Care Home: Woodside Hall

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What the care home does well The atmosphere at the home was relaxed with communication between staff and residents being positive, open and friendly, whilst maintaining their respect and dignity. There is a Service Users Guide and Statement of Purpose in place which is informative and written in a style that is easy to understand. The home is well maintained, comfortable and attractively decorated and furnished with specialist equipment available to meet the varied needs of the residents. The lifestyle meet service users expectations and preferences at this time and residents are involved in the running of the home. The feedback in respect of the food was positive and the meals seen were attractively presented and enjoyed by the residents. The menus seen evidenced a varied and well balanced diet in line with the residents preferences. The training for staff is good and covers a wide variety of resident related conditions and mandatory training which give the staff an understanding of the residents needs. All service users and visiting professionals contacted as part of the inspection process confirmed a satisfaction with the home and its services. Comments recieved regarding the home included, `its very nice here` ` the staff are wonderful, so caring`, There is a robust recruitment process that protects the service users What has improved since the last inspection? Since the last inspection, the home have introduced pendant call bells for those residents that are able to use them, call bells were seen to be in reach of all residents and those that are unable to use the call bell have a monitoring system in place. The home now confirms in writing to the prospective resident or their representative that with regard to the needs assessment completed the home can meet the needs of the prospective resident. This ensures that decisions around admission to the home are informed. The procedure for investigating complaints was seen to be improved and records viewed demonstrated a thorough investigation process. The recruitment practice was seen to be improved with the required checks being completed before staff are deployed to work in the home. An appropriate record of identification is retained in the home along with a recent photograph to ensure residents are safeguarded. The AQQA confirmed that appropriate up to date policies and procedures are in place, two polices and procedures were selected for sampling and evidenced a recent review. The individual and environmental risk assessments were seen to be robust andincluded the garden area and new conservatory. What the care home could do better: The care plans reviewed identified shortfalls in the specific needs of individual residents and this is an area that needs to be monitored and developed by the home manager to ensure that the residents health, social and safety needs are promoted and protectd by informed staff. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Woodside Hall Polegate Road Hailsham East Sussex BN27 3PQ     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: Deborah Calveley     Date: 2 3 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Woodside Hall Polegate Road Hailsham East Sussex BN27 3PQ 01323-841670 01323845561 zita.allen@woodsidehall-nh.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Premium Care Ltd care home 59 Number of places (if applicable): Under 65 Over 65 59 0 old age, not falling within any other category physical disability Additional conditions: 0 59 The maximum number of service users to be accommodated is 59. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Physical disability (PD). Date of last inspection Brief description of the care home Woodside Hall is registered to provide nursing care for fifty-nine service users, who meet the registration category of elderly, physically disabled and up to two service users with a terminal illness. Woodside Hall is a converted hotel that was converted into a nursing home and has been extended with a large purpose built extension. The whole home has now been upgraded and modernised. The accommodation offered is situated on two floors and comprises of forty-seven single rooms, all with en suite facilities and two double rooms both with an ensuite facility Care Homes for Older People Page 4 of 29 Brief description of the care home There are two large dining areas, one on each floor and three good-sized lounge areas; there is also a hairdressing room. Communal bathing facilities are provided with a mixture of shower rooms and assisted baths. The home has a selection of specialised equipment such as hoists, pressure mattresses, and electric beds. The rooms and communal areas are pleasantly decorated whilst maintaining a homely atmosphere. A recent addition is a conservatory to the rear of the property. The home is situated on the main A22 and whilst there are no near local amenities, the towns of Hailsham and Polegate are approximately 3 miles distance. It has large landscaped gardens, and there are car-parking facilities. Fee details are available on request. Additional charges are made for hairdressing, chiropody, newspapers, nail painting and outside activities such as visits to the theatre. Intermediate care is not provided. The homes literature states the main objective of the Woodside Hall Nursing Home to provide care to all service users to a standard of excellence, which embraces the fundamental principles of good care practice. Care Homes for Older People Page 5 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 reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Woodside Hall will be referred to as residents. This was a key inspection that included an unannounced visit to the home and follow up contact with residents representatives and visiting health and social care professionals. This unannounced inspection was carried out over 6 hours on the 23 April 2009. There were 43 residents living in the home on the day of which four were case tracked and Care Homes for Older People Page 6 of 29 visited. During the tour of the premises eight other residents both male and female were also spoken with. The purpose of the inspection was to check that the requirements of previous inspections had been met and inspect all other key standards. A tour of the premises was undertaken and a range of documentation was viewed including the Service Users Guide, Statement of Purpose, care plans, medication records and recruitment files. Two members of care staff were spoken with in addition to discussion with two registered nurses, registered manager and the director of the service. Telephone contact was made with visiting professionals following the visit and their views and comments are incorporated into the report along with the information received verbally during the site visit. An Annual Quality Assurance Assessment was received from the manager completed in full prior to this key inspection. What the care home does well: What has improved since the last inspection? Since the last inspection, the home have introduced pendant call bells for those residents that are able to use them, call bells were seen to be in reach of all residents and those that are unable to use the call bell have a monitoring system in place. The home now confirms in writing to the prospective resident or their representative that with regard to the needs assessment completed the home can meet the needs of the prospective resident. This ensures that decisions around admission to the home are informed. The procedure for investigating complaints was seen to be improved and records viewed demonstrated a thorough investigation process. The recruitment practice was seen to be improved with the required checks being completed before staff are deployed to work in the home. An appropriate record of identification is retained in the home along with a recent photograph to ensure residents are safeguarded. The AQQA confirmed that appropriate up to date policies and procedures are in place, two polices and procedures were selected for sampling and evidenced a recent review. The individual and environmental risk assessments were seen to be robust and Care Homes for Older People Page 8 of 29 included the garden area and new conservatory. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 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 10 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. The home provides prospective residents and relatives with a good level of information about the home its facilities services and the costs involved. The admission procedures allow for the needs of prospective residents to be assessed by a competent person before admission and people are assured in writing that their needs will be met. Evidence: There is an informative Statement of Purpose and Service Users Guide in place, which contains information about the home and the services it provides along with some information regarding the qualifications of staff. In order to reassure prospective residents that the staff have the knowledge and competency to meet their needs more information regarding the training and updates they receive would be beneficial. It was confirmed whilst talking to residents that the contract arrangements were clear and understood. There is a copy of the terms and conditions of residency included in Care Homes for Older People Page 11 of 29 Evidence: the homes information documents. The information regarding the home complimentary letters and activity book with photographs of residents partaking in activities parties and outings are displayed in the reception area of the home. A review of the care documentation confirmed that pre admission assessments are completed by the manager. The last three admissions to the home were identified and the records relating to the admission procedures followed were reviewed. This confirmed that pre admission assessments are completed and in the main provide a clear assessment of prospective residents care needs. The format of the pre admission form is under review. Prospective residents are seen either in their home or hospital before admission and the input from relatives and other professionals is used whenever possible. This approach could be more clearly recorded on the assessment documentation to demonstrate the procedure followed. It was confirmed that the home now confirms in writing that having regard to the assessment that the home can meet the assessed needs of the prospective resident. The manager was able to verbally demonstrate her knowledge and awareness of the different specialities required in the home and ensure that the staff employed have attended relevant courses to deal with the needs of the elderly and also specialised courses for certain diseases such as dementia and motor neurone disease. Trial visits to the home can be arranged the manager confirmed that residents are invited to a trial period to ensure suitability of the home this is clearly stated in the Statement of Purpose and in the statement of terms and conditions. Intermediate or rehabilitative care is not provided at Woodside Hall. Care Homes for Older People Page 12 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. From direct observation the health and personal care needs of residents are on the whole met with evidence of specialist advice sought when necessary. However some residents are potentially at risk due to care plans not being updated to reflect the residents current needs. Medication practices in the home promote and protect the health needs of residents and on the whole the privacy and dignity of residents are promoted. Evidence: The home use a computerised care plan system which has been in use for two years. The care documentation pertaining to four residents were reviewed in depth as part of the inspection process, these residents were also visited during the site visit. In the four care plans viewed the assessment documentation was in the main thorough and evidenced that staff are assessing individual residents in a person centred way. However as discussed there were areas that that had not been addressed in the care plans and risk assessments despite being identified in the daily records. These include aggression, nutritional needs, anxiety and depression, dementia, communication and Care Homes for Older People Page 13 of 29 Evidence: specific pain control use. For example: One resident is receiving specific medication for pain which requires close administration monitoring, however this was not reflected in his care plan and medication risk assessment. Another was seen to be having a thickener in their fluids but this was not reflected in the care plan and there was no evidence of swallow assessments or prescription for the thickener in their records. Another care plan stated that they could not assess the residents communication skills or social needs as they could not communicate with her, however from reviewing the information she does have a close family who visit very regularly and they should have been involved in assisting the staff with vital information regarding how this resident expresses pain, sadness and happiness. A named registered nurse is now responsible for an allocated area of care. During this site visit, the wound care and nutritional folders were reviewed in conjunction with the care plans. They evidenced that advice is sought from dietitians and a private tissue viability consultancy when it is identified that it is required. Health professionals contacted as part of this inspection process, said that the home was pro-active in assessing the residents needs and asking for advice. The home are using fluid charts for those residents identified as being at risk of not drinking. as discussed, these need to more consistently completed as at present they indicate that they are not being giving sufficient fluids and are contradictory with the written care notes. There are tools in place for skin integrity and moving and handling and the home staff ensure that the type of hoist and sling used is clearly documented and the settings for the pressure relieving equipment included in the risk assessment, this informs all staff involved in the care of the residents and ensure that the equipment is used consistently for the desired outcome. These shortfalls were acknowledged during the site visit by the manager and discussed in full and will be addressed and developed immediately. The staff spoken with do have a good knowledge of the people they care for and the standard of care is overall good with residents being clean and comfortable. It is apparent that despite the documentation shortfalls the outcomes for residents are not at this time negatively impacted on. These shortfalls need to be addressed and acted on to ensure the continued health and safety of all the people living in the home and to encompass staff changes. Staff spoken with confirmed that they received a full report on each resident daily and the daily records are completed by the registered nurses and were seen and were informative. The care staff complete a personal care matrix which comprises of them ticking the personal care given on each day. There are two clinical rooms in the home and are both well organised and kept clean and tidy. There are suitable storage Care Homes for Older People Page 14 of 29 Evidence: facilities for medication stocks and dressings. Medicine trolleys are stored in these rooms and they are kept clean and minimally stocked to prevent spills and wastage. Clinical fridges are in place and temperatures of the room and fridge are recorded daily. There are policies and procedures in place for staff to refer to regarding the safe administration, storage, disposal and recording of medication. These were viewed and evidenced a recent review, the home need to procure an up to date formulary from their dispensing chemist. There are suitable systems in place for the recording and checking of controlled drugs and the stocks are checked and documented weekly. The Medication Administration Charts (MAR) were viewed and a few gaps were identified. All verbal and handwritten entries need to be signed and dated to ensure that there is a clear audit trail. The MAR sheets include the codes use by staff for the non administration of prescribed medicines and staff are to be reminded that the reasons for non administration need to be documented clearly on the reverse of all the administration charts. The comparison signatures of staff able to administer medication were available and current. Staff were seen to be respectful and considerate to all residents whilst attending to their needs. The relationships between staff of all nominations and residents was positive and inclusive. Each of the residents were addressed by their preferred term and dressed appropriately in well laundered clothing. Care Homes for Older People Page 15 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. Social activities and meals continue to be creative and provide daily variation and interest for people living in the home. Residents are able to make a range of choices about their lives as well as maintaining links with friends and relatives. Evidence: There is an activity co-ordinator in the home who takes responsibility for organising activities, outings and visiting entertainers within the home. The activity programme is displayed in the entrance area of the home and evidenced a range of activities, that included using herbs in cooking, brain training, netball, skittles movement classes and arts and crafts. Residents spoken with enjoyed the activities and were complimentary regarding the interaction they had with the staff. There is a book of photographs showing residents and staff enjoying various activities and festivities in the main reception area and it was evident from talking with the staff that they are continuously looking at new ideas to meet the residents interests and hobbies. The computer care plans viewed evidenced some residents past histories and social preferences, but there were no social plans in place for individual residents. The activity co-ordinator writes in the daily care record the activity undertaken by the Care Homes for Older People Page 16 of 29 Evidence: residents. It was discussed that social and mental health care plans need to be in place for all of the residents no matter what their level of interaction is. This should include identifying depression and isolation and guide staff in ways to meet these problems consistently. As the management of the home is pro active a requirement has not been made at this time, but this will be an area that is reviewed at the next key inspection. The AQAA states that the home have quarterly residents meetings where ideas on improvements are discussed within these groups residents are able to make decisions on what they would like to see on activities programmes. Relatives and Power Of Attorneys are also invited to attend these meetings. They continue to work closely with outside transport agencies to give residents a choice of services available to them, e.g. an afternoon on the seafront, a drive around Eastbourne or a visit to a park. The home continue to make activities variable as possible and residents mentioned that they had been involved in singing, games, cookery, theme days, quizzes and gardening. Residents are facilitated and supported to maintain their independence for as long as they are able. There are no restrictions on visiting times as long as consideration is shown to all the residents. There are communal areas throughout the home that are available to residents and their visitors for private meetings if required. The tour of the home evidenced that many of the residents have individualised their bedroom with items from home and residents and relatives spoken with confirmed that they are encouraged to make it homely. It was observed during the inspection that the routines at the home are flexible, residents spoken with confirmed that they were consulted about all aspects of their lives. The home has an advocacy policy in place and the information regarding this is available to all residents. Breakfast and the mid day meal was observed and was seen to be organised and well managed. The staff ensure that those residents needing assistance are given time and able to have the assistance that they needed in an unrushed manner by having separate sittings. It was confirmed that residents had a choice at lunchtime which included a vegetarian choice or a variation if they do not fancy the main choice. The menu on the site visit was a special one to celebrate St Georges Day. Menus are used and circulated the day prior to the meals being provided and are also on the tables for residents to remind themselves of the meals on offer. There are no records kept on what food is eaten by each resident unless there is a problem and it was discussed that records are beneficial in identifying appetite traits early. The chef on duty was knowledgeable and committed to his role, he did acknowledge as did staff spoken with that communication between the kitchen and care staff could be improved. He was Care Homes for Older People Page 17 of 29 Evidence: able to discuss the special diets and confirmed that they provide fortified milk for those who are underweight on the coffee and tea rounds. The soft and pureed food was presented in an attractive way. One area that that was discussed was that the diabetic puddings are different from the main menu and generally restricted in choice. This is an area that that would benefit from review and discussed with the residents who receive a diabetic diet. The feedback in respect of food feedback was in the main complimentary and comments included: No complaints, I enjoy my food, I have choices in the meals and the meals are good. One visitor mentioned that the food was sometimes cold by the time staff were able to assist certain less able residents. There are two dining areas, one on each floor and both are pleasant with good quality furniture and natural light. The meals provided looked appetising and were served in a manner that ensured it looked attractive. Fresh fruit is provided and assessable to the residents in the dining areas, it was also seen on the tea trolley being offered to residents. The safer cooking better business book is completed daily and there has been a recent environmental health inspection, which was positive. The kitchen was clean with rotas in place for regular cleaning and temperature checks. Care Homes for Older People Page 18 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 home has a formal complaints system with evidence that residents feel that their views are listened to and acted upon. Staff receive training to protect residents from abuse. Evidence: The complaint policy and procedure is clear and uncomplicated and a copy of this is readily available in the home and in the Service Users Guide. A system of recording complaints was demonstrated to the inspector during her visit to the home. The home has received one formal complaint since the last inspection. Residents spoken with confirmed that they were confident that any complaints or concerns that they had would be listened to and responded to. The home has relevant guidelines on the protection of vulnerable adults and staff have all received appropriate training. The management team has a clear understanding of adult protection guidelines and are aware of how to initiate an investigation if required. 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. The home provides a comfortable clean and safe environment for those living in the home and visiting. Residents are enabled and encouraged to personalise their room and rooms are homely and reflect the residents personalities and interests. Evidence: A tour of the home confirmed that the home is well maintained and bedrooms are attractive with some being very personalised and all bedrooms have an ensuite facility. Residents spoken to said that they liked their rooms one saying that the home Its very comfortable Everything as I could want Its become my home. The home have a choice of various communal areas which are comfortable and attractive and allow for different uses ensuring residents have choice and how they spend their time. Since the last inspection the home have added a new conservatory and patio, which is welcomed by residents and is sometimes used for family gatherings. The AQAA stated that all rooms are redecorated on a rolling basis and 16 rooms have been redecorated in the last 12 months. There are adequate communal bathrooms and shower rooms in the home with specialist equipment to ensure all residents can have a bath or shower. The home has specialised equipment available throughout the home to promote residents Care Homes for Older People Page 20 of 29 Evidence: independence. During the inspection it was noted that staff were using lifting and supporting equipment appropriately. A recommendation of good practice is that staff explain what they are doing to the resident as they are doing it. Call bells are provided in all areas and some residents were seen to have a pendant call bell ensuring they have access at all times. The home has a range of special mattresses and seat cushions which are used on an assessed needs basis to prevent tissue damage. The lighting in the home is of domestic quality and there are above bed lights as well as the main ceiling lights. Water temperatures are controlled and monitored on a regular basis and a record kept. There are systems in place for monitoring safety issues such as fire checks, fire drills, PAT testing, electrical tests and gas and boiler checks and all the rooms are routinely checked for safety and maintenance issues. The records in the home confirmed they were up to date. The tour of the home confirmed that staff are aware of the fire safety policies no doors were found inappropriately wedged open. Some fire extinguishers were not attached to the wall and this was identified to the staff and dealt with. Polices and procedures for infection control are in place and are updated regularly. The home was clean and free from offensive odours on the day of the inspection. Sluice facilities were clean and hygienic, laundry areas were found to be clean and safe. In the main good practice in respect of infection control by staff was observed during the inspection visit, soiled linen was appropriately put in red bags and all areas of the home were clean. Residents were complimentary about the laundry service indicating clothes are generally returned the same day and looked after well. Care Homes for Older People Page 21 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. Robust recruitment procedures are in place to protect residents and staff training ensures they are aware of their roles and are able to provide the support and care the residents need. Evidence: At the time of the inspection visit 43 residents were living at Woodside Hall. The staffing rota was viewed and the staffing levels were seen to be sufficient to meet the needs of the residents at this time. It was noted that the managers hours are not reflected on the durt rota and this needs to be shown. The manager confirmed that the staffing arrangements are flexible and respond to residents dependency. Staff spoken to said that there was enough staff to look after the residents to a good standard. Comments received included sometimes the staff are too busy to chat for long. Feedback received from residents relatives and visiting care professionals as part of this inspection was very positive about the staff and comments received included, Nice people very friendly, knowledgeable staff, couldnt wish for better people to care for me, I am very well cared for. A roster is held giving names and designations of staff on duty. A selection of staff recruitment files were viewed and demonstrate that a robust recruitment process has been introduced to protect residents and contained all the Care Homes for Older People Page 22 of 29 Evidence: relevant information required. There was evidence of health questionnaires, Criminal Record Bureau checks, two references, a resume of previous employment and work permits where necessary. All the paperwork is kept within a lockable facility. There is an induction programme in place and has been introduced for all staff. Files seen confirmed this. New staff are required to complete an initial induction programme and undertake mandatory training including fire and health and safety. This leads into foundation training in preparation of NVQ training. At present 45 per cent of staff have an NVQ qualification with further staff enrolled on a course. The induction and foundation training is in line with the Skills for Care guidance. The manager facilitates regular training sessions and recent ones have included safe cleaning food hygiene nutrition infection control and moving and handling. There is a rolling programme of training which will ensure that staff receive the training necessary to meet the residents needs. Staff spoken with said that training opportunities at the home are good and they are well supported by the senior staff and the manager. Care Homes for Older People Page 23 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. The overall management of this home is good with effective systems in place to protect residents. Evidence: The manager was registered by the CSCI in November 2007. She has 40 years experience in the caring profession. She is a Registered Nurse and has completed the Registered Managers Award. During the inspection visits there was no doubt that the manager had a good working relationship with everyone in the home and everyone spoken to said that she was approachable and responded to issues raised quickly. There is a clear management structure in the home with staff having designated responsibilities. Regulation 26 are undertaken monthly and available for viewing. There are systems in place to monitor the quality in the home and include the use of Care Homes for Older People Page 24 of 29 Evidence: questionnaires. These are conducted annually and the results are audited. There are regular resident and relative meetings that are documented formally and areas identified by residents and families are then looked at and addressed as necessary. There are systems in place to monitor the quality in the home and include the use of questionnaires it was confirmed that these are now audited reported on and responded to There are resident relative and staff meetings which are all minuted and areas for improvement and development discussed The home does manage small personal monies for a number of their residents Residents monies are held as per the homes policies and procedures It was confirmed that the system used provides an audit trail of how transactions are managed on behalf of residents Staff supervision is in place along with yearly appraisals, staff confirmed that they recieve individual supervision and that they find it beneficial. Supervision is slightly behind at present. Woodside Hall looked well maintained and systems are in place to report any problems to the maintenance person that need attention. Certificates relating to Health and Safety in the home were reviewed and found on the whole to be full. Full records of hot water checking are kept and there are measures in place to prevent Legionnaires disease. The health and safety policy is up to date and all areas of the home are risk assessed to ensure the residents continued safety. The accident book was viewed along with the actions taken to prevent a re occurrence. It was discussed that expert advice be sought regarding those residents that have recurrent falls and cross referenced within the individual residents care plan and risk assessments. First aid boxes are in place but would benefit from being more assessible throughout the home. The kitchen first aid box would benefit from including a burns treatment and an eye wash for immediate first aid. Good practice was observed throughout the inspection in respect of promoting the safety and well being of the residents. Care Homes for Older People Page 25 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 26 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 1 7 15 That the registered person 06/07/2009 ensures that care plans accurately reflect the needs of the service users in respect of their health, social and behavioural needs. In respect of syringe drivers, communication and mental health needs. To promote the service users health, social and behavioural needs. 2 38 17 That the registered person ensures that all incidents in respect of falls and trips are recorded and then cross referenced within individual care plans and risk assessments to prevent a re occurance. To ensure that residents safety is promoted at all times. 06/07/2009 Care Homes for Older People Page 27 of 29 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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