Care Home: Woofferton House Residential Home

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What the care home does well The staff are cheerful, friendly and helpful and encourage people to enjoy themselves but also try to make sure that they are safe and well looked after. The feedback from surveys received by us indicates that the home provides a friendly and supportive home where people are respected and well looked after. The daily care records are detailed and show that care is delivered in a way that suits the individual. What has improved since the last inspection? Areas of the home have been decorated which the residents welcomed. What the care home could do better: People spoke of being comfortable with being asked their views which is common place. People spoken to indicated that changes to information, premises, being asked about their food have been welcomed and makes them feel `noticed`. The recorded involvement of people in the daily life of the home could be better. The sequence of care plan recording could be better, so staff show that their train of thought regarding assessment, care delivered to meet needs and evaluation is more obvious to the reader. In order to minimize cross infection, maintain the health and safety of people using the service and staff, sluicing facilities need to be provided and separated from the laundry area. A controlled drugs cabinet which meets the required specifications should be installed without delay. The service should introduce a more robust quality monitoring system so that spot checks and regular audits are recorded which can then be used to drive service improvement. Key inspection report Care homes for older people Name: Address: Woofferton House Residential Home Woofferton Ludlow Shropshire SY8 4AL     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: Pat Scott     Date: 1 6 1 2 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 23 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 23 Information about the care home Name of care home: Address: Woofferton House Residential Home Woofferton Ludlow Shropshire SY8 4AL 01584711207 01584711962 jandeep_gill@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Fidelity Care Services Ltd care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 15 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 15 Date of last inspection Brief description of the care home Woofferton House is a privately owned and managed care home registered to provide care and accommodation for up to 15 older persons. It is located some five miles south of Ludlow, in South Shropshire, on the A49 set back off the main road in its own grounds providing a peaceful location. The accommodation is provided in a large detached house. Five bedrooms are situated on the first floor, accessed via a staircase, and eight are on the ground floor. All but one bedroom have en-suite facilities. Care Homes for Older People Page 4 of 23 Over 65 15 0 0 9 1 2 2 0 0 8 Brief description of the care home The home is owned by Fidelity Care Services Ltd, Mrs Jan Gill being the current manager. Care Homes for Older People Page 5 of 23 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 is a key inspection for Woofferton House. This inspection site visit provided an opportunity to find out how peoples developing care needs are being met, together with the services plans for improvement. This report draws on information received from the home in their Annual Quality Assurance Assessment, which is a self-assessment process that requires care services to record how well care outcomes for the people living in their service are being met as well as providing a range of statistical information about the service. We also looked at information we have about how the service has managed any complaints. We reviewed what the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. Care Homes for Older People Page 6 of 23 We reviewed the previous key inspection outcomes of 9th December 2008. We gathered relevant information from other organizations such as the Environmental Health Office and the Fire Safety Officer. Two staff working at the home were interviewed and records were reviewed. The manager was not available on this day. We spoke to three people using the service to ascertain their views. One Regulatory Inspector carried out this inspection over 3 hours. Care Homes for Older People Page 7 of 23 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 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 23 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 23 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. People who use the service can be confident that they will have their needs fully assessed and have the opportunity to visit the home before living there. This ensures that all parties can be sure the home can meet all individual needs in the required way. Evidence: During the visit we spoke at length with three residents who live at the home. These residents confirmed that they had been given written information about the home prior to entering and had made visits before moving in. We saw written details of assessments on the residents care file. Care Homes for Older People Page 10 of 23 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. People who use the service can be assured that all individual needs are agreed between residents and staff and are documented to ensure that all these needs are appropriately met. Procedures followed in the home ensure that people are always treated with dignity and are protected by a thorough system for dealing with their medication. Evidence: During the morning we spoke with several residents in the lounge and bedrooms. All said that the staff gave them all the assistance they needed in an appropriate way. During the morning the residents sitting in the lounge confirmed that staff in the home treated them with respect and that they saw health professionals in private in their bedrooms. We checked the care plans for some of the residents spoken with and these were documented and contained information, which reflected what people had said. Residents had not signed plans but appropriate risk assessments were in place. Moving and handling assessments had been completed as necessary and conversations we had with staff and residents suggested that any assistance given to Care Homes for Older People Page 11 of 23 Evidence: help residents to transfer or move was provided in a safe and appropriate way. Medication is administered by staff at the home. Systems are in place for satisfactory receipt and disposal. The service does not provide the correct storage for controlled medication. The deputy manager stated that a visual check is undertaken to ensure that medication is handled in line with the policies and procedures of the home and that people receive the correct medication at the right time. This is not recorded. Care Homes for Older People Page 12 of 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are enabled to be in control of their own daily lives and they are able, as a group to make choices about how the home is run. Residents enjoy the food in the home and are supported to maintain community links so that they can maintain a sense of well-being and enjoy living in the home. Evidence: We spoke with residents in the lounge who said that care staff provide most of the daily activities and that events included quizzes and bingo and some gentle sitting exercises. Residents said that they would like more activities but enjoyed what is provided. One person said I have always led a busy life before, so would like more to do. We saw people sitting in their rooms or lounge but doing very little. The radio was on the television. People said that they had enjoyed the party concert provided from external musicians the night before. The record of activities seen detailed events up to September 2009. We spoke to one resident in their room who said that they always decided what clothes they wore and usually got up when they liked. This resident said they could stay in bed if they wanted to and usually managed their own personal care. We were also told that visitors were welcomed in the home at all times. Care Homes for Older People Page 13 of 23 Evidence: The residents said they had found the old TV in the lounge hard to see and they thought the sound was awful. They said that the manager had listened to this and they now have a new large TV which they really like. The kitchen was clean and there were records of appropriate monitoring of equipment and food monitoring. We asked residents about the food and all those spoken with said they enjoyed the meals. One resident said the food was great and one that it was always wonderful. Another stated that if they fancied something then the Chef, who is wonderful, is always happy to cook it. Residents told us that they do not chose their food for the day from a choice of at least two options but they always liked what they had. The residents who spoke with us also confirmed that staff provided drinks all through the day and at night if they wanted. Care Homes for Older People Page 14 of 23 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. People who use the service can be confident that the procedures followed in the home ensure that any concerns residents might have are listened to and that residents are protected from all forms of abuse. Evidence: We asked residents if they understood how to complain and all said they would have no problem about voicing any concerns if they had them. There have been no formal complaints made to the home since the last inspection. The Commission has not received any complaints about the home. There are written policies on complaints, safeguarding adults and whistle blowing and the completed AQAA confirmed that these policies have been updated. There have not been any referrals made to the local authority under the safeguarding adults procedures. The deputy manager understood the responsibilities around deprivation of liberty and mental capacity. No one in the home is subject to a deprivation of liberty authorisation from the local authority. Care Homes for Older People Page 15 of 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents find living in the home a pleasant experience as it is well maintained and attractively presented. Procedures followed ensure that the home is kept clean and hygienic which helps to keep the residents safe and in good health. Evidence: The service states in the AQAA areas which it considers it needs to improve, such as; the lighting in the main lounge area as some residents have mentioned they do not like the strip light. Also the conservatory needs to be replaced as it is unsightly and cold. The utility room needs to be decorated and so does the residents toilet near the main lounge. We visited all parts of the home during the inspection and all areas were very clean and some newly decorated. Carpeting in the main stairwell and corridors is worn and needs replacing as in parts it is threadbare. All the bedrooms seen were personalised and were warm and all had new call alarms. Some residents said they had chosen to bring their own furniture into the home. The home does not have a passenger lift so the ability of people is taken into account when assessing new people. The service does not have modern facilities for cleaning utensils such as commode pots and urinals. These are disinfected by hand and two urinals were seen sitting in a container is a communal bath. The laundry sink is inadequate as there is no separate hand basin and the door between the kitchen and laundry was wedged open. The Care Homes for Older People Page 16 of 23 Evidence: deputy manager stated that a quote had been obtained for renewing the sink area. There have been no outbreaks of infection. We spoke with a care worker who confirmed they had received appropriate training, especially around health and safety and infection control and they wear protective clothing. Evidence of good training was seen in staff files viewed. Fire safety alarms in the staff quarters were being connected to the main system during the visit. Care Homes for Older People Page 17 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that residents are appropriately supported and have their care needs met because there are enough well trained staff on duty in the home. The procedures followed for recruiting staff are thorough and help to ensure the protection of the residents. Evidence: We spoke to two staff members who said that there were usually enough staff on duty in the home, to meet all the needs of the residents and those residents we spoke with confirmed this. Residents said they could get up and go to bed when they wished and were not rushed by staff. One member of staff confirmed that they were involved in administering medication, and they had been trained in the procedures. This member of staff said they had had a good induction to the home and to the residents and had training courses booked. The manager has stated in the AQAA that staff are being supported to do NVQ training. We checked the recruitment files of more recent staff and all had criminal records bureau checks in place and two appropriate written references prior to being employed. All staff are provided with a detailed job description. Care Homes for Older People Page 18 of 23 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. Residents are content and enjoy living in the home, which they feel is well run and feel their views affect what happens on a daily basis. Procedures followed in the home safeguard their financial interests and ensure that the welfare of both staff and residents is promoted. Evidence: The manager has been away from the home over the last 12 months and the deputy has been in charge. There is little recorded evidence of the service monitoring its own quality and seeking views of people living there. People tell us that they are asked frequently everyday what they would like to do and whether everything is going well for them. Staff are knowledgeable about peoples needs. The manager and staff find out what people like by talking to them, involving them in their care and holding informal resident meetings so that any issues can be discussed. The AQAA contains information that is supported by some evidence and informed us of Care Homes for Older People Page 19 of 23 Evidence: changes planned to make any improvements to the service over the next 12 months. People who use the service say that they trust the staff and feel safe in the home. Comments from people include: I am shown kindness and wonderful attention, the manager finds time to listen and is willing to discuss problems. Care Homes for Older People Page 20 of 23 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 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 8 The format of care plans would benefit staff if they recorded specific plans of care rather than incorporating all information in the daily record. The service needs to provide a controlled rugs cabinet which meets the specific requirements of the Misuse of Drugs Act 1973. People should be offered a choice of main meal from a variety of options displayed on the menu. The provider should explore the provision of sluicing facilities so that the possibility of cross infection is minimised. The provider should conduct audits of service provision to show that the quality of care and staff performance meets the policies and procedures of the home and thus the aims and objectives of the service. 2 9 3 4 15 26 5 33 Care Homes for Older People Page 22 of 23 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. 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