Care Home: Woodview

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Woodview 58a Park Road West Birkenhead Wirral CH43 8SF two star good service The quality rating for this care home is: 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: Paul Ramsden Date: 0 8 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. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. 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. Internet address www.cqc.org.uk Information about the care home Name of care home: Address: Woodview 58a Park Road West Birkenhead Wirral CH43 8SF 01516536566 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) : Alternative Futures Limited care home 4 Number of places (if applicable): Under 65 Over 65 4 0 learning disability Additional conditions: The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 4 Date of last inspection 0 9 0 4 2 0 0 8 A bit about the care home Woodview is registered to provide residential care for up to 4 adults who have a learning disability. The service is provided by Alternative Futures. The home is a two storey detached house which backs onto Birkenhead Park, with the back of the house and the large garden having attractive views across the park. It is on a busy main road, less than half a mile from Claughton Village where there are local shops and bus services. The home has a lounge and dining area on the ground floor. There is also a shower room, toilet and laundry on this floor. Each of the people living at the home has a large single bedroom on the first floor, which also houses an office, toilet and bathroom. Woodview has its own minibus for the use of people living at the home. The fee for staying at Woodview is £1,027.90 per week. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Poor Adequate Good Excellent How we did our inspection: This is what the inspector did when they were at the care home This unannounced visit took place on the 8 April 2009 and lasted for a total of three hours and fifteen minutes. Paul Ramsden, Inspector, undertook the visit on behalf of the Care Quality Commission [This replaced the Commission for Social care Inspection on 1st April 2009]. Any references to us or we in the report refer to the Commission. Feedback on the findings of the inspection was given to the home manager as it progressed. This visit was just one part of the inspection. Prior to the visit the home manager was asked to complete an Annual Quality Assurance Assessment [AQAA] to provide up to date information about the service provided in the home. This is a very detailed questionnaire that provides us with a lot of information about the service before the visit. Any other information received since the previous inspection was also reviewed. During the visit various records and the premises were looked at. When looking at the documents relating to the type of care each person needs [assessments and care plans] we use a system called case tracking. This is a method that allows us to follow or track a particular situation in order to ensure it was dealt with appropriately. Two service users and the member of staff on duty were spoken with; the staff member gave their views about the home and the service provided. Some of these comments have been included in the report. What the care home does well Alternative Futures and Woodview constantly reviews its practice and is always striving to improve the service offered to the people either living in the home or to prospective service users. The service is flexible and this helps to ensure that the home is able to respond to changing needs, which in turn enables people to maintain as much independence as possible. There is a strong commitment from everyone working at the home that helps to ensure that the quality of care is provided to a good standard. People are treated with respect and dignity. We found that staff members were able to demonstrate an awareness of the diverse needs of the people they were caring for. Positive and warm relationships were seen to exist between the service users during the visit and staff members. A wide choice of meals is offered and the standard of catering is good. The quality of record keeping within the home is being maintained to a very good standard; this helps to ensure that peoples needs are identified and addressed quickly. What has got better from the last inspection What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Paul Ramsden CQC North West office 3rd Floor, Unit 1, Tustin Court Portway Preston PR2 2YQ 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 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Information and opportunities to visit before moving in are available and service users are assessed before moving in to ensure their needs can be met at the home. Evidence: A statement of purpose and service user guide is available; these describe the services offered at the home. The service user guide is currently being updated. In addition to this the company have also produced a handbook; this document explains what services are offered by Alternative Futures. Information provided for service users includes the use of pictures and is written in plain English. These contain all of the information required and we think these documents should provide sufficient information for anybody who is thinking of moving into the home. People generally visit the home before making the decision to live there; they can also stay for a meal and have a trial visit before deciding. If they have any queries they can contact the manager or senior staff members. An assessment demonstrating that the service user’s individual needs could be met by the home had been undertaken prior to admission for the person who had most recently moved into the home. The home manager explained the process that would be followed. Following any referral the locality manager would complete an initial assessment of the individual; this would then be followed by a full assessment carried out by the home manager where the vacancy existed. The manager will visit people in their own home, another care home or hospital to gather the necessary information before admitting someone. This provides an opportunity to make sure the home can accommodate the person and their individual needs. When someone is funded by the Local Authority they also Evidence: provide an assessment of the persons needs prior to admission. This provides background information as to the reasons why a move to the home is needed and is very useful when combined with the homes own assessment. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The service users care plans seen were well maintained and provided all of the information needed for staff members to be able to take appropriate action to meet an individuals needs. Evidence: The care planning documentation; called a Person Centred Plan [PCP] held on each service user is comprehensive. Where service users are unable to agree to their care plan,, relatives have been consulted about the plan of care. The care plans are initially based upon information obtained during the pre-admission assessment process but then develop over time. Information covering each identified area that requires support/supervision or assistance; for example morning routine is available. This helps to ensure to ensure that the staff members are able to meet the individual service users needs at all times. PCPs are re-written and reviewed when required or at six monthly intervals, where possible all parties involved in the care of the service user attend any review. During discussions with the manager and the staff member on duty it was clear that they had a good understanding of the people they were supporting and were able to meet their diverse needs. Staff members are working to a high standard to ensure that people receive the care they need. They monitor a residents health and emotional needs daily and there was evidence to show that residents were receiving appropriate support from health care professionals. This included GPs, community nurses,, optician, dentist and chiropodist. A key worker system is in place. Risk assessment and risk management are addressed within individual plans and from Evidence: discussions with the manager and staff member it was obvious that they were aware of an individual needs and they worked hard at balancing the persons need for privacy and independence whilst maintaining their safety. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living in the home are supported to use local community facilities, to maintain relationships and to develop their skills. Evidence: Where possible service users are encouraged to develop their individual skills and one person attends a day centre during the week. Links with the local community are maintained and people are supported to participate in community activities either individually or collectively. Each care plan contained information on activities etc that the person liked to be involved in. People are encouraged to maintain family links and relationships. The arrangements for contact with the family are written into individual care plans so that staff members can make arrangements for service users to keep in touch with people. From discussions with the manager and staff member on duty we were able to see that the homes routines are flexible and can be changed if needed. Written guidelines for staff emphasise the need to promote the privacy and dignity of service users. The staff induction also covers these aspects of care. A record of all meals provided is maintained and information regarding likes and dislikes is recorded on the care plans. The manager explained that a new menu had recently been introduced. Evidence: Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Care plans give clear guidance to staff to assist service users in the way that meets individual needs and preferences. Evidence: A key worker system operates in the home; this ensures that support is flexible, consistent, and is able to meet the changing needs of service users. The staff members respect individual preferences and have expert knowledge about individual needs when providing support. Where required, information is available for staff about the assistance and guidance service users need to ensure their personal care needs are met. There are appropriate arrangements in place for service users to access the services of a doctor, dentist, optician and other health care professionals where required. Each person has a Health Action Plan; this contains; personal details, medical history, plus information regarding, for example personal care and mobility information which is transferred to the PCPs. This is a comprehensive document and is reviewed every year. There are policies and procedures in relation to the safe handling of medicines available. Where staff members provide assistance with the administration of medication, it is signed for. Medication is appropriately stored. All members of staff receive training in the administration of medication. We consider that the arrangements for the administration of medication during the inspection were good and that service users were taking their medication as prescribed. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service users and relatives are able to complain/make suggestions and action would be taken to respond to their concerns. Adult protection training is provided for staff in order to ensure the continued safety of residents. Evidence: Woodview has a complaints procedure available; this is included in the service user guide. There have been no complaints since the previous inspection visit. The home has an adult protection [now referred to as safeguarding] procedure that complies with all of the relevant legislation and good practice guidelines. This is designed to ensure that any possible problems that arise are dealt with openly and people are protected from possible harm. The manager confirmed that no safeguarding issues have been identified in the previous year. Staff members undertake training in this area. Both the manager and staff member spoken with confirmed that this had just taken place. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Woodview provides service users with a safe, homely, clean and comfortable home. Evidence: The home is a detached property situated in a residential area and is close to local amenities. It is in keeping with other properties in the area and there are no outward signs that it is a care home. The location and layout of the home is suitable for the current service user group. Woodview is decorated and furnished in a domestic style and provides a homely environment for service users. Each person has their own bedroom that is furnished and decorated to reflect their personality. The home has a large lounge and dining area on the ground floor; the kitchen adjoins the dining room. There is also a shower room, toilet and laundry on this floor. There are four large bedrooms, a bathroom and a small office on the first floor. Since the previous inspection visit a number of areas within the home have been refurbished or redecorated; these include, a new driveway, the fitting of a new door in the hallway to provide more light, some new windows [more are due to be fitted], new laminate flooring throughout the ground floor and in the upstairs bathroom, a new kitchen, new shower room. In addition the home has been completely redecorated and some new furniture, including a three piece suite has been bought. New curtains and blinds are also on order. We consider that the standards of hygiene within the home are good and believe that all of the staff members and, where possible, the people living there work hard at to ensure that the home is well maintained. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Staff members work positively with residents and families to improve the quality of life of people living in the home. A robust staff recruitment process is in place in order to protect residents from possible harm. Evidence: A staff team of eight people [including the manager] working on a rota basis support the four people living in Woodview. Two/three members of staff are on duty at all times. One member of the team, with an on-call covers the waking night shift. The staff members we spoke to were cheerful and friendly and had a very good knowledge of the people they were supporting. We saw that the staff team worked well together and relationships between them were relaxed and positive. The manager confirmed that six of the team held a National Vocational Qualification [NVQ], a recognised qualification for people working in the care profession. There has been one new staff member appointed since the previous inspection visit, she was currently completing her induction. Recruitment is dealt with by Alternative Futures Human Resources [HR] Department so the recruitment file had not yet been sent to the home. It was agreed that we would contact the HR department after the visit to discuss the process. During a telephone call to them they explained the steps that were followed when appointing new staff. They also confirmed that a satisfactory CRB disclosure must be obtained before employment commences. Alternative Futures believes that the recruitment of good quality staff members is an integral component in delivering a good service. The result of this is that the current team have the skills, knowledge and experience to meet the diverse needs of the service users. New staff members undertake a thorough induction-training programme, which includes both in-house and external training. This meets the National Induction Standards for Care. The copy of the induction record for the new staff member was Evidence: seen on the day of the visit. Woodview and Alternative Futures provide a range of training courses for staff members; the manager confirmed that all of the required mandatory training was up to date and safeguarding had just been completed. This was confirmed by the staff member on duty. All staff members are supervised on a continuous basis; in addition they all receive formal supervision approximately six times a year. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is being well run and managed on a day-to-day basis and there are appropriate procedures in place to make sure that residents are safe. Evidence: The manager is experienced and attends courses/training in order to keep his practice up to date and to fulfil his management responsibilities. He has completed his NVQ 4 and Registered Managers Award and can clearly demonstrate an awareness of the needs of the people living in the home and how to manage the staff team. He is supported by a small staff team who are all committed to providing a good service to the people living in the home and who hard to ensure that the quality of care provided is maintained at a good level. Alternative Futures has a quality assurance system in place in order to ascertain whether service users and families are happy with the standards of care being provided. The home is visited on an unannounced basis by a senior representative from Alternative Futures at least once a month in line with Regulation 26 of the Care Homes Regulations 2001. These visits form part of the quality assurance process. We looked at the records of service users personal allowances held in the home; those checked had correct balances and were being well managed. The systems for the recording of any monies held were considered to be good. The home has a range of policies and procedures to promote and protect both service users and staff members’ health and safety. The maintenance records seen demonstrated that the appropriate service contracts were in place. These included; the fire alarm system and the gas and electrical installations. Evidence: The fire safety log book showed that the tests on the system and emergency lighting were being carried out at the recommended intervals. Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description 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 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. - 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. 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