Care Home: Woodleaze EMI Unit

What the care home does well Information made available about the home and the admission processes, ensure that placement is offered to those people whose needs can be met. A person centred approach to care planning ensures that each individual will receive the specific care and support that they need. Medications are well managed. People will be treated with respect. The people who live in Woodleaze will have the opportunity to be involved in a range of stimulating and meaningful activities. Formal and informal adhoc activities happen on a regular basis. Meal times experiences will be tailoured to meet individual needs. The management of any complaints or concerns that people who live in the home, or their representatives may have, means they will be listened to and the appropriate action will be taken. People will be safeguarded from harm. Woodleaze is a comfortable and safe home. The faciltities have benefited from being upgraded and are appropriate for people with dementia. People who live in Woodleaze will be looked after by a staff team who are well trained and competent - they will be able to meet individual`s specific care needs. People who live in Woodleaze will find that the home is well run, and the service provided is in line with their individual needs. The home is kept safe. What has improved since the last inspection? Following the last inspection, South Gloucestershire Council provided us with a detailed action plan stating how they had, or would be addressing the shortfalls referred to in the April 2009 report. This inspection had verified that all the required and recommended improvements have been put in place. The following improvements have been made : 1) Any concerns or complaints will be handled correctly and the outcomes clearly recorded. This will enable the service to monitor the quality of service and identify any trends. 2) The use of bed rails is no longer deemed appropriate. 3) The policy for all bedroom doors to be locked during the day has been removed. Bedroom doors are fitted with large brass numbers and name plates 4) A person centred approach to care planning has been adopted. 5) The activities arranged are more suitable for people with a dementia, this will include meeting people`s spiritual needs as required. 6) Staff training and supervision has increased to raise the quality of care provided. 7) A full quality assurance assessment of the service has been undertaken and a development plan for the service devised. What the care home could do better: The staff team must make sure that they make accurate records of daily care given, particularly when it has been necessary for them to make `best interest decisions` on behalf of the person they are looking after. The grab rails in the corridors on the ground floor need to be repainted. They are currently scratched and unsightly. Key inspection report Care homes for older people Name: Address: Woodleaze EMI Unit Station Road Yate South Glos BS37 4AF     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Vanessa Carter     Date: 2 3 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Woodleaze EMI Unit Station Road Yate South Glos BS37 4AF 01454866043 01454866041 jeanette.isaacs@southgloucs.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): South Gloucestershire Council Name of registered manager (if applicable) Mrs Susan Elizabeth Simmons Type of registration: Number of places registered: care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: Date of last inspection Brief description of the care home Condition of registration The Home cares for people with Dementia aged over 65 years. South Gloucestershire Council operates Woodleaze and the Manager is Mrs. Sue Simmons-Tasker. The Home is registered to accommodate thirty-four older people with dementia. Two of these places are kept for short-term care. Each of the 34 single bedrooms has a washbasin and fitted wardrobes. None of the rooms have ensuite facilities. The property is arranged over two floors with shared space on the ground level, including a conservatory. Bedrooms are on both floors. There is a central courtyard pleasantly laid out with flower and plant containers and exterior furnishings. Woodleaze is a purpose-built home, built in the 1980 s. It is one of 8 care homes for older people that South Gloucestershire Council own and run. The Home is close to shops, amenities and bus routes. 0 Over 65 34 Care Homes for Older People Page 4 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection of this service was undertaken on 30 April 2009 and our overall judgement about the quality of the service provided at that time, for the people who live in Woodleaze EMI Unit, was that people received an adequate service. A number of requirements and recommendations were made in order to improve the quality of the service. We were provided with an action plan by the service provider telling us how they would be making the required improvements. In line with our scheduled inspection programme, we planned to visit the service again within a year, in order to check that the necessary improvements had been made and sustained. Prior to this inspection we asked the registered manager to complete an annual quality assurance assessment (AQAA). This is a self assessment document that focuses on how well outcomes are being met. The assessment had been completed in detail and told us about the improvements that have made over the last 12 months and their plans for improvement in the next 12 months. It also provided us with some data Care Homes for Older People Page 5 of 29 information about the service. We sent surveys out to the home manager for dispersal to people who live in the home, relatives/carers/advocates, and health and social care professionals who have an interest in the service. We received a total of 21 completed forms back and these gave us useful information about what it was like to live in the home, to visit the home and whether the service is meeting peoples needs. During the inspection we looked at records kept by the home, including care records and those that are kept in respect of the running of the home. We spoke to the manager, two duty managers and those care staff on duty. We also spoke to some of the people who live there and a number of relatives who were visiting. We observed the interactions between individual staff and the people who they were looking after. At the time of writing this report the fees for placement in the home are 670 pounds per week. There are extra charges for chiropody, and hairdressing services. People funded through the Local Authority have a financial assessment carried out in accordance with Fair Access to Care Services procedures (FACS). Local Authority fees payable are determined by individual need and circumstances. General information about fees and fair terms of contracts can be accessed from the Office of Fair Trading web site at www.oft.gov.uk Care Homes for Older People Page 6 of 29 What the care home does well: What has improved since the last inspection? What they could do better: The staff team must make sure that they make accurate records of daily care given, particularly when it has been necessary for them to make best interest decisions on behalf of the person they are looking after. Care Homes for Older People Page 7 of 29 The grab rails in the corridors on the ground floor need to be repainted. They are currently scratched and unsightly. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information made available about the home and the admission processes, ensure that placement is offered to those people whose needs can be met. Evidence: The statement of purpose and service user guide (the welcome pack) are comprehensive and have all the information necessary to enable people and their relatives to make an informed choice about living in the home. Both documents are kept up to date and fully reflect the service and facilities on offer. Four of the people who completed our survey forms said that they had received enough information about the home to help them decide to move in, whilst six didnt know. The eight relatives who completed our survey forms said they had been provided with enough information. All admissions in to Woodleaze are referred via the Mental Health Older People Team (South Gloucestershire Council). Each person will have had an assessment of their Care Homes for Older People Page 10 of 29 Evidence: care and support needs prior to admission - this will be completed by either a social worker or care manager. A copy of this assessment and care plan is given to the home manager in order to determine if the persons needs can be met at Woodleaze. The manager told us that often people will have attended the day centre that is located next door, or will have had a period of respite stay in the home, before considering a permanent placement. We looked at the assessment that had been completed for a person who had most recently moved into Woodleaze - it provided a very clear picture of the persons specific care and support needs plus provided additional information about the persons life and family history. We spoke to one person and their relative. They told us that they had moved to the home following a period of hospitalisation the social worker arranged everything and I came to have a look around and meet the staff. The person, and any relatives will be encouraged to visit the home prior to admission and may have a days visit arranged. Initially each person will have a four week assessment period and this will be reviewed by the social worker, home staff, the person themselves and their representatives. Sometimes a four week period is not long enough for a person to settle in, or for the staff to make a judgement that the home is the right place for the person. In these circumstances, the trial period may be extended. Care Homes for Older People Page 11 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A person centred approach to care planning ensures that each individual will receive the specific care and support that they need. Medications are well managed. People will be treated with respect. Evidence: We looked at the care planning documentation for four people living at the home, one person having only recently moved in to the home, and two people who were having a short respite stay. A person centred approach to identifying each persons care needs and to the arrangements in place for meeting those needs, has been introduced since the last inspection. A service provider plan is prepared for each person based on the needs and wishes of the person. Each of the plans we saw had been completed in detail and provided a very clear picture of the persons needs and how they were to be met. There are also documents in place which identify important people in my life including relatives, friends community links and significant occasions. A one page profile for each person within the home is currently being developed which describes the essence of them. This will be kept at the front of each persons records and also in each persons room. The plans are supported by a number of risk assessments Care Homes for Older People Page 12 of 29 Evidence: (some may be specific to the actual person and focus on areas which are pertinent to their care, whilst others are generic), including a manual handling risk assessment. At each monthly review of the service provider plan, the moving and handling profile is checked to ensure it is still fully reflective of the persons needs. Since all the people who live in Woodleaze will have been assessed by a social worker or care manager from the community mental health team, a care assessment and care plan will have been provided so that staff have sufficient information about the person to form a basis to their own care plans. A record of daily care is made. The staff team must make sure that they make accurate records of daily care given, particularly when it has been necessary for them to make best interest decisions on behalf of the person they are looking after. This is so that they can clearly evidence why they took the actions they did, and is in line with the mental capacity act. A record is kept of all visits by healthcare professionals - this includes GPs, opticians, chiropodists and community nurses. We were able to speak with a community psychiatric nurse and a district nurse during our inspection visit. We were told the following - the staff are very good at contacting us for advice and always do this in a timely manner, the staff are very aware of peoples needs and they provide good care. We received three surveys back from other healthcare professional. One said they promote person centred care, another said the service does everything well. During the inspection we had a discussion with the manager and other staff members about the management of medications. There is a clear policy in place for managing peoples medicines within the home. Each member of staff authorised to give medicines has signed the policy to say that they have read and understood it. The medication for each person is provided by the pharmacy in a dossett blister pack containing the medication for the morning, lunchtime, afternoon and evening separately. Records are kept of the receipt of each pack and also of the administration of the medication. We were assured that there are safe procedures in place for the ordering, receipt,storage, administration and disposal of medications. Our observations were that people were treated with dignity and respect and that the staff team conducted themselves professionally. We observed friendly interactions and staff members showing patience at times of repetitive behaviours. It is evident that there is a real commitment by the staff team to interact with people in positive and meaningful ways. Comments received on our survey forms included the following the staff keep me warm and clean, I live in a very good home and I like living Care Homes for Older People Page 13 of 29 Evidence: here. Care Homes for Older People Page 14 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in Woodleaze will have the opportunity to be involved in a range of stimulating and meaningful activities. Formal and informal adhoc activities happen on a regular basis. Meal times experiences will be tailoured to meet individual needs. Evidence: Throughout the inspection, there was a great deal of activity in the home, and a number of people were moving about independently, within the home and out into the central courtyard. The communal areas were well used, particularly the two lounge/dining rooms at the front of the home and the corridors. Some people were using the corridors to have their daily walk. We also saw people using the courtyard. In general we were told that people do not stay in their bedrooms during the day but come downstairs to socialise and use the communal facilities. Rummage boxes have been placed around the home and these help generate activities and interest for the people who delve in to them. A range of different activities are arranged on a daily basis - these may be group or individual activities. One of the lounges tends to be used for individual craft work. During the inspection, we observed staff members interacting on a one to one basis with individuals, either helping hang washing out, tidying up in the lounge or just Care Homes for Older People Page 15 of 29 Evidence: sitting and chatting. One person was being helped to read a pamphlet that they were interested in. Social gatherings are arranged and so far this year the following have been arranged - a valentines day party, easter, st davids day, st patricks day and st georges day celebrations. Birthdays and other festivals will always be celebrated. The home has access to the day centre minimbus at certain times and will use this for trips out. Photographs were displayed in the main receptions area of a recent trip out. A hairdresser visits the home on a weekly basis. We looked at the planned activities for the week preceeding and saw that there was a songs of praise programme shown on the sunday, and a bingo session, a singalong and a reminiscence session, throughout the week. On the day of inspection it was planned that a matinee film would be shown - we observed that a group of people were offered a choice from a selection of films. An activities file is maintained along with individual diaries for each person. One of the relatives who completed our survey forms thought that the more able-bodied people would benefit from being involved in completing tasks around the home and being more occupied. The manager and other staff are currently undertaking project work with a specialist dementia care provider - Dementia Care Matters (as featured in the recent Gerry Robinson television programmes). This project will enable them to look at how to better provide for people with dementia. A number of initiatives have already been introduced which have had a positive effect on the lives of people. The home has an open visiting policy and visits by family and friends are encouraged. One relative told us that I am kept in touch with what is going on and invited to attend any functions. Although I still live in our own home I am always invited. One relative who completed a survey form said they involve and support the family at difficult times. It was evident from this inspection and from what we saw and were told. that people are encouraged to make choices about when they get up in the mornings, when they go to bed, what they wear, what they do and how they spend their time. We were told about one persons preferred style of dress, and another person who did not like to get up until after 11 oclock. We specifically looked at mealtimes as the previous inspector had felt that people were not provided with a good mealtime experience. There has been a great deal of improvements made in the last 12 months. We were in the home during the midday meal. We saw that staff members sat with people and had their own meals at the same time - they provided sensitive and unobtrusive support for the people they were sat with. Pictures of the meals beings served were displayed by the main serving Care Homes for Older People Page 16 of 29 Evidence: hatch and people were also shown a prepared plated meal and encouraged to choose what they wanted to eat. There was a choice of two main meals - fish and chips or chicken curry plus lemon meringue pie. The food is very good, I feel the cooking staff provide a sensible menu with adequate proportions and there is a lot of choice. Those people who completed our survey forms said that they usually or always enjoyed the meals they were given. During mealtimes the tables were laid with tableclothes and decorations. Some people got up and walked away from the meal table and returned later to sit and eat. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of any complaints or concerns that people who live in the home, or their representatives may have, means they will be listened to and the appropriate action will be taken. People will be safeguarded from harm. Evidence: The homes complaints procedure is displayed in the main reception area and is included in information that is made available about the home. South Gloucestershire Council (service provider) has a department that deals with any concerns and formal complaints and leaflets are available detailing the contact arrangements. The home maintains an internal complaints book and any informal issues are recorded. Clear outcomes are recorded and it is evident that any issues that are raised are dealt with appropriately. All those people who completed our survey forms stated that they were aware of the homes complaints procedure and knew who to speak to if they were unhappy. We spoke with the relative of one person who was very happy with the care that his wife was receiving. He said that he had no complaints about the home and that if there were any issues that he always felt able to raise them and that they were dealt with immediately. He said that he felt that all his wifes needs were cared for at the home. Another relative told us there is nothing to complain about here. The staff do their best in what must be a very difficult job. We spoke with some staff and asked them how they would know if a person was unhappy if they were unable to communicate - we were told about behavioural changes and increased agitation. Care Homes for Older People Page 18 of 29 Evidence: We have not received any concerns or complaints regarding Woodleaze since the last inspection. The manager told us that one formal complaint has been dealt with by South Cloucestershire Complaints Department The home/ council has a safeguarding adults policy (SOVA) and clear guidance is available for the staff to follow if abuse is suspected, alleged or witnessed - Joint Policy and Procedure for Safeguarding Adults from Abuse (last updated January 2009) . Staff have completed safeguarding training as part of their National Vocational Qualification (NVQ) training however will be accessing a new training programme being developed by the safeguarding adults team manager, for South Gloucestershire Council. The manager aims to ensure that the whole staff team will have completed this within the next year. Discussions with those staff on duty evidenced that they are aware of their responsibilities to safeguard people from harm and are aware of the actions they should take. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Woodleaze is a comfortable and safe home. The faciltities have benefited from being upgraded and are appropriate for people with dementia. Evidence: Woodleaze is a purpose built two storey care home. It has car parking to the front of the building and level access in to the home via a front door. The door is secured with a door entry system and visitors need to ring the bell to gain access. Inside the inner foyer, visitors need to sign in the visitors book and information is displayed including the last inspection report, certificate of registration and insurance details. A second secured door leads into a large hallway. The duty managers office is located by the front door making these senior staff very accessible to visitors. There is a passenger lift to the first floor (security coded to ensure that it is not used by those who may not be safe to use independently). The staircase that enters into this hallway is covered by a full length curtain - steel shutters are still in place to prevent people using the staircase in order to protect them from injury, but they are now hidden. The home has four communal lounge/dining rooms, each on the ground floor. We saw all four rooms - each of the lounges is furnished with a selection of comfortable chairs and dining room furniture. TVs are in two of the rooms, the third is a conservatory, and the forth room is used for activities. One of the lounges has recently been redecorated and new curtains put up at the windows. The rooms each contained Care Homes for Older People Page 20 of 29 Evidence: rummage boxes and included items that may prompt a memory. We saw people making use of all the things that were placed around the home. There is a central courtyard that can be accessed from several points in the home, and corridors go round the building in a circle and enable people to wander freely but return to the communal areas. Grab rails are fitted either side of the corridors but those on the ground floor were damaged and unsightly - they need to be repainted. All other areas of the home were in fair decorative order and had a lived in feel. Sections of the corridors are painted in different clours to enable people to locate their bedrooms and any doors that are deemed as staff areas are painted the same colours so as to be not visible. New flooring has been fitted throughout the downstairs communal areas. All toilets and bathrooms have accessible equipment including grab rails and specialist baths. The doors are painted red in order to make them clearly identifiable so people can use them independently if they are able. The doors also display signage in pictoral format. The toilet room located off the main hallway on the ground floor is to have the keypad removed and will be used by people who live in the home, visitors and staff. A new call bell system is in the process of being installed. There is some moving and handling equipment (hoists) already provided and additional equipment would be sourced dependent upon each individuals needs. Whilst bedroom sizes meet spatial standards, there are difficulties in using hoisting equipment therefore people may need to be referred for alternative accommodation if the use of moving and handling equipment causes health and safety issues. All of the bedrooms are for single occupation and have fitted wardrobes and a vanity unit. There is a rolling programme of furniture replacement and was saw that a number of bedrooms have already been fitted out with more modern styled furniture. There are 18 bedrooms downstairs and 16 upstairs. Some bedrooms have been redecorated. People are encouraged to personalise their bedrooms - we saw some that had been made to reflect the personality of the occupant but others were bland. The manager explained that it is each persons personal preference, and that of their family, in respect of how their room is arranged. All bedrooms are now unlocked but people can still be provided with a key if they want to keep their room and their personal belongings safe. We saw that one person chose to have a key on a pendant. On each bedroom door, there is a plaque showing the persons name plus a large brass number. All but eight of the beds are electric profiling beds, and the remainder divans will be replaced on a rolling programme. We were assured that these beds are still appropriate for the person using them. In one bedroom we saw a pressure mat this is placed inbetween the mattress and the bedding and will alert staff to the person getting out of bed during the night. Bed rails are not used in this home as will Care Homes for Older People Page 21 of 29 Evidence: generally pose a greater risk - the profiling beds are able to be lowered close to the floor, as required. We saw all of the home during our inspection and all areas were clean and fresh smelling. Air freshener units are located throughout the home. Care Homes for Older People Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Woodleaze will be looked after by a staff team who are well trained and competent - they will be able to meet individuals specific care needs. Evidence: The staff team consisits of the home manager, deputy and assistant managers, care and ancillary staff. The staff rotas showed that in addition to management staff there are six care staff each morning, four in the afternoons and evening. Overnight there are two waking staff. This appears to be an appropriate level of staff cover, but is kept under constant review and would be amended if needs changed. On the day of inspection there was also one domestic, one laundry assistant and four catering staff on duty. We received the following comments about the staff team on survey forms that were returned to us - the staff are always busy but stop and help when asked, under the circumstances the staff do an excellent job, the staff are very well trained and patient and I think the care workers should wear a uniform and have name badges. The staff that were interviewed during the inspection were very happy working in the home and had been there for several years. They said that they had regular training and that supervision is given every 6-8 weeks or on request when necessary. They were clear about what they would do in the event of a safeguarding concern regarding any person and said that residents and families come first in my eyes. Care Homes for Older People Page 23 of 29 Evidence: There has been progress in the number of care staff who have achieved a National Vocational Qualification (NVQ) in Care, since the last inspection. At the time of writing this report, 50 of care staff have achieved at least a level 2. All duty managers have either achieved the A1 assessors award or will be doing the training in the near future, and the home is working towards achieving a fully qualified NVQ staff team. We looked at a randomly selected sample of staff recruitment files. All workers will have completed an application form and will have attended for a face-to-face interview. An interview assessment is recorded which evidences how the interviewer made the judgement that the worker was suitable for the job. An occupational health assessment, at least two written references and an enhanced CRB checks (this includes a ISA1st check) are completed prior to employment commencing. All new recruits will complete a Skills for Care induction training programme at the start of their employment. We saw evidence that this programme had been followed for two recently employed staff. A staff training and development bulletin is provided by the council on a regular basis and staff have access to a range of different training. The trainign programme is linked to the national minimum standards and we saw that there was training in focused support planning, medication techniques, nutritional awareness, safeguarding adults alerter, dementia awareness, equality and diversity, and various health and safety sessions. All staff will complete core training in manual handling, fire awareness, health and safety, and food hygiene. The staff training file provided evidence of each staff members training profile. Safeguarding training was completed by the majority of the team and the others will complete this in the next couple of months. We discussed with the manager the dementia care training that is in place - this is a three part training course and covers initial dementia awareness, communication needs and anger and behavioural management. In the last 12 months all staff have had Mental Capacity Act (MCA) training and the managers have had deprivation of liberty safeguards (DOLS) training - information regarding this has been shared with the staff team in staff meetings and supervisions. Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Woodleaze will find that the home is well run, and the service provided is in line with their individual needs. The home is kept safe. Evidence: The registered manager Mrs Sue Simmons-Tasker was available on the day of the inspection and co-operated with the inspection process. Her hours of work are Monday to Friday and she is supported by a deputy manager and assistant officers. One of the team will be on duty during each day and there are on-call arrangments overnight if needed. The manager has the necessary experience and qualifications (the registered managers award and NVQ Level 4) to manage a care service, and demonstrated her knowledge of the staff team, the needs of each person who lives in the home, and the requirements of the Care Homes Regulations. Two of the other duty managers also have the NVQ level 4 qualification. We asked about quality assurance systems in place to make sure that people are satisfied with the service they receive and it meets their needs. Feedback for people Care Homes for Older People Page 25 of 29 Evidence: who live in Woodleaze and their relatives is used to reflect on service provision, plus outcomes from any complaints or concerns raised, is used to change practice where possible. A full quality assurance asssessment was completed at the end of 2009 and has resulted in a development and action plan. A staff survey is currently in the process of being completed. All new placements will have a care review at the end of four weeks and then at the most on an annual basis. We spoke to a relative who confirmed these arrangements and we were told the staff are all very committed to getting things right, even though my husbands needs change on a daily basis. There are good administrative systems in place to manage peoples moneythat is looked after and all transactions in and out of each account are recorded and backed up with receipts or invoices. We sampled a check of three accounts and found them to be correct. We are assured that peoples finances are safeguarded by the procedures that are in place. Those staff we spoke with during the inspection and a check of a random sample of staff supervision records, evidenced that supervision is arranged regularly. Staff supervision is shared between the home manager and the duty managers. The manager explained that some of the staff team have more support than others, but all will have a minimum of six sessions per year. Each staff member will also a performance deveolpment and performance review on a yearly basis. It was evident during the inspection that day to day support for the staff team is good - a handover report is completed at each staff change so that staff are fully aware of what is expected of them. We looked at the various health and safety records. The fire records showed that all the monthly and weekly checks had been completed and unannounced fire drills are done regularly. The majority of staff had completed fire safety training in February 2010. Each perosn will have a manual handling risk assessment completed and a moving and handling profile is devised, providing safe systems of work for people who need to be helped to move from one place to another. We observed staff undertaking moving and handling tasks, using safe techniques. The home has a designated member of staff who is trained and responisble for the management of moving and handling. There are systems in place for ensuring that all equipment is maintained and serviced regularly. Any incidents or accidents are recorded and monitored - trends are identified so that preventative actions can be taken. Risk assessments are completed some may apply to all people who live in the home, whilst others are specific for an individual. No health and safty issues were raised as a result of this inspection. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 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 7 Records of daily care given, must clearly evidence when best interest decisions have been made. This is so that it is transaparent why staff took the actions they did, and is in line with the mental capacity act. The grab rails in corridors on the ground floor need to be repainted. 2 19 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - 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. You have been warned!