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Care Home: Woodlea Residential Care Home

  • 196 Upper Chorlton Road Woodlea Manchester M16 7SF
  • Tel: 01618629521
  • Fax: 01618820744
  • Planned feature Advertise here!

Woodlea is a private care home providing support and accommodation for up to 15 adults with mental health needs. The home is a large converted Edwardian House set in a residential area of Trafford. Shops and a post office are within walking distance of the home. Public transport routes into Manchester city centre and the surrounding area are close by. The philosophy of the service is to maximise the potential of each resident and to develop and maintain independence. Accommodation is provided in 15 single bedrooms, none of which have en-suite facilities. Sufficient toilet and bathroom facilities are provided to meet the needs of the residents. Communal space comprises of a lounge with connecting dining room and a non-smoking lounge on the lower ground floor. There is a large private garden to the rear of the property and parking space at the front. The weekly fees are 699 pounds each week. Residents pay for trips and for taxis.

  • Latitude: 53.453998565674
    Longitude: -2.2669999599457
  • Manager: Manager post vacant
  • Price p/w: ~
  • UK
  • Total Capacity: 15
  • Type: Care home only
  • Provider: Mr S Pascau
  • Ownership: Private
  • Care Home ID: 18297
Residents Needs:
mental health, excluding learning disability or dementia

Latest Inspection

This is the latest available inspection report for this service, carried out on 15th June 2009. CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

For extracts, read the latest CQC inspection for Woodlea Residential Care Home.

What the care home does well The home continued to support people to make sure that they keep as healthy as possible with regular visits to the G.P. dentist, optician and also to more specialised health services for mental health issues and other ongoing health problems. If people require support with their personal care the home will work with them to try to make sure they keep their independence. Residents have developed relationships with the staff team that allowed them to raise any concerns and worries they have. There was a complaint procedure and residents were aware of other organisations and individuals they can speak to if worried about anything. What has improved since the last inspection? The home has introduced gardening to the activities available at Woodlea for residents and have put up a greenhouse and a vegetable patch which has sparked the interest of many residents, particularly during the summer months which enables them to remain within the comfort of their own home whilst at the same time benefiting from outside activities. Residents continue to benefit from choosing their own colour schemes and furnishings for communal areas as well as their own bedrooms. We were told that all bedrooms have undergone refurbishment this year. A large digital TV and a dvd player have been purchased and installed in the main lounge enabling residents to benefit from the array of programmes available through digital television. A smaller digital TV and DVD player has been purchased and installed in the downstairs lounge where residnets can listen to music, quietly and away from the main lounge. The home have written a more user friendly Statement of Purpose and Service User Guide along with an improved initial assessment booklet. The management have obtained a passport for one resident and intend to make applications for other residents who may want to go on holidays abroad. We were told that all care staff have undertaken Protection of Vulnerable Adults(POVA) training in line with both Manchester and Trafford local authority procedures. All staff have been enrolled on Government Funded NVQ training courses. In addition we were told all staff have either completed, or are in progress of required training encompassed by new Mental Health Capacity Act. What the care home could do better: We looked at two care files.The care plan needed to have additional information in them so as to let staff know how and when they should provide care and support toresidents.They need to be more person centred.Daily records or diaries did not fully reflect the care, attention and support provided to these people. We evidenced that some social activities do take place. People we spoke to felt there was room for additional opportunities to be created. Residents should have, in accordance with their assessed needs,routine and increased opportunities to socialise and mix with others and visit the local community and places of interest. The acting manager needs to make sure when a variable dose of medication is prescribed to residents for example one or two tablets the actual number administered should be recorded on the medication administration records.This will ensure that there is an accurate record of medication administered to residents. To make sure that residents get the right medication at the right time.When medications is handwritten on the medication administration records ensure that the person writing the medication dosage and frequency sign the record and a second person also signs the record to confirm the accuracy of the copying out. To keep medication that needs refrigeration safely and securely the acting manager needs to obtain a medication refrigerator which locks. And also ensure that the temperature of the refrigerator is maintained at the correct temperature and the thermometer is checked for accuracy to make sure what the problems with the fridge temperatures are. The acting manager must ensure that there are risk assessments in place for all residents who self administer all or part of there medication . And that these are up to date and reviewed periodically to keep residents safe. The medication administration records should be checked when medication is received into the home to make sure that the instructions on the records are as the residents doctor prescribed the medication to be taken. Any medication which is prescribed as and when it is needed by a resident should be indicated as such on the records. People did tell us they feel listened to, however further development of the complaints procedure to include the routine of recording complaints and comments and the outcome of the comments or investigation would further demonstrate good outcomes for residents. The acting manager needs to undertake an audit of the toilets and bathrooms and bedrooms to find out which sinks do not have plugs in them and provide plugs to all the wash hand basins and baths so that residents can use these facilities independently and as they were intended. The bathroom and toilet door locks need some attention and either need fitting with new locks or repairing the locks already on the doors. This will promote residents privacy and dignity whilst using the bathroom or toilet. To safeguard residents and staff the acting manager needs to cease propping orwedging open fire doors and seek alternatives to promote the choice of the residents and the safety of residents and staff. The acting manager needs to check out with the local authority that the home is complying with the smoke free regulations in relation to staff employed at Woodlea and to put in place any safeguards to further protect staff in line with the discussions with the local authority. The acting manager should make sure that prospective employees indicate a complete employment history on their job application form and any gaps in employment are explored and written down. The acting manager needs to make sure that when the job application form is reviewed that there is a space for applicants to detail the dates of their education and training. This will further enable the acting manager to ensure that prospective employees indicate a complete history of training and in turn explain in some cases any gaps in employment. The contract of employment for staff needs to be accurate in relation to staff start dates and staff should sign these contracts to confirm they agree to the terms and conditions of their employment. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Woodlea Residential Care Home Woodlea 196 Upper Chorlton Road Manchester M16 7SF     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: Kath Oldham     Date: 2 5 0 7 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 Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 37 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 Adults (18-65 years) Page 3 of 37 Information about the care home Name of care home: Address: Woodlea Residential Care Home 196 Upper Chorlton Road Woodlea Manchester M16 7SF 01618629521 01618820744 woodlea@talktalk.net 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) : Mr S Pascau care home 15 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: 15 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 categories: Mental disorder, excluding learning disability or dementia - Code MD. The maximum number of service users who can be accommodated is: 15. Date of last inspection Brief description of the care home Woodlea is a private care home providing support and accommodation for up to 15 adults with mental health needs. The home is a large converted Edwardian House set in a residential area of Trafford. Shops and a post office are within walking distance of the home. Public transport routes into Manchester city centre and the surrounding area are close by. The philosophy of the service is to maximise the potential of each resident and to develop and maintain independence. Accommodation is provided in 15 single bedrooms, none of which have en-suite facilities. Care Homes for Adults (18-65 years) Page 4 of 37 Brief description of the care home Sufficient toilet and bathroom facilities are provided to meet the needs of the residents. Communal space comprises of a lounge with connecting dining room and a non-smoking lounge on the lower ground floor. There is a large private garden to the rear of the property and parking space at the front. The weekly fees are 699 pounds each week. Residents pay for trips and for taxis. Care Homes for Adults (18-65 years) Page 5 of 37 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This visit was unannounced, which means that the manager, staff and residents were not told that we would be visiting, and took place on 16th June 2009 commencing at 8:30am. The acting manager was available on the visit. The acting manager provided us with a lot of detail, information and support during the visit. The acting manager has a wealth of knowledge about residents and their needs and support. The inspection of Woodlea included a look at all available information received by the Care Quality Commission (CQC) about the service since the last inspection. Care Homes for Adults (18-65 years) Page 6 of 37 We looked at the Annual Service Review (ASR) that was carried out on 14th July 2008. This is a review of good and excellent services that takes place between key inspections. Good services only have an inspection every two years and excellent services every three years. At that time we found no evidence to suggest that our quality rating had changed or that we needed to bring the inspection forward. We also sent the acting manager a form before this visit for them to complete and tell us what they thought they did well, and what they need to improve on. We considered the responses and information the acting manager provided and have referred to this in the report. We call this form the Annual Quality Assurance Assessment (AQAA). Woodlea was inspected against key standards that cover the support provided, daily routines and lifestyle, choices, complaints, comfort, how staff are employed and trained, and how the service is managed. Comment cards were sent prior to the inspection for distribution to people staying and working at the home, the views expressed in returned comment cards and those given directly to the inspector are included in this report. We got our information at the visit by observing care practices and talking with the acting manager and staff. A tour of the home was also undertaken and a sample of care, employment and health and safety records seen. The main focus of the inspection was to understand how the home was meeting the needs of residents and how well the staff were themselves supported to make sure that they had the skills, training and supervision needed to meet the needs of residents. The care service provided to two residents were looked at in detail to help form an opinion of the quality of the care provided. The term preferred by people living at Woodlea was residents. This term is, therefore, used throughout the report when referring to people living at the home. A brief explanation of the inspection process was provided to the acting manager at the beginning of the visit and time was spent at the end of the visit again with the acting manager to provide verbal feedback. Four out of nine staff have received training in respect of Deprivation of Liberty safeguards (DOLS) and we were told further training is arranged. We have received no complaints about this service and have been made aware about one safeguarding referral. The local authority took the lead in relation to this as they should do.The service were cooperating with the investigation and the outcome was that the investigation was inconclusive. References to we or us in this report represents the Care Quality Commission. What the care home does well: What has improved since the last inspection? What they could do better: We looked at two care files.The care plan needed to have additional information in them so as to let staff know how and when they should provide care and support to Care Homes for Adults (18-65 years) Page 8 of 37 residents.They need to be more person centred.Daily records or diaries did not fully reflect the care, attention and support provided to these people. We evidenced that some social activities do take place. People we spoke to felt there was room for additional opportunities to be created. Residents should have, in accordance with their assessed needs,routine and increased opportunities to socialise and mix with others and visit the local community and places of interest. The acting manager needs to make sure when a variable dose of medication is prescribed to residents for example one or two tablets the actual number administered should be recorded on the medication administration records.This will ensure that there is an accurate record of medication administered to residents. To make sure that residents get the right medication at the right time.When medications is handwritten on the medication administration records ensure that the person writing the medication dosage and frequency sign the record and a second person also signs the record to confirm the accuracy of the copying out. To keep medication that needs refrigeration safely and securely the acting manager needs to obtain a medication refrigerator which locks. And also ensure that the temperature of the refrigerator is maintained at the correct temperature and the thermometer is checked for accuracy to make sure what the problems with the fridge temperatures are. The acting manager must ensure that there are risk assessments in place for all residents who self administer all or part of there medication . And that these are up to date and reviewed periodically to keep residents safe. The medication administration records should be checked when medication is received into the home to make sure that the instructions on the records are as the residents doctor prescribed the medication to be taken. Any medication which is prescribed as and when it is needed by a resident should be indicated as such on the records. People did tell us they feel listened to, however further development of the complaints procedure to include the routine of recording complaints and comments and the outcome of the comments or investigation would further demonstrate good outcomes for residents. The acting manager needs to undertake an audit of the toilets and bathrooms and bedrooms to find out which sinks do not have plugs in them and provide plugs to all the wash hand basins and baths so that residents can use these facilities independently and as they were intended. The bathroom and toilet door locks need some attention and either need fitting with new locks or repairing the locks already on the doors. This will promote residents privacy and dignity whilst using the bathroom or toilet. To safeguard residents and staff the acting manager needs to cease propping or Care Homes for Adults (18-65 years) Page 9 of 37 wedging open fire doors and seek alternatives to promote the choice of the residents and the safety of residents and staff. The acting manager needs to check out with the local authority that the home is complying with the smoke free regulations in relation to staff employed at Woodlea and to put in place any safeguards to further protect staff in line with the discussions with the local authority. The acting manager should make sure that prospective employees indicate a complete employment history on their job application form and any gaps in employment are explored and written down. The acting manager needs to make sure that when the job application form is reviewed that there is a space for applicants to detail the dates of their education and training. This will further enable the acting manager to ensure that prospective employees indicate a complete history of training and in turn explain in some cases any gaps in employment. The contract of employment for staff needs to be accurate in relation to staff start dates and staff should sign these contracts to confirm they agree to the terms and conditions of their employment. 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 Adults (18-65 years) Page 10 of 37 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 11 of 37 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People thinking of moving into the home received sufficient information to help them to make a decision and staff received enough information to understand the persons needs. Evidence: The AQAA informed us that,Our referrals are received from Social Services and Health Authorities who must provide the Home with detailed background information and a current assessment. If the Home believes it can provide the necessary care for a particular individual then the Manager will carry out an in depth assessment.If the referral is considered suitable,prospective residnets will then be given the opportunity to visit for day and overnight stays thus enabling the individual to make an informed decision as to their preferrred living accommodation. Copies of assessments were present on the two residents files that we looked at during the visit.The acting manager said all residents are assessed before they come to the home.The placing local authority undertake their own assessment which is given to the Care Homes for Adults (18-65 years) Page 12 of 37 Evidence: acting manager and from this,and from conversations with the local authority the acting manager would then visit the person to carry out her own assessment.This assessment is to check if the home had the facilities available to the person,that the staff have the necessary qualifications and skills to look after the person properly. It is important to record and promote peoples needs and wishes to make sure that residents receive the care and support they need. The person who was thinking of coming to the home would visit on as many occasions as they wanted to and perhaps stay for a meal or visit for the afternoon before a decision was made by them to go to live at Woodlea.If the person wants to go to live at the home they would have a trail stay to check again if it was the place for them. Residents are provided with a statement of purpose and service user guide which is sometimes given to the local authority worker who is enquiring about the placement.This is then passed on the prospective resident so they can read the paperwork when they want. It gives them information about the home and the rules and regulations.If a prospective resident was to visit the home first,then this information would be provided to them directly.We were told that the statement was revised and updated in 2008 and that all residents currently staying at Woodlea had a copy of this.When we looked in a sample of the residents care files there was a note which they had signed to say they had seen these documents. Care Homes for Adults (18-65 years) Page 13 of 37 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have care plans in place and have their needs recognised.Care plans were not in enough detail to demonstrate how residents health and personal care needs were being met. Evidence: All people who use the service have a written care plan in place.The information within care plans varied in their content.Care plans were not specific or identify individualised routines for practice such as personal care and support and how they are supported to look after themselves, cleaning or the practice required to maintain their social skills. The care plan didnt direct staff on how and when support should be undertaken, nor were there any specific records to demonstrate staff had completed the support at the required frequency. Some ladies with personal care needs did not have the detail of the support and care they receive to support them with these tasks. The acting manager did say that they did receive support in these areas, however the observations on the visit did not show this.A member of staff said that the home, Care Homes for Adults (18-65 years) Page 14 of 37 Evidence: provides care to every resident. A member of staff felt that the home could improve by, get carers to have key workers and get more involved. More detailed and individual daily report recordings are needed if the home is to demonstrate the day to day life of each person, the support they receive, day time occupation,and activities undertaken. Night time records detailed support provided to all residents on one record, but it was unclear as to the times the support was given.Rising times of people who use the service were not routinely recorded. As part of the initial assessment process,the home should undertake a comprehensive risk assessment that looks at specific areas, such as moving and handling needs, falls, personal care, communication and risks associated with the community and environment. Those areas that are identified as known or potential hazards may need to be assessed further by the relevant specialist and support or guidance in minimising those hazards and risks may then need to be developed. Examination of one residents file who had been staying at the home for about six months did not include risk assessments.The strategies in place to minimise risk were not indicated,which has the potential to put residents at increased risk and does not enable staff to have information which may be necessary to keep residents and themselves safe. To ensure the needs of residnets are known and met appropriately,records should clearly detail the needs of people and how those needs should be and are met. Care Homes for Adults (18-65 years) Page 15 of 37 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents had choice and support to meet their expectations and preferences regarding their daily lifestyle. Evidence: A wall planner indicated the activities that had taken place and which were planned. Residents have the opportunity to visit local cafes,restaurants,pubs and other amenities that they enjoy. Residents also have the opportunity to continue maintaining their own independence skills through undertaking domestic tasks within the home and shopping. The activities they take part in are based on their abilities,needs and goals.These are not recorded so it is difficult to see if the activities are meeting the identified goals. Care Homes for Adults (18-65 years) Page 16 of 37 Evidence: A member of staff in response to the question what could the home do better said, Improve the support to clients eg to be involved in community, going out, doing games or even going for holidays. Instead of staying home all day doing nothing. Meaningful activities and leisure opportunities for residents should be provided.The records we looked at identified insufficient group or individual activities being carried out.Individual care plans did not detail social routines and support provided to promote social involvement,hobbies or interests.The manager told us that there are things arranged and a lot of the residents do not want to take part in anything.The acting manager needs to re think the activities and opportunities on offer to residents and consider other things that people might want to take part in on an individual level or in small or larger groups.Residents said,it would be much better having somewhere to go and someone to go out with in the evening. We report in the staffing section there are two staff plus the manager on duty during the week.There are currently no domestic or cooking staff.This may limit staff from undertaking outings and activitys with residents as they are spending time cleaning and cooking. We were told that some residents had been involved in gardening at the home. The manager has bought a greenhouse and staff and some residents have started growing vegetables. The staff have worked hard to motivate some residents to take part in this activity and residents did say they were looking forward to eating the tomatoes they had grown. Some residents go out on their own. This is predominantly to shopping centres. One resident who is planning a holiday has been out with the manager to buy clothes and accessories in readiness for their holiday.Some residents appear to have months where they have not been supported in an activity outside of the home. The home has not provided residents with the opportunity to have an annual holiday away last year. We were told that a group of residents were hoping to go away to Llaundodno later in the year and one resident was going abroad with their family later in the month of our visit.The acting manager told us that some residents do not want to go away on holiday.The AQAA indicated, one of our goals is to obtain meaningful outside employment for those residents able to undertake such activities. It is essential that residents have the opportunity to choose from a varied, appetizing, nutritionally balanced menu to ensure their nutrition needs can be met and that they have a choice of meals. Residents spoken to during the visit were complimentary Care Homes for Adults (18-65 years) Page 17 of 37 Evidence: about the meals they said they had a choice and could eat what they wanted.Meals are based on residents needs and choices and appear nutritionally balanced. Some of the comments we received included, very good course we have enough to eat. you tell them what you want cooking and they cook it. (we have a)choice. We were told that residents like to have cereals and toast in the morning and have a snack meal at lunch time. The main meal is served in the evening. Residents told us about themed nights when a variety of different meals from differing cultures were prepared.Chinese food being the most favoured at the moment. Staff take full responsibility for the preparation and serving of meals.Whilst it was evident that basic food hygiene training had been completed by most staff two had not received training and some were due for updated training.This needs to be arranged to ensure safe practice when preparing or serving meals. Care Homes for Adults (18-65 years) Page 18 of 37 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems within the home ensure that residents have their health care needs met and are as far as possible supported to maintain good health. Evidence: Community Psychiatric Nurses or social workers from the mental health service support residents to address their emotional and mental health needs.Appointments are also arranged and attended by residents with consultants in mental health when this is required.The residents doctor and dentist undertake health care.A number of residents attend other specialist health consultations.Residents appeared well dressed and clean.Throughout the visit staff supported residents in a discreet and dignified manner. Residents care files identified that their general health care needs were recorded and monitored.Records of professional health care and support services were in place. The information provided to us in the AQAA indicated, Service users are protected by the homes policies and procedures for dealing with medicines which are administered Care Homes for Adults (18-65 years) Page 19 of 37 Evidence: by designated,trained personnel with the written permission of the service user. We looked at the medication records to check that residents were being given their medication correctly.We saw that some medication wasnt signed as having been given to residents when it should be. When we gave feedback to the acting manager and she looked at this medication we were told that this medication was actually prescribed to residents when they needed it and didnt have to be given to them all the time. The printed medication records didnt say this. Looking at the medication records it looked like staff just hadnt given out the medication as the doctor had said it should be taken. The instructions for how often the medication should be given is printed on the medication records in line with the prescription from the doctor. When medication is received by the home it should be checked with what it says on the prescription and that the medication records are also checked. This cant have been done properly as this omission would have been picked up. Some medication is prescribed as a variable dose for example one or two tablets or spoonfuls and the person can say how many tablets or spoonfuls they need in line with the doctors prescription. Best practice indicates that the actual number that the resident takes is indicated on the medication records so an accurate record is maintained of residents medication.This would be particularly important if a resident had to go to hospital for example so they would know exactly what medication someone has taken. The acting manager needs to arrange for this to be indicated on the medication administration records. When medication is prescribed by the doctor,after the medication records have been printed,staff have to write down the medication on the medication records. It would be best practice to make sure that a second member of staff checks that this has been written down properly and signs the record to confirm this. There should be two signatures one by the person who is writing the record and a second by the staff who is verifying that the entry is correct.This minimizes the risk of error and residents should get the correct medication to keep them well. One of the residents was prescribed medication to be taken twice a day. On one occasion the medication was recorded as having been given three times in one day. The acting manager when looking at these records identified that the error was with the recording and the resident had only been given the correct dosage at the right frequency. One resident looked after some of their medicines. There were no risk assessments Care Homes for Adults (18-65 years) Page 20 of 37 Evidence: made to make sure that the resident could take and look after their medicines safely.The medication administration records we looked at didnt indicate that this person self administered this medication. There was no recording at all on the medication administration record,so, it looked as if the person wasnt getting this medication routinely.The acting manager told us that this person self administered one of their prescribed medication.It is essential that risk assessments are in place for residents who look after some or all of their medicines to make sure they can do so without putting their health at possible risk. A photograph of each resident was kept with the medication so that staff could easily identify residents before administering any medicines. This is good practice. There were no residents prescribed controlled drugs on the day of the inspection. We did advise the acting manager to obtain a controlled drugs register so if a residents doctor did prescribe this type of medication,then they could completed the necessary records in line with regulations. We were told that the controlled drugs cupboard could not be unlocked. Secure storage of controlled drugs help prevent mishandling and misuse.When a doctor prescribes controlled drugs medication this must be stored differently to other prescribed medication. This would help make sure they were safely kept. The acting manager needs to arrange for a new controlled drugs cupboard to be obtained and she was advised to check with the pharmacist for guidance on the type to comply with new legislation in this matter. Some medication needs to be kept in the fridge and a minimum maximum thermometer used to check the temperature is right to keep the medicines correctly. The temperature of the medication fridge was,on the day we visited recording as too low or the thermometer was not working properly. When we looked at the temperature recordings we saw that they had been recorded each day and that these were in excess of the required temperature. When we looked at the medication fridge it didnt have a locking mechanism on it to keep it locked. A medication fridge should have a lock on it to maintain the medication safely and securely. Care Homes for Adults (18-65 years) Page 21 of 37 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Written complaints procedures in place ensure residents or their representatives have a means to raise views about the service they receive.Procedures relating to adult protection ensure residents are protected from abuse. Evidence: Woodlea has a written complaints procedure in place. From comment cards received it is evident that residents feel able to raise matters of concern and feel confident complaints will be dealt with appropriately.We were told that,Service users understand that their views are listened to and from abuse,neglect and self harm by ensuring their welfare acted upon and that they are protected through our systems for addressing complaints and dealing with allegations of abuse. The detail we received in the AQAA about complaints had not been completed suggesting that no complaints had been received at the home within the last twelve months.There was no record of any complaints or comments from residents,there representatives or staff within the complaints book since April 2007.The acting manager should further develop the complaints procedure to include the routine of recording complaints and comments relating to service provision. Adult protection procedures are in place.Comment cards indicated that residents had confidence in the staff to protect them. Training records identified staff had received Care Homes for Adults (18-65 years) Page 22 of 37 Evidence: adult protection training by the manager and some had received this training which is provided by the local authority. The acting manger said that other staff were scheduled to attend the formal training with the local authority when it was next available. All staff we were told had looked at the local authorities adult protection procedure so would know what to do if an allegation of abuse is made. There had been one safeguarding adult investigation undertaken by the local authority in line with procedures. Four out of nine staff have received training in respect of Deprivation of Liberty safeguards (DOLS) and we were told further training is arranged. Care Homes for Adults (18-65 years) Page 23 of 37 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate 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 comfortable environment.Improvements,repair and upgrade of the home will go some way to promote the comfort,privacy,dignity and respect of residents. Evidence: We had a look around the house and looked in some of the residents bedrooms, the lounges and bathroom and toilets. Three of the residents bedroom doors were propped open, one by a fire extinguisher, another by a laundry basket and a third by a set of drawers. This practice compromises the safety of residents. There was nothing in the fire procedures to alert staff to this fact or what to do with these doors if the fire alarm went off. We understand that some people may like to keep there bedroom doors open either whilst in bed or when the room is empty, however safer practices need to be looked into to make sure residents and staff are safe. We also noticed when we looked around that a lot of the wash hand basins either in bedrooms or in the bathrooms or toilets didnt have plugs.This wouldnt enable residents to use the sinks properly. This needs attention. Some of the bathroom or toilet doors didnt have locks that worked so residents Care Homes for Adults (18-65 years) Page 24 of 37 Evidence: privacy could not be promoted when using the bathroom or toilet. One toilet that did have a lock was very hard to lock. We were told of the homes plans to change one of the bathrooms to a walk in shower which would be more beneficial to residents who found it hard to have a shower in the bath or go upstairs to the other shower room. The bedrooms we looked at were clean and had been personalized by the resident with the support of staff. Some residents didnt want us to look at their bedrooms and this was respected.On one of the bedroom doors the locking mechanism or barrel was not in place. This door is a fire door and having a hole in it defeats the object of having a fire door in place,as it would not at the moment act as a barrier in the event of fire. The flooring in a number of bedrooms was cushion floor as opposed to carpet. the acting manager told us that residents have a choice of what type of flooring they would like. All the bedrooms we were told have a lockable cupboard in which residents can keep private items securely if they choose. One residents told us they had everything they needed in there room and their bed was comfy. We were told of the acting managers plans to replace the bedroom furniture in bedroom 2, as the current furniture is showing signs of wear and tear. The AQAA infiormed us of the improvements made to the home in the last twelve months these were said to be, We have purchased a 42 inch digital TV and DVD recorder which has been located in the communal lounge on the ground floor.The purchase of a small digital TV and DVD player in the downstairs lounge where there is also a stereo unit where service users can spend quiet time if they wish away from the hubbub of the main lounge. The house has two lounges one on the ground floor and the other downstairs. The lounge on the ground floor was the one most used on our visit. This lounge being the one residents used to smoke in. We gave advice to the acting manager to check out with the local authority that the home was complying with the smoke free regulations. The lounge is fitted with ventilation to extract smoke to the outside of the building, however staff do spend time in the lounge and the acting manager needs to check whether the safeguards in place do support staffs health. We were told that all the laundry equipment was working properly and some residents do some of their own laundry. The kitchen,the acting manager told us,is due to be refurbished to update and improve the kitchen environment. Care Homes for Adults (18-65 years) Page 25 of 37 Evidence: There are gardens outside which staff have,with the support of some interested residents started to plant out. The gardens are private at the rear of the house and there is seating for residents to use in the better weather. Care Homes for Adults (18-65 years) Page 26 of 37 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The procedures for the recruitment of staff need to be more thorough to ensure suitable staff are employed to safeguard people who use the service. Evidence: A detailed rota of what actual hours are worked should be in place along with the full names of the staff working. This ensures that a full record of who is on duty is available to all. During the week there were two staff recorded as being on duty plus the acting manager. At weekends there were two staff on duty.At night time there is one waking and one sleeping member of staff and the acting manager or senior are on call. This staff ratio is to provide care and support to the 12 residents who are currently accommodated at Woodlea. The acting manager said that,when the numbers of residents increase to full capacity they will have a cook and also a domestic. A domestic has,we were told in the past been employed for four hours a day cleaning the communal areas.In addition the cook is on extended sick leave and at this stage the acting manager is not aware of any return date. Care Homes for Adults (18-65 years) Page 27 of 37 Evidence: Some staff said they were usually enough staff on duty and others responded there weresometimes enough staff on duty. Two staff to the same question responded always. Residents who completed comment cards said that staff are always available when they need them and staff always or usually listen to them and act on what they say. And they always receive the care and support they need. Staff supported all residents to complete the comment cards we received. There are currently no cleaning or cooking staff. Care staff undertake this role in addition to their caring role.The acting manager told us that ordinarily she would do the cooking when on duty but due to the inspection the senior prepared lunch. This reduces the time the acting manager is in a management role and also reduces the time care staff are providing support to residents as opposed to cleaning duties. We looked at a sample of staff files for staff that had started work at Woodlea since our last visit. We looked at three staff files. It is important to check prospective employees previous work history and to explore,if they have gaps in employment what they have been doing. This is a safeguard for residents and is an essential part of a thorough recruitment and selection procedure. When we looked at one of the staff files it didnt detail a complete employment history. There was no record that this had been discussed with the applicant at interview for example. This would be best practice and would demonstrate that the home is taking all the right steps to get the right people for the job. The job application form that had been completed by these new staff did not have a space for the applicant to write down the dates when they attended education. This would further assist the acting manager when recruiting staff to check for any gaps in employment. When the home is next reviewing the job application form this needs to be attended to. On one of the staff files we looked at there was no record of the interview questions or responses made by the applicant. There was for a member of staff some information which should have been disclosed by them and we would expect to see reference to this disclosure. This we did not see. The acting manager did say that she had been told of this and was accepting of the information received. Again,it would demonstrate the recruitment and selection procedure if this detail was written down. Care Homes for Adults (18-65 years) Page 28 of 37 Evidence: A contract was in place in the staff files we looked at.This provides the staff with the details of their employment and the rules and regulations. In one of the staff files we looked at, the date the member of staff started work was queried with the acting manager. We were told the date quoted in the contract was incorrect and the staff actually started later than the date indicated. The contract of employment was not signed. Another contract which was signed by the member of staff didnt indicate the date that they had commenced working at Woodlea. References are an important part of the recruitment and selection procedure. In one of the staff files we looked at there were two references on file both of which were not addressed directly to anyone at the home.The acting manager did say that they had been requested and this is how they had been received by the home. For references such as these best practice would be to verify the content with the named referee by telephone for example and a written note made by the acting manager to detail what was said and the date it was confirmed. There was no such information on this staffs file. It is so important to ensure that the recruitment and selection procedures are thorough and robust to safeguard residents. The AQAA told us, All personnel have been enrolled on Government Funded NVQ training courses. In addition all personnel have either completed, or are in progress of required training encompassed by new Mental Health Capacity Act. We looked at the records which told us what training staff had received. We were told that three staff have enrolled on NVQ training which supports them to do there job well. There was no record that some staff had done training in food hygiene, first aid or moving and handling. We were told that one of these staff had been off work for the last two months and a further member of staff had been off for four weeks. These staff were appointed in August 2008 and December 2008. We understand that staff are not able to attend training whilst they are absent,however,there were a number of months prior to their absence when this training could have been arranged. It is important that staff receive the right training to ensure they do there job well ands keep themselves and residents safe. Staff do attend induction training both in house and when a course becomes available with the local authority. This ensures that staff have the basic knowledge to do the job they are employed to do. Staff were observed supporting residents in a positive manner and demonstrated a good knowledge of their needs and wishes.One resident said that they,trusted the staff who supported him. Care Homes for Adults (18-65 years) Page 29 of 37 Care Homes for Adults (18-65 years) Page 30 of 37 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of Woodlea is based on openness and respect.This ensures that the home is run in the best interests of the people who live there. Evidence: At the time of our visit there was no registered manager in post. An acting manager has been in post since the registered manager has been absent. The acting manager was carrying out the day to day management of the home. We were told that the owner is in the process of obtaining the necessary paperwork to formally register the manager with the Care Quality Commission (CQC). There was some evidence during the inspection that residents had been asked for their views on changes to decoration around the home and the menu served.However,we didnt see any comment cards to obtain the views of relatives,friends,advocates or stakeholders in the community about the service.It is important to obtain peoples views about the service in order to devise an action plan for improving the Care Homes for Adults (18-65 years) Page 31 of 37 Evidence: service.Residents meetings are periodically arranged. We were also told that the home is actively putting together our own quality assurance system. Health and safety records looked at identified that safety checks and services were in place.And weekly and monthly fire safety checks were carried out. Fire safety records confirmed that practical fire drill training had been undertaken by staff at the required frequency. The organisation needs to ensure that Regulation 26 visits are completed each month, which means the owner or their representative consults with people who use the service and staff about service provision and standards, look at records and discuss the running of the home with the acting manager. Copies of the report of these visits were not available on our visit. Insurance certificates were displayed in the office and the registration certificate is no longer on display. The acting manager has been in discussions with the Care Quality Commission (CQC) registration section and they are to send a replacement certificate. Examination of residents personal allowance records identified they were completed appropriately.Residents sign on receipt of their monies and,to assist residents to budget,individual times during the week are arranged for collection of their monies. Care Homes for Adults (18-65 years) Page 32 of 37 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 Adults (18-65 years) Page 33 of 37 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 1 6 Care plans should clearly detail all the needs and support requirements of people who use the service and how those needs are to be met. The manager must ensure that risk assessments are undertaken for residents where risk is defined. Records maintained should enable the home to demonstrate the day to day routines of individual people who use the service,including rising and retiring routines,care support provision,their achievements and successes as well as any activities undertaken. Residents should have in accordance with their assessed needs,routine and increased opportunities to socialise and mix with others and visit the local community and places of interest. Risk assessments must be in place for all residents looking after all or some of their own medication at any time, to make sure that their health is not at potential risk from harm. The acting manager needs to make sure when a variable dose of medication is prescribed to residents for example one or two tablets the actual number administered should 2 3 7 7 4 13 5 20 Care Homes for Adults (18-65 years) Page 34 of 37 be recorded on the medication administration records. To make sure that residents get the right medication at the right time.When medications is handwritten on the medication administration records ensure that the person writing the medication dosage and frequency sign the record and a second person also signs the record to confirm the accuracy of the copying out. To keep medication that needs refrigeration safely and securely obtain a medication refrigerator which locks. Ensure that the temperature of the refrigerator is maintained at the correct temperature and the thermometer is checked for accuracy to make sure what the problems with the fridge temperatures are. The acting manager must ensure that there are risk assessments in place for all residents who self administer all or part of there medication . And that these are up to date and reviewed periodically to keep residents safe. The medication administration records should be checked when medication is received into the home to make sure that the instructions on the records are as the residents doctor prescribed the medication to be taken. Any medication which is prescribed as and when it is needed by a resident should be indicated as such on the records and in some cases an assessment made and recorded of when a decision is made when to give the resident the medication if they are not able to decide for themselves. 6 22 The manager should further develop the complaints procedure to include the routine of recording complaints and comments relating to service provision and the outcome of the commnets or investigation The acting manager should ensure that there are sufficient staff on duty so that staff are not taken away from providing care and support to residnets and the hours include hours to manage and develop the home as opposed to the manager undertaking other roles in the home at the detriment of managing and developing the service. The acting manager should make sure that prospective employees indicate a complete employment history on their job application form and any gaps in employment are explored and written down. The acting manager needs to make sure that when the job application form is reviewed that there is a space for applicants to detail the dates of their education and training. 7 31 8 34 Care Homes for Adults (18-65 years) Page 35 of 37 The contract of employment for staff needs to be accurate in relation to staff start dates and staff should sign these contracts to confirm they agree to the terms and conditions of their employment. References should always indicate the person they are intended for by their name and when these do not arrive in this format verification should be made of the content of the reference which is detailed in the staff file. 9 10 34 35 Staff rotas should record the full names of staff on duty in addition to the times that staff are on duty. Arrangements need to be made for all staff to receive training in food hygiene, first aid and moving and handling in a timely manner ensuring they have the skills to do their job well. Staff should receive formal dedicated and structured time set aside to receive support and supervision from their manager. For example one to one meetings, group supervision and perhaps observation of practice. Good practice would be that a combination of these methods are used. Records of the supervision should be kept and shared and agreed with the staff member.These sessions should be at least six times a year. A registered manager needs to be in place at the home. The registered person must remedy the situation with regard to the management of the home and have a registered manager in post at the home in line with regulations. The organisation needs to ensure that Regulation 26 visits are completed each month, which means they consult with people who use the service and staff about service provision and standards, look at records and discuss the running of the home with manager. A quality assurance system must be established and maintained that reviews and improves the quality of care in the home. This system must provide for consultation with residents and their representatives,advocates or family and other health care professionals.The outcome of which is published. 11 36 12 37 13 37 14 39 Care Homes for Adults (18-65 years) Page 36 of 37 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 Adults (18-65 years) Page 37 of 37 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. 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