Care Home: Woodlands Villa

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What the care home does well There is a relaxed and friendly atmosphere. The people who live in the Service say and show by their relaxed manner that support workers are kind and attentive. People say that they have good meals. People receive the support and assistance they need. Support workers know what they are doing. They have a detailed knowledge of what each person needs and wants. Medication is given safely and people are helped to promote their good health. Sensible steps are taken to reduce the chance of accidents. What has improved since the last inspection? People have been introduced to a wider range of occupational and social activities. Support workers have attended a number of relevant training courses. What the care home could do better: In general the individual plans of support are quite detailed and are well presented. However, the arrangements in place to support one person to smoke safely need to be strengthened. This is important because the present arrangements aren`t working and the person may be creating a fire risk. The plan for another person also needs to be strengthened. This is so that support workers have more information about how best to respond when the person concerned becomes physically unwell. Parts of the shower room, one of the bathrooms and the small kitchen are not well presented. They look rather run down and they aren`t the inviting spaces they should be. The Registered Provider has not asked us to register the Assistant Manager in her post. We understand that we will receive the application in the near future.This is important because there needs to be an accountable person in day to day charge of the Service. There are some gaps in the fire safety checks and in the programme of fire safety training. These might reduce the level of protection available in the Service. CARE HOME ADULTS 18-65 Woodlands Villa 496 Loose Road Maidstone Kent ME15 9UF Lead Inspector Mark Hemmings Unannounced Inspection 16th March 2009 08:15 Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodlands Villa Address 496 Loose Road Maidstone Kent ME15 9UF 01622 746295 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ellen Rose Russell Ellen Rose Russell Care Home 13 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (0) of places Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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: 2. Mental disorder, excluding learning disability or dementia (MD). The maximum number of service users to be accommodated is 13. Date of last inspection 19th December 2007 Brief Description of the Service: Thirteen people who have difficulties with maintaining parts of their mental health can make their home in Woodlands Villa (the Service). When full, two of the bedrooms can be shared by two people each. All of the bedrooms have a private wash hand basin. The premises are a detached property. One side is the main building and the other is a large extension. On both sides the accommodation is on the ground floor and the first floor. There is a shower room and two bathrooms. Each of these also has a toilet and there are some additional toilets. There is the main kitchen on the ground floor. There is also another smaller kitchen on the first floor in the extension. This can be used for people who want to practice their cooking skills. The dining room is near to the main kitchen. There is a main lounge and a smaller lounge. At the back of the property there is a conservatory. This looks out on to the enclosed and secluded garden. The Service is set back a bit from the street. It’s quite a busy road with lots of traffic. It’s quite close to the centre of Maidstone and there are some general shops within walking distance. The Service doesnt have its own vehicle. The Registered Provider is a private individual. The weekly fee for living in the Service is £505.97. This includes the cost of accommodation, personal care and meals. It does not include things like meals out and toiletries. Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 5 People who might want to move in can find out things about the Service. There is a Service Users’ Guide. This is a brochure that outlines the main things available in the Service. There is also a document called a Statement of Purpose. This is more detailed than the Guide. If you want to find out more about Woodlands Villa you can also phone up and speak with the Assistant Manager. Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this Service is 2 star. This means that the people who use this Service experience good quality outcomes. Since 1 April 2006 we have developed the way we do our inspection of care services. This inspection of the Service was an unannounced Key Inspection. We arrived at the Service at about a quarter past eight in the morning and we were there for about seven hours. It was a thorough look at how well things are going. We took into account information provided by the Registered Provider in her self-assessment. This is called the Annual Quality Assurance Assessment (the Assessment). Further, we considered any information that we have received about the Service since our last inspection. We spoke with four of the people who live there. Also, we spoke with the Assistant Manager and with four of the support workers. We looked at some key records and documents and we had a look around the accommodation. Before we went to the Service, we asked ten of the people who live there to fill out a questionnaire for us. We wanted them to tell us what they think of their home. Six people kindly filled out our questionnaire and returned them to us. We also asked ten members of staff to complete a questionnaire. Three people sent them back to us. In addition to our questionnaire, the Registered Provider also asks the people who live in the Service and their relatives to complete a questionnaire for her. We looked at five of the former ones. We’ll tell you some of the things that people are saying in the various questionnaires as we go through our Report. What the service does well: There is a relaxed and friendly atmosphere. The people who live in the Service say and show by their relaxed manner that support workers are kind and attentive. People say that they have good meals. Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 7 People receive the support and assistance they need. Support workers know what they are doing. They have a detailed knowledge of what each person needs and wants. Medication is given safely and people are helped to promote their good health. Sensible steps are taken to reduce the chance of accidents. What has improved since the last inspection? What they could do better: In general the individual plans of support are quite detailed and are well presented. However, the arrangements in place to support one person to smoke safely need to be strengthened. This is important because the present arrangements aren’t working and the person may be creating a fire risk. The plan for another person also needs to be strengthened. This is so that support workers have more information about how best to respond when the person concerned becomes physically unwell. Parts of the shower room, one of the bathrooms and the small kitchen are not well presented. They look rather run down and they aren’t the inviting spaces they should be. The Registered Provider has not asked us to register the Assistant Manager in her post. We understand that we will receive the application in the near future. Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 8 This is important because there needs to be an accountable person in day to day charge of the Service. There are some gaps in the fire safety checks and in the programme of fire safety training. These might reduce the level of protection available in the Service. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. We looked at Standard 2. People who might want to move in are asked about what support they want. They are then helped to settle in. EVIDENCE: The Assistant Manager says that if someone is thinking of moving into the Service, she will speak with them to find out what support they want and what sort of life they want to follow. As part of her enquiries she looks into how best to respect and promote the persons individuality in terms of things such as their gender, religion and culture. She will also speak with other people such as family members and care managers (social workers). This will be done so that she can check out points of detail that help her to be clear about what is needed. After this is done, the person will be invited to visit the Service. This is so that they can get a first hand feeling of what Woodlands Villa is like. Also its done so that they can meet the other people who have already made the Service their home. Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 11 The Manager recognises that moving into a new home is a big step for anyone to take. She emphasises that the Service wants to do everything possible to make the move a positive experience for everyone. We looked at some of the information that was collected to support someone who may be moving in. There is lots of useful information. For example, about their family and the contacts they have with them. There is also information about the support they need, about their health and about the sorts of social life they enjoy. The Manager says that she shares this information with the support workers. This is done so that they can support the person in the right way from the point they move in. After this, they can get to know them better as time goes by. We asked support workers about how all of this works out in practice. They say that they are fully involved in the steps taken to help someone move in. We asked one person about how things went when they first came to the Service. They say, ‘when I came here I came to have a look around and I met people to see if I liked it. You need to see a place don’t you first or else it can be a bit frightening’. In our questionnaire for people who use the Service we ask, did you receive enough information about this home before you moved in so you could decide if it was the right place for you? Four people say that yes they did have enough information and two people answer ‘no’. The people who say ‘no’, don’t really give us anything more to go on about why they are answering in this way. Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 12 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. Standards 6, 7, 9 and 10. There are individual written plans of support. These give a clear account of the help that each person has agreed to receive. There is a sensible approach to everyday risk taking. This means that people can lead normal lives of their own choosing. EVIDENCE: People say that the support workers offer them all the assistance they need. There is a written individual plan of support for each person. These are important documents. This is because they are one of the means by which people can decide about the support they need. Also, they are a way for them to show their agreement with how this is going to be done. The plans are a source of information for support workers. This then helps them to provide Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 13 support in the right way. We looked in some detail at three of these plans. They have information about a number of relevant things. For example, there is information about how to help people say what they want and about how to support them in managing parts of how they go about things. There is guidance about how to help them with practical things such as using the bathroom and keeping their bedrooms how they want them. In more detail, there are arrangements to help one person stay safe when they are out of the Service. For another person, there is a sensible plan to help them not become too isolated by taking part in everyday life. We spoke with three support workers about whats in these plans. They know it. They also know how to use the information in practice to give people the support they need. We saw them using this knowledge to good effect. For example, one person was gently being helped to get their own breakfast. Another person was being supported to generally be about the place. The plans are kept up to date so that they are accurate. This involves support workers making daily notes about how things are going. Each person has a key worker. This is a support worker who meets regularly with them to check out in detail how things are going. There is also a programme of three monthly reviews. These are when the key worker and the person concerned have a longer chat about how things are. Some of these latter reviews are a bit overdue. About once a year there is a larger review. This is where people like psychiatrists, care managers and family members are invited to meet with the person to see how things are going. These reviews are organised by the care managers. Some of them are overdue. Some of the people who live in the Service are helped to manage their financial affairs. This is because they find all of the paperwork involved quite difficult to keep on top of. This help is done by family members or by the local authority. The Registered Provider doesnt get directly involved. Everyone has their own bank account that they run like we all do. They take money out as and when they need it to buy things. The Registered Provider has been asked to hold some money for some of the people. This is done so that their money doesn’t get lost or get spent all at once. We asked one of these people about this arrangement. They say that they are quite happy with it. We looked at some of the records that are kept of the various transactions that are done for this arrangement. Everything is in order. Sensible consideration is given to promoting peoples personal safety. They are not over-the-top and so people are still free to do things that they want to. There are written plans that say what potential risk is being considered and what needs to be done. For example, people are encouraged to do things for themselves and this can involve going in the kitchen. Support workers have thought about this. For each person they have taken into account if theyre okay with using ordinary kitchen equipment. Another thing they have thought Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 14 about is how safe people are when they go out and about in the local community. Some of the people who live in the Service like to smoke. One person is finding it difficult to put their cigarettes out safely. Although support workers are trying to deal with this situation, they’re only being partly successful. More now needs to be done. The Manager is going to look into this so that the person concerned can be given whatever extra support is needed to keep themselves and other people safe from the risk of fire. This is going to be done by 1 May 2009. Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 15 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. We looked at Standards 12, 13, 14, 15, 16 and 17. People can do occupational and social things that interest them. People are helped to keep in touch with their families. They can spend their days as they wish. Good quality meals are served. EVIDENCE: People are free to do things that interest them. The Assessment says that the range of opportunities made available to people has been increased and that it will be kept under review in the future. Some of the things that people can do involve helping out a little bit and in their own way around the house. Over time, each person has developed their own things that they like to do each Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 16 week. This variously includes going out to work and going to local resource centres where they can do various occupational activities. They also do everyday things such as going to the shops to buy what they need. In our questionnaire we ask, can you do what you want to during the day, in the evening and at the weekend. Four people say ‘yes’ and two people say ‘no’. One of the former people adds, ‘you have to do your chores but apart from that you are free to do as you like’. One of the latter people says that they’re not happy with the understanding that they come home by 10 o’clock in the evening. People are helped to keep in touch with members of their families. Family members and friends are welcome to call to the Service whenever they want. We looked at the records about this. They show that support workers contact family members to tell them how things are going. One person doesn’t want to have contact with their family at the moment. The Assistant Manager has taken suitable steps to make sure that this request is honoured. People say that they have good quality meals and that they have enough to eat. One person summarises the general mood when they say, ‘we get really good food and there’s plenty of it. The meals are very good and I’ve got no complaints at all’. The Registered Provider’s questionnaire for people who live in the Service asks, ‘are you given choices of meals?’ and ‘are your dietary requirements met?’ Everyone answers ‘good’ or ‘very good’. Support workers do most of the main cooking, but some of the people do help with bits of it. There is a weekly menu. However, this is not too rigid. People can and do change it if they want something different. Over time, everyone has got to know what each other likes and dislikes. The menu pretty much reflects this. We looked at the menu for dinner over a period of several recent days. The main dishes served include things like fish and roast chicken. There is a small tea bar where people can make themselves a cup of tea. We saw this being used quite a lot. Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 17 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. We looked at Standards 18, 19 and 20. People are helped in ways that are right for them. They are helped to stay well. There are safe systems to manage and administer medicines. EVIDENCE: People are helped in ways that are right for them. They take for granted that their home is how they like it and that support workers are their friends. The support workers are relaxed and informal in how they are. Things are orderly without being too much so. When things look like they might be getting a bit too much, they gently point people in a different direction. This isnt done in an obvious or bossy way. People are helped to wear neat and clean clothes so that they can look how they want. They are helped to sort out any post they get and they can use the phone when they want. In our questionnaire we ask, do the carers listen and act on what you say? Four people say that they Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 18 always do, one person says usually and one person says ‘never’. These latter people dont add any more information about why they have answered in this way. When we were in the Service we only got positive comments from people about the support workers. One person says, ‘they’re good and treat me well, they always help and I like them even when I get nagged at I know it’s for my own good’. Another says, ‘the staff are friendly to me and I like them. They are patient and I like living here like it’s a family sort of thing. I don’t want to move anywhere else’. The Registered Provider’s questionnaire asks, ‘are staff approachable?’ and ‘are you given adequate support’. Everyone answers ‘good’ or ‘very good’. People are helped to keep healthy. Support workers keep a tactful eye open so that a doctor can be called if someone is becoming unwell. One person has a special medical need. We looked in detail about how they are being helped to deal with this. They have seen their doctor but on some occasions they aren’t helping themselves by following the right diet. This can make them unwell. Support workers keep a tactful watch out so that they can call for medical help if it’s needed. However, there is some uncertainty about at what stage this might be necessary. The Assistant Manager is going to seek advice about this matter. This is so that more detailed information can be put into the person’s support plan in order to give support workers a clearer idea of how best to respond. She’s going to do this by 1 May 2009. People are also helped to take care of themselves in a positive way. For example, by following a balanced and healthy diet. At the moment, no ones doing their own medication. The Assessment says that people with be supported to do this for themselves whenever this is the right thing for them. There is a system to check that the correct medicines are received from the chemist. Once in the Service, they are stored securely. There is a procedure for administering medicines. This is designed to double check that the right medicines are given to the right people at the right time. There is a record that is completed on each occasion that a medicine is given. We looked at three sets of these records. They are correctly completed. We looked at three medicines in more detail. We wanted to see if the remaining stock matches what should be there. It does. Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. We looked at Standards 22 and 23. People are free to make a complaint if they want to. People are kept safe. EVIDENCE: There is a written complaints procedure. This explains how someone can go about making a complaint if they want to. Since our last inspection, the Registered Provider has received one formal complaint. This was about an incident where one of the people who live in the Service thought that a support worker was a bit abrupt with them. The Assistant Manager looked into the matter by speaking with everyone concerned. We understand that the support worker concerned has since been given extra guidance about how to deal with potentially difficult situations. We also have been told that the person who made the complaint is satisfied with what’s been done. However, some of the records that the Assistant Manager has kept of how she sorted the complaint out aren’t thorough enough. This is important because we need to be able to check in detail what has been done to resolve any complaints. The Assistant Manager says that in future a proper record will be kept. We asked several people who live in the Service about the general subject of making complaints. They say that they dont have anything concerning them at Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 20 the moment. In our questionnaire for people who live in the Service we ask, do you know how to make a complaint? Everyone says that ‘yes’ they do. The Registered Provider’s questionnaire asks, ‘are your concerns and worries dealt with? Most people answer ‘good’ or ‘very good’. People say and show by their relaxed manner that they feel safe living in Woodlands Villa. In our questionnaire for people who live in the Service we ask, do the staff treat you well? Four people say that they ‘always’ do, one person answers ‘usually’ and one says ‘never’. The latter two people don’t say any more about their replies. The Registered Provider has a written policy and procedure that tells support workers what to do if they become concerned about someone being mistreated in some way. The training records we talk about later on, show that support workers have done training about this matter. We spoke with two of them about safeguarding people who live in the Service. They know what to look out for in terms of possible mistreatment and who to contact if they become concerned. They say that they havent seen or heard anything to worry them. Indeed, they are confident that the people who live in the Service are safe and are well supported. One of them sums up the general mood when they say, ‘the residents really do come first here and they’re all kept safe because they need our help or they wouldn’t be living with us. We think of them as family really. That’s what this place is all about I suppose’. Since we were last in the Service, the local authority has looked into a specific incident involving the wellbeing of one of the people who was using the Service. We understand that the Registered Provider cooperated fully with the investigation. We also understand that the Assistant Manager subsequently changed some of the arrangements used to keep people safe. She did this so that theres less chance of a similar incident happening again. Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. We looked at Standards 24, 25, 28, 29 and 30. People live in a generally comfortable setting that promotes their independence. The kitchen is clean and well equipped. There is a separate laundry. This means that used clothes dont have to go anywhere near the kitchen. EVIDENCE: In general, the accommodation is comfortable and homely. There are various training certificates on the wall in the kitchen. They’re the sorts of things you might find in an office rather than in someone’s home. The Assistant Manager says that she has been asked to display these things in the past by official visitors to the Service. She says that shell be pleased to take them down now. Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 22 There are some things that need attention. In the ground floor shower room there is mould in the shower enclosure. Also in this room, the floor covering under the wash hand basin has come loose. In one of the first floor bathrooms the shower hose attached to the bath tap has worn out. In the first floor kitchen, the carpet floor tiles have shrunk over time and there are large gaps between them. The Assistant Manager says that she will attend to all of these items by the end of the year. People say their home is kept warm enough in winter. When we there the place was comfortably warm. The hot water service is working okay. We went to the top of the house furthest away from the boiler and there was plenty of hot water. The premises are fitted with an automatic fire detection system. This provides a high level of fire safety protection. We understand that the fire brigade people say that the fire safety measures in place meet the national standard. The Registered Provider has prepared a fire risk assessment. This has been done to ensure that the fire safety system continues to work as intended. The assessment may need to be strengthened. This is because there are special security arrangements for the two front doors that might slow down an evacuation. The Assistant Manager is now going to revise the necessary part of the assessment. After this is done she is going to send it together with the one on smoking we mentioned earlier, to the fire brigade people. This is so that they can check that the fire safety things in Woodlands Villa are still up to the national standard. This will be done by 1 May 2009. The people from the local Department of Environmental Health called to the Service last year. They say that things in the kitchen are running okay. We looked at the kitchen too. Its neat and clean. It looks well used like anyones kitchen. Theres a system to make sure that the refrigerators are cold enough to store foods safely. Sensible steps are taken to promote good hygiene. For example, support workers know about the importance of washing hands. In particular, if theyve been doing other things like working in the laundry. Once foods are opened they are date marked. This is done so they arent allowed to be kept in store for too long before they’re used. As we said earlier, when the Service is full two of the bedrooms can be shared. Only one of them is being used in this way at the moment. We understand that all of the people who currently share a bedroom have said that they’re happy to do so. We asked one person about this. They say that they are satisfied with their bedroom and don’t want to move to have one of their own. At the moment none of the people who live in the Service need a lot of help in the bathroom. Several need a steadying hand to get into and out of the bath. The Assistant Manager recognises that more things may need to be provided in the future if people become less able than they are at the moment. Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 23 Rather oddly the laundry is part of the foyer area and so you go through it when you enter and leave the building. It’s quite small. At the moment it’s being refurbished after a water leak caused quite a lot of damage. There’s a large washing machine and tumble drier. There are new regulations that have been introduced to ensure that used water doesnt leak back into the main pipe-work. The Assistant Manager is going to check with the local water supply company to make sure that the Service meets whats needed. This will be done by 1 June 2009. Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 24 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. We looked at Standards 32, 33, 34 and 35. There are enough support workers around to make sure that people get the help they need. Security checks are completed on staff to make sure that theyre trustworthy. Support workers know what they are doing. EVIDENCE: There are always two workers on duty from early in the morning until the evening time. There is a waking staff presence in the Service at night. Also, there are special security arrangements at night. We looked at the roster in some detail for two recent days. We wanted to see if the various shifts are being filled reliably. We found that they are. In our questionnaire for members of staff we ask, ‘are there enough staff to meet the individual needs of all the people who use the Service?’ Everyone says that ‘yes’ there are. Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 25 Its very important that all of the support workers are honest people who can be trusted to spend lots of time with the people who live in the Service. With this in mind, the Registered Provider completes a number of security checks for new support workers. These include checking the persons identity and their employment history, getting references and doing a police check. We looked at the personnel file for one support worker who has been appointed since our last inspection. Also, we gathered some extra information about this person. We’re satisfied that the Registered Provider has completed the necessary security checks. The records themselves are a bit disorganised. More can be done to make them orderly and easier to follow. New support workers have introductory training before they begin supporting people. After their introduction to the Service, they start completing a more detailed training programme. This involves them attending various courses. For example, they are expected to do courses in things such as mental health awareness, first aid, health and safety and food hygiene. These courses are then repeated regularly for existing support workers. This is done to make sure that all support workers keep up to date with what is seen to be good practice. We looked at some of the records of who has done what courses in the past few years. In general, support workers have done quite a lot of training. The Assessment says that all support workers are encouraged to complete a relevant National Vocational Qualification (NVQ). This is a good idea because the qualification is designed to support people being helped in ways that are right for them. The majority of the support workers already have the qualification and three more are currently studying for the Award. In our questionnaire for members of staff we ask, ‘are you being given training which helps you to understand and meet the individual needs of service users and keeps you up to date with new ways of working?’ Everyone says that ‘yes’ they are. We also ask, ‘do you feel that you have the right support, experience and knowledge to meet the different needs of people who use the Service?’ No one says that they ‘always’ do. Everyone answers that they ‘usually’ do. When we were in the Service, one support worker added that the Assistant Manager, ‘is really good about training and she’s always arranging things for us to do. She takes training seriously and if I wanted some addition training on something relevant I’m sure that she’d arrange it’. When we spoke with support workers we asked them about points of detail to do with their work. We wanted to see what they know about a range of things likely to be relevant to working in Woodlands Villa. They have a sound understanding of important things. For example, they know in some detail about how individuals living in the Service prefer to express themselves. They know that some people sometimes express themselves by what they do rather than by what they say. They also realise that some people need much more guidance and help than do others. Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 26 Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 27 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this Service. We looked at Standards 37, 39, 41 and 42. The Service is reliably managed. However, the Assistant Manager isn’t registered in her post. People are asked what they think about how things are going, but this could be a bit more developed. People’s health and safety is promoted. EVIDENCE: The Assistant Manager has been running Woodlands Villa for more than a year. She is the daughter of the Registered Provider and so she has been indirectly involved with the Service for many years. The arrangement is that she is in Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 28 day to day charge of all aspects of the Service. The Registered Provider calls to the Service normally on a weekly basis to check out how things are going. The Assistant Manager knows a lot about all of the people who live there and about the support workers. She has one of the two formal qualifications that we expect. These qualifications are important. This is because they are intended to help managers ensure that people reliably receive high quality residential care services. She says that she intends to complete the second of the qualifications by the end of 2010 at the latest. We understand that the Registered Provider intends to ask us to register the Assistant Manager in her post. This is important because we need to have the opportunity to look in detail at her suitability for this position. The Assistant Manager tells us that we will receive her application by 1 June 2009. Various things are done to help staff work as a team. There are handover meetings at the beginning and end of each shift. These are when support workers say how things are going and what needs to be done on the next shift. Also, there are staff meetings. We looked at the records of the most recent of these meetings. A number of important things were discussed. For example, they talked about how to make the most of the handover sessions. The support workers noted that it’s important to focus on important things only and not to get side-tracked with minor details. Support workers say that there is good team work. We saw plenty of evidence of this. Support workers check out with each other who is going to do what, with whom and when. Also, they plan their work in advance so that they use their time to the best effect. In our questionnaire for members of staff we ask, ‘do the ways you pass information about people who use the Service between staff (including the Manager) work well. Everyone says that ‘yes’ they do. The people who live in the Service are asked about how well they think things are going in their home. These include informal everyday discussions. There are also each persons one to one sessions that we spoke about earlier. There are house meetings every two or three months or so. These are when everyone who lives and works in the Service can get together to chat about how things are going. We looked at the records of the most recent meeting. Most of the people who live in the Service went along. They talked about important practical things. For example, they came to an agreement that some people won’t make too much noise at night when other people want to go to sleep. We’ve already mentioned about the questionnaires. There’s no real system to tell people who live in the Service what everyone has said in their responses. We think that this is really important. Also, there needs to be a way of telling people what is going to be done by the Registered Provider to respond to any improvements that may have been suggested. The Assistant Manager says that she will address these issues. This will be done in time for us to be told Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 29 about it when the Registered Provider sends us her next Annual Quality Assurance Assessment. The present Assessment doesn’t give us a very detailed account of how things are going in the Service. We will expect it to be much more thorough next time. Support workers are doing regular checks to make sure that the fire alarms are working normally. However, the checks that should also be done of the emergency lights and fire extinguishers are overdue. The Assistant Manager is going to put this right from the date of our inspection visit. There are more detailed tests of all of the above equipment that have to be done by contractors. These are up to date. There are unannounced fire drills. Support workers attend an annual fire safety lecture. The Manager says that she is now going to introduce a new system. This will increase the frequency of this training to twice a year, this being the national standard. She is going to introduce this new arrangement by 1 May 2009. The Assessment says that, all items of equipment in the Service are serviced as necessary to make sure that they remain in good working order. We looked at the contractors’ checks that have been done recently on the gas appliances and on the electrical wiring installation. The reports say that everything is in order. The various records that are kept in the Service are stored securely. This is important because some of them contain confidential information. The people who live in the Service can see their own records if they want to. We looked at the record of accidents and other untoward events that have occurred in the Service this year. With the exception of the choking incident we mentioned earlier, there is nothing out of the ordinary. One of the support workers checks the place over regularly to make sure that theres nothing broken that needs fixing. We looked at some of the records she keeps. These show that she’s doing quite a thorough review. They show that there are some minor bits of maintenance work to do. She doesn’t think that there’s anything major that might result in someone having an accident. We kept our eyes open when we were walking around and we didn’t see anything obvious either. Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 30 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 X 28 3 29 3 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 2 X 3 X 3 2 X Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 31 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Woodlands Villa DS0000024084.V374512.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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