Care Home: Woodville Rest Home

What the care home does well Woodville Rest Home is a clean comfortable and well maintained home. Regular health and safety checks are carried out to prevent residents being placed at risk. Staffing levels in the home are good, and staff are always available to spend time with the residents. Residents are able to maintain their autonomy and make choices in regard to their day to day routines. There are a variety of activities available for residents, and residents are able to choose on a day to day basis what activity they would like to participate in. Residents rights to privacy and dignity being maintained is respected by the staff. What has improved since the last inspection? All residents records are now kept seperately and securely in the home. There has been some improvement in the daily record keeping and ensuring care plans are up to date, but some further work needs to be done to document how staff are meeting the assessed needs of the residents. The registered provider has purchased new sit on scales so that residents nutrition levels can be monitored regularly. All residents who need or have requested liquidised food now have this presented in an attractive and appetising manner. The home now has appropriate policies and procedures to ensure staff have a good understanding of different types of abuse that can occur, and the symptons of these abuses taking place. Infection control procedures have improved with a new industrial washing machine in place that offers a sluicing facility and the home is now being kept free of offensive odours this now helps to reduce the risk of infection for residents living in the home. The home was seen to be clean, tidy and well maintained, and since the last key inspection electronic fire door closures have been fitted. Staff recruitment practices have improved ensuring that all appropriate information is available and suitable references are obtained prior to a new member of staff being employed by the home. Staff mandatory training in health and safety issues, medication and safeguarding vulnerable adults has improved with further training booked over the coming few months. The registered manager has developed a good quality assurance system in the home, to ensure that residents receive a good quality of care, and that the home and equipment is kept in good working order, so as not to place residents at risk. What the care home could do better: While improvements have been made to recording in daily reports and care plans further work needs to be carried out by the manager, to evidence that staff have met residents assessed needs. A requirement has been made to ensure that errors found in the administration and recording of medication is acted on, to prevent residents being placed at risk. While staff training has improved, further in depth dementia care training should be put in place to ensure that staff have a thorough knowledge of dementia type illnesses, and have the skills to work with residents with these illnesses. Key inspection report Care homes for older people Name: Address: Woodville Rest Home 8-10 Woodville Road Bexhill-on-sea East Sussex TN39 3EU     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: June Davies     Date: 0 1 0 6 2 0 0 9 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 25 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) 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Woodville Rest Home 8-10 Woodville Road Bexhill-on-sea East Sussex TN39 3EU 01424730497 01424736479 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Pages Homes Limited care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users to be accommodated is 17 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Dementia (DE) Date of last inspection Brief description of the care home Woodville provides residential and social care for seventeen older people over the age of 65 years with a dementia-type illness. Cur The home is a detached property, set in a quiet residential area of Bexhill-on-Sea, close to Egerton Park, the seafront and the town centre. Residents accommodation is provided on two floors and there is a stair lift to access the first floor. There are 11 single bedrooms and three bedrooms registered for double occupancy. Seven of the service users rooms have en suite facilities. The home provides a lounge with a dining area. There is a small rear garden with a sun lounge at the rear of the property. The current scale of weekly charges ranges from 423.00 to 580.00 per week and there are extra charges for hairdressing, chiropody, newspapers, magazines and toiletries. The registered proprietor has recently obtained planning permission to extend the home for a further five en suite Care Homes for Older People Page 4 of 25 17 Over 65 0 Brief description of the care home bathrooms and to demolish the summerhouse. Work on the extension has just started. The inspection report is on display in the front entrance and included in the statement of purpose. Care Homes for Older People Page 5 of 25 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: This key unannounced inspection took place on the 1st June 2009 over a period of seven hours. Documentation relating to the key standards were inspected, the inspector spoke with the registered individual Mr Puvi Sri , registered manager Nina Cooper, staff, and one resident, a tour of the home was carried out, and an audit of medication took place. Some information contained in the Annual Quality Assurance Assessment sent to the Commission by the registered manager has also been used in this report. The resident spoken to said that they were happy living in the home, that the staff treated them well and that the food was good at all times. The people who use this service experience GOOD quality outcomes. Care Homes for Older People Page 6 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 7 of 25 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 25 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 25 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 Service user Guide has been updated and produced in picture format to assist prospective residents with a dementia type illness. The registered manager visits prospective residents in their own homes or hospital to carry out pre-admission assessments. Evidence: Since the last key inspection the manager has produced the Service User Guide in picture format, and this has proved popular. Pre-admission assessments viewed were for two recent residents who were admitted to the home as emergency admissions, therefore there was no in depth detail on these assessment forms, but the registered manager did state that when there is a planned admittance to the home then she would ensure that information gained was more detailed. Care Homes for Older People Page 10 of 25 Evidence: During this pre-assessment visit the manager obtains as much information as she is able to, in regard to the residents, personal, physical, health and social care needs. This information is then used by the manager to ensure that the staff team have the skills and knowledge to meet the residents needs, and to form the basis of an individual care plan. Care Homes for Older People Page 11 of 25 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. The care planning system is clear and does provide staff with the information they need to meet residents needs. The medication in the home needs some improvement to ensure that residents are not placed at risk. Personal support in this home is offered in such a way as to promote and protect residents, privacy, dignity and independence. Evidence: From the two care plans viewed the inspector found that they were detailed and gave staff they information they need to meet residents needs, risk assessments were in place and both care plan and risk assessments are reviewed on a monthly basis. Seperate daily record books are used for each individual resident, some were well written while others did not give sufficient detail. There was good evidence on care plans that all the residents health care needs are met, and that external health care professionals are used as and when required. One resident spoken to said that she is Care Homes for Older People Page 12 of 25 Evidence: able to see her Doctor as and when, but she could not remember the last time she had seen a Doctor. The registered manager is considering changing the format of care plans, to ensure they are more user friendly. The home has up to date clearly written policies and procedures for medication. Staff administering medication have received medication training. Some errors were found on Medication Administration Records and it was uncertain due to gaps if four residents had received their medication. For one resident whose medication had been brought in mid cycle and hand written onto Medication Administration Record there were no directions as to the quantity of medication to be administered or at what time. Liquid medication is not dated on the bottle on the day of opening. A nasal spray prescribed for a resident stated that it should not be used after two months of opening, but had been prescribed in January 2009 and as there was no opening date on the bottle this medication would have been out of date at the time of this inspection. A requirement is being made that medication is received, stored, administered, recorded and returned in line with the Royal Pharmaceutical Society Guidelines for Administration of Medication in Care Homes. During the inspection staff were observed talking to the residents in a friendly and kind manner. Personal hygiene tasks were being carried out by staff who respected the residents rights to privacy and dignity. Care Homes for Older People Page 13 of 25 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. Residents are able to make choices about daily living routines and activities they wish to participate in. The meals in this home are good offering both choice and variety and catering for special diets. Evidence: Residents are able to make choices in regard to their day to day living, and also have a choice of activities which they are able to choose from day to day. Staff have time to spend one to one with residents, doing puzzles, talking or helping them with an activity. Residents are able to follow the religion of their choice, and the manager arranges for ministers to visit from various religions. Staff take residents out into the community, either to the local park or on shopping trips. The home has an open visiting policy and relatives and friends are made welcome at any time. The menus in the home are good and offer residents a varied, nutritious and appealing menu. Residents are able to make choices in regard to what food they would like. At Care Homes for Older People Page 14 of 25 Evidence: the present time a four week rotating menu is available but is only provided in written format, but the manager said that she is considering producing in picture format, so that residents can relate to what is on offer. Some residents require liquidised diets, and these are presented attractively. Where staff are required to assist residents with feeding this is done discreetly. The chef confirmed that specialised diets can be catered for, but at the present time she is only providing two residents with a vegetarian diet. Care Homes for Older People Page 15 of 25 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 satisfactory complaints system and their is evidence that residents, and relatives feel their views are listened to. Staff have good knowledge of Safeguarding Vulnerable Adults which helps to protect residents from abuse. Evidence: The complaints policy and procedure has been reviewed and updated and is displayed in the main entrance of the home. One complaint has been received since the last key inspection and from viewing the complaints file evidence was available to show that this complaint had been investigated and reply was made to the complainant within the timescales set out. Residents are supplied with a copy of the complaints procedure when they come to live at the home and this is set out in written and pictorial format. Policies and procedures are in place for the Safeguarding of Vulnerable Adults and the home has a copy of the Sussex Multi Agency policy and procedures for Safeguarding Vulnerable Adults. All staff have received training in Safeguarding Vulnerable Adults, and no new member of staff is employed without the appropriate checks being carried out. Care Homes for Older People Page 16 of 25 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 standard of the environment within the home is good providing residents with an attractive and homely place to live. Infection control procedures are good helping to prevent risk of cross infection to residents. Evidence: Woodville Rest Home provides a comfortable, well maintained home for its residents. There is a planned programme for refurbishment and renewal. Work has just started on an extension to be added to the home, and systems are in place to ensure that this causes the least disruption to residents, all health and safety risk assessments are in place for this extension. Residents bed rooms are bright and cheerful, and are comfortably furnished. Communal space comprises of a large lounge with dining area, again this is well decorated and furniture is of a good quality. While building work is going on residents will not have access to the back garden, but plans are in place that residents will have a safe area to walk around in once the extension has been completed. Care Homes for Older People Page 17 of 25 Evidence: Infection control procedures are well managed in the home, and there are no offensive odours. The laundry while being small does have an industrial washing machine with sluicing facility, and an industrial tumble drier, the flooring is in good condition. Staff are supplied with appropriate disposable clothing to keep risk of cross infection to a minimum Care Homes for Older People Page 18 of 25 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. Staffing levels in the home are good and there are sufficient staff on duty throughout the day to meet the residents assessed needs. Staff have the qualifications and training to meet the varied needs of the residents. Recruitment practices are consistently followed resulting in residents receiving care from staff that have been appropriately vetted. Evidence: Staffing levels in the home are appropriate to the needs of the residents at the present time. The manager keeps staffing levels under review to ensure that the needs of the residents can be met. The staff team have some knowledge and skills to meet the residents needs at the present time. Staff have attended short courses in understanding dementia, but further more intensive training would be beneficial to ensure staff have an in depth knowledge of dementia care. Recruitment practices in the home are good and all new staff have appropriate checks carried out prior to starting employment. All new staff are expected to undertake an initial induction followed by Skills for Care induction, this they are expected to complete within a set timescale. Care Homes for Older People Page 19 of 25 Evidence: The majority of staff have completed their mandatory training, and further courses have been booked and these will take place within the next few months to ensure that staff mandatory training is up to date. Care Homes for Older People Page 20 of 25 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 manager has a good understanding of what needs to improve in the home. The quality assurance system developed by the manager is good and ensures that residents receive a good quality of care. Where the home has been requested to keep residents personal allowances, appropriate documentation is kept. Health and safety in the home is well monitored so that residents live and staff work in a safe environment. Evidence: The registered manager, Nina Cooper has the appropriate qualifications and skills to manager the home, and regularly updates her knowledge by attending training courses. She operates an open door policy when she is on duty, and spends some time each week working alongside care staff. Care Homes for Older People Page 21 of 25 Evidence: The home has a good quality assurance system in place. Quality assurance questionnaires are given to residents, relatives, friends, visiting professionals and staff, with a summerised report made of the responses. The manager carries out regular monitoring checks of all systems used in the home to ensure that residents receive a high standard of care throughout. Risk assessments are carried out in regard to fire safety, health and safety and to ensure that all equipment used in the home is fit for its stated purpose. Where the registered manager is asked to keep personal allowances for the residents, this is managed appropriately, with each resident having their own account sheet and receipts kept of any expenditure made on the residents behalf. Account sheets and monies are kept safely and securely. As mentioned under staff training many of the staff have completed their mandatory training related to health and safety issues with further courses having been booked to ensure that all staff receive or update this training. From information sent to CQC from the registered manager and documentation kept in the home there is evidence that all appliances used in the home have up to date maintenance certificates, and that the fire system, hot water delivery, emergency lighting, call bells are checked on a regular basis to ensure they are operating correctly. There are up to date health and safety policies and procedures in place, that are easily available to staff. All accidents are appropriately recorded, and where there is evidence of residents falling more than three times in one month the registered manager ensures that they are referred to their General Practitioner for a health check. Care Homes for Older People Page 22 of 25 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 23 of 25 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 9 13 The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Medication must be properly administered, and recorded to ensure that residents are not placed at risk. 31/07/2009 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 30 The home is registered for Dementia Care and therefore staff should have the skills and knowledge through in depth training to develop their knowledge and skills when working with residents who have a dementia type illness. Care Homes for Older People Page 24 of 25 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 25 of 25 - 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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