld and their individuality is acknowledged and respected. What has improved since the last inspection? Since the last inspection the quality assurance system has been improved to include internal audits which assist with making improvements in the service. New staff have been recruited to minimise the need for agency staff and more staff have obtained a NVQ (National Vocational Qualification) in Care. What the care home could do better: When application forms are completed the manager needs to ensure that a full employment history is obtained so that they can be confident that any gaps are accounted for. Staffing levels while currently satisfactory need to be carefully monitored to ensure that residents ever changing needs can be met in their preferred way and in a safe manner. Greater attention needs to be given to ensuring medication records are always signed correctly to ensure an accurate record is maintained of medications given. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Woodlands Rest Home 19-23 Lovedean Lane Waterlooville Portsmouth Hampshire PO8 8HJ     The quality rating for this care home is:   two star good service 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: Kathryn Emmons     Date: 2 1 0 4 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. 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. 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 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. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Woodlands Rest Home 19-23 Lovedean Lane Waterlooville Portsmouth Hampshire PO8 8HJ 02392594427 02392792007 woodlands@brookvalehealthcare.co.uk 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) : Heatherland Healthcare Limited care home 31 Number of places (if applicable): Under 65 Over 65 0 0 31 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 31 5 0 The maximum number of service users who can be accommodated is: The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Dementia - DE Mental Disorder, excluding learning disability or dementia - MD Date of last inspection Brief description of the care home Woodlands is a care home providing accommodation and care for 31 service users in the category of Older Persons (OP) and/or those over 65 years in age with dementia (DE). The home may also accommodate 5 service users who are over 65 years in age and who have mental health problems. Care Homes for Older People Page 4 of 26 Brief description of the care home The home is owned by Heatherland Healthcare Limited. The registered manager is Mrs. Heather Taw. Communal space comprises two lounges and dining room. Bedrooms are situated on two floors, accessed by a shaft lift. The main door is kept secure by the use of a keypad exit system. There are 28 single and 2 shared rooms, although one of these is traditionally used as a large single. Eleven single rooms have en suite facilities. There is a well-kept garden and patio area to the rear of the property and car parking space at the front. The home is situated in a quiet residential area, close to local amenities, shops and public transport. The fees for the home currently range between #435 & #515 dependent on need and whether the room has en suite facilities. Care Homes for Older People Page 5 of 26 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 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 visit to the service was undertaken by one inspector who spent five and a half hours at the home. The care received by three residents was looked at in detail. This is a method called case tracking. This included looking at their personal records, a range of general records and staff details. This forms part of a key inspection and focused on the standards in the key areas that most effect the quality of life for the residents. Information already held such as the last Annual Service Review , we did ,a service history and the providers self -audit which is called an AQAA (Annual Quality Assessment Audit) were used to plan the visit. During the visit the inspector spoke to the responsible individuals representative , manager,operations director, four staff and nine residents. We observed residents interactions with staff. We also sent comment cards for staff and residents and health care professionals to complete and we Care Homes for Older People Page 6 of 26 considered the comments these contained when writing the report. 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 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. Care Homes for Older People Page 8 of 26 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 9 of 26 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. Residents are given admission details so they are able to make an informed decision to live at the service. This is underpinned by a contract which protects their rights. Pre admission assessment and information gathering ensures the resident can be confident the service can meet their assessed needs. Evidence: We casetraked three residents and one of these was the last person to be admitted to the service. We saw evidence in their file, that before they were admitted to the service the manager had carried out a full assessment of the residents needs and lifestyle. There were details obtained from the resident, their relatives and the hospital staff and care manager. This means that the manager is able to make a decision regarding meeting the residents needs with as much information as possible to ensure the admission is successful. If a residents needs can be met at the service the manager will inform the resident that a place is available for them. This also needs to Care Homes for Older People Page 10 of 26 Evidence: be in writing so the resident can be confident that the manager and care team really understand their needs. Two documents are in place called the statement of purpose and service user guide. These provide information about the service such as lay out ,staff team and meals provided and activities. These documents were on display in the front hallway along with the latest inspection report. We saw in files that contracts of service were in place. This means that residents can be confident that the services they were offered when they moved into the home are arrangements which are legally binding. Those residents who are not able to sign their contracts have a relative sign on their behalf. Through discussion with the manager it was clear that the manager had the authority to make a final decision whether to admit a prospective resident to the service and was not expected to admit any person just so that beds would be occupied. This means that the right people are admitted to the service who will have their needs met. Care Homes for Older People Page 11 of 26 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. Care changes need to be recorded as well as verbally passed to staff to ensure that all staff provide the right level of support to all residents. Residents are very satisfied with access to health care services. Administration sheets need to be completed correctly to minimise medication errors and ensure residents have received their prescribed medication. Interactions between residents and staff are very good and uphold the residents rights. Evidence: Since the last inspection more work has been carried out on care plans and they are presented in a different format. We could see that details relating to the needs to be met were clear and in most plans ,we looked at ,any change in care need had resulted in a change to the care plan detail. We found a couple of occasions when the care had changed but the care plan had not been updated but staff had verbally been informed of the change in care. We saw that residents had been involved in their care plans and where possible they had signed to say they agreed to the details . Care Homes for Older People Page 12 of 26 Evidence: We were told that there were a couple of district nurses who attended the service when needed and that residents had access to doctors when needed. Due to the service admitting people who may have a dementia type condition the service also have good links with the community mental health team for support and guidance when needed. We saw a prescription in a file from the optician and the manager confirmed that all residents had the opportunity to see the visiting optician or chose their own optician. Currently a dentist does not visit the service and families are excepted to assist residents with obtaining a dentist.Residents we spoke with were satisfied with the health care they received and made comments such as You only need ask and the doctor will visit and I had my eyes looked at just a little while ago. We looked at the medication administration records (MAR) sheets which are used when medication is administered. We saw that mainly they had been completed correctly but on a couple of occasions we found that medication had not be signed for even though it had been removed from the blister pack. This was discussed with the manager who said they would look in to the matter. The service does internal auditing of their medication systems and on the last audit all staff had been administering medication correctly. We could see that all staff who administer medication had received training and had been deemed competent. The local pharmacy who provides the medication also provides an advisory service to the home. We looked at comment cards before we carried out the visit to assess residents views of how they were treated by care staff. Comments were all positive and when we talked with residents during the visit, again we received very positive feedback. This included they cant do enough for you, they are really good, they know exactly what you want and answer the bell as soon as they can. We observed how residents were spoken to by all staff on duty during our visit. Without exception all of the interactions were appropriate and well meaning. All of the residents were spoken to in a dignified way and in a patient and kind manner. Those residents who have a confusion were spoken to gently and reassured and guided to their room or to a lounge area. Care Homes for Older People Page 13 of 26 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. Residents have their dietary needs and choices met. Activities take place and these are varied and the residents choice. Spiritual needs are acknowledged and met. Residents are given choice in many aspects of their lives and supported to make informed choices and decisions. Evidence: Comment cards we received stated that there were a range of activities available. During the visit the residents we spoke with said they could chose if they participated in activities. Their was a poster on display and details of activities on a memo board on the first floor of the service. We were told that a couple of singers had recently visited the service and that care staff did activities in the afternoon. The AQAA records activities such as garden parties, manicurist and purchasing of two canaries and a tropical fish tank.We were told by the residents that they were able to chose how they spent their days and that trips out of the home had been arranged previously and they were looking forward to going out when the weather improved. It was not always documented if residents had attended activities or been offered to participate. The manager said a new form was being designed to ensure this information was clear and could be referred to. One resident said they used to spend a lot of time in their garden Care Homes for Older People Page 14 of 26 Evidence: and they were able to sit in the garden at the home when they chose. New garden furniture has been purchased to provide a more comfortable sitting area. We asked if residents felt they were able to live their lives as they did before they moved into the home. Comments included it is like when I was at home but with company, I could do what I wanted at home and here your left to do what you want,I pretty much kept myself to myself and I can still do that here. During the visit we saw residents watching television and reading , one resident said they had got the book from the visiting mobile library, and one resident told us they had recently done some art and craft work. The service celebrates Christan festivals such as Easter and Christmas and one resident told us they received Holy communion once a month from visiting clergy. The AQAA states that all residents are supported to attend religious services in the local community to meet their spiritual and religious beliefs. A recent relative meeting took place which was well attended and regular resident meetings take place. Minutes are maintained and these provide an action plan for the manager and the Responsible Individuals(RI) representative to use to provide an improved service to the residents. We looked at sample menus during our visit and spoke with the chef. Residents told us they enjoyed the food and we saw that dietary requirements such as a vegetarian diet and sugar free diet were provided for. All comments on cards were positive and during our visit all comments were positive except one regarding choice of supper dessert which was referred back to the manager for looking into. Care Homes for Older People Page 15 of 26 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. A complaints policy enables residents and visitors to the service to raise any issues. They can be confident that their concerns will be listened to and dealt with. Staff receive safeguarding adult training and the services policy is up to date. Evidence: There is a complaints policy on display and also contained within the homes brochure. We have not received any concerns or comments or allegation regarding the service. The AQAA informed us that no concerns or complaints had been received at the service. Residents told us they knew any issue they raised would be taken seriously and will always be investigated. Staff we spoke with said if they received any concerns they would try to address them straightaway and also inform the manger immediately. We saw in staff records, and all staff we spoke with confirmed that they had received training in safe guarding adults. We could see from the AQAA that the safeguarding adults policy had recently been reviewed but we did not view it on this visit. Induction records we viewed evidenced that Safeguarding Adult issues were covered as part of the induction process.We were told the latest edition of the Hampshire County Council Safeguarding Adult procedure was in place but we did not view this during the visit. Scenarios we gave to staff in relation to safeguarding Adult issues were answered well and demonstrated that staff had a good understanding of practices which may constitute abuse. Care Homes for Older People Page 16 of 26 Care Homes for Older People Page 17 of 26 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. Residents live in a safe environment and the staff have been trained to identity hazards and minimise the spread of infection . Residents live in comfortable surroundings and the RI will provide additional equipment to assist residents and staff as needed. Evidence: We undertook a tour of the premises and found them to be clean and fresh throughout. We saw that domestic staff are employed and residents we spoke with said their bedrooms were always vacuumed and kept clean and tidy. We found the decor to be satisfactory and in good repair. Security to the service is good with entry being gained by the door being opened by either staff or residents with staff support. We saw three residents bedroom with their permission and we were told by the residents they were satisfied with their rooms. Bathrooms we viewed were clean and tidy and the AQAA informs us that bathing aids such as hoists have been regularly serviced. The manager told us that any maintenance is recorded and work is carried out promptly. One resident is now in need or being assisted to stand with the use of a hoist. This had been requested and the RIs representative confirmed that this equipment would be in the home in the following couple of weeks. Residents told us they were satisfied with how their clothes were laundered and one Care Homes for Older People Page 18 of 26 Evidence: said They always come back smelling nice and well pressed. We did not note any hazards while we toured the home and the manager said that environmental risk assessments were in place where necessary.Staff told us they had received training in infection control and we did see the care team wearing aprons and gloves at various times during the visit. Staff records showed us that staff had received training in infection control and health and safety. Care Homes for Older People Page 19 of 26 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. An enthusiastic and motivated care team provide a good level of care for residents. The residents can be confident that the right people are recruited and they are trained to deliver care in a safe way. Staffing levels need to be continually monitored to ensure that residents ever changing needs are met. Evidence: Many of the staff team have been in post for many years. We looked at the recruitment records for three staff who had been recruited since the last inspection. We could see that all the necessary paper work was in place. This included references Criminal Record Bureau(CRB) checks and application forms. In two forms there was not a full employment history recorded even though this was discussed at the interview.It is important that a full employment history is obtained and any gaps are explained so the manager can be confident there is no concerning reason why there is a gap. Feedback in comment cards regarding staff attitude was positive and during the visit residents made comments such as All of them are so kind to you and you see the same ones regularly which is nice. The manager said that the team worked well together and that new staff were in receipt of an induction as soon as they started work. We saw that new staff shadowed an experienced member of staff until they were deemed competent of carrying out care safely. Care Homes for Older People Page 20 of 26 Evidence: Staffing levels are consistent and residents indicated on comment cards that staff were available mostly on five cards and always on 2 cards. Staff said that the staffing level was sufficient most of the time bit on occasion it was very busy especially around supper time. A recent relative meeting also raised the issue of locating staff in the evening and call bells taking a while to be answered. The RI representative has put a system in place to review call bell times and use this to re assess staffing levels and if necessary increase staffing levels at busier times of the day. We could see from training records that training was taking place on a regular basis. This included dementia care, first aid, moving and handling and health and safety. We also saw that one staff had completed a NVQ (National Vocational Qualification ) in Palliative care. The AQAA informed us that all of the staff employed had completed a nationally recognised induction course and fourteen of the twenty six staff had obtained a NVQ 2 or 3 in Care. This means that staff have more enhanced skills and knowledge to underpin the care they provide to the residents. Care Homes for Older People Page 21 of 26 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. The service is managed by a competent, motivated , enthusiastic and experienced manager who provides a good service. The care team feel supported by the manager and residents feel that the manager works well with them. Systems are in place to review and monitor the quality of the service so it can continue to evolve and improve. Evidence: The registered manager has been in post for the past five years. Comment cards recorded that residents had a good relationship with the manager. Staff we spoke with said the manager was really easy to get on with and She will support you and take your views back to the owner. We observed interactions between the manager and staff and residents. The manager was enthusiastic in her work and said that she was always trying to improve how we work here. The manager is supported by the organisations operations director and the Responsible Individuals representative who visits the service most days. We met with the operations director and the RIs representative during the visit and Care Homes for Older People Page 22 of 26 Evidence: for feedback. Since the last visit the quality assurance system has been improved. This included undertaking internal audits of care practices such as medication , infection control and health and safety through to maintenance of the building. These audits then form the plan for moving the service forward. The RIs representative recently held a residents and relatives meeting which was well attended, in order to hear views on how the service was operating. Small quantities of residents monies are held at the service and these were supported by a clear audit trial of monies in and out. Staff supervisions sessions take place which mean that staff have an opportunity to discuss their work and any development needs they have. The service have kept us informed of events and incidents that we needed to know about. Health and safety issues are reviewed and relevant risk assessments are in place. We did not view polices and procedures on this visit but the AQAA records that all are reviewed regularly. Care Homes for Older People Page 23 of 26 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 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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