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Archived: Woodbank House

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Reports


Inspection carried out on 19 February 2014

During an inspection looking at part of the service

At our previous inspections in June and July 2013 we observed examples of poor practice in relation to how Woodbank House respected people�s dignity, privacy and confidentiality. At this inspection we found people had received a good standard of personal care and attention which meant that people�s dignity and human rights were upheld.

People who were able told us that overall they were happy living at the home and satisfied with the care and support they were receiving. Their comments included, "The staff are nice and look after us," "I'm happy and settled here" and "I'm used to this place and get on with everyone like a house on fire."

We spoke with one relative. They told us, "If I have needed anything addressing this has been done quickly and the staff have been fantastic."

At our previous inspections we identified some concerns in relation to the safety and security of the premises. During this visit we found the ambience in the home was friendly and homely. We found people were cared for and supported in a clean, safe and well maintained environment.

At this inspection we found suitable arrangements were put in place to ensure staff were appropriately supported to enable them to deliver care safely and to an appropriate standard.

At the previous inspection we identified concers about the maintenance and storage of people's records. At this inspection we found that records were held securely and retained for an appropriate period of time.

Inspection carried out on 26 June and 4, 17 July 2013

During a routine inspection

We used both formal and informal observation during our inspection visits. We also reviewed a range of records and spoke with six people, one relative, six members of staff and the home manager. Our inspection also included checking that improvements had been made to staffing arrangements at the home.

We observed examples of poor practice in relation to how Woodbank House respected people�s dignity, privacy and confidentiality.

People were positive about the care they received at Woodbank House. One person stated, �staff here are nice and they know me.� People generally experienced care and support that met their needs. People felt,'safe,' and we found that appropriate arrangements were in place to safeguard people. We found systems were in place for the management of medicines.

People were protected from the risk of infection as a result of the provider implementing the actions of a recent external infection control audit. We identified some issues in relation to the safety and security of the premises.

We found there were enough staff to provide care. Suitable arrangements were not place in relation to the training, supervision and appraisal of staff.

Woodbank House had an effective system to regularly assess and monitor the quality of service that people received. We identified issues about the maintenance and storage of people's records.

Inspection carried out on 8 March 2013

During an inspection looking at part of the service

We found that Woodbank House had an effective process to ensure that employees were of good character and held the necessary checks, skills and qualifications to work at the home.

Our conversations with people, relatives and staff, together with observations on the day of our inspection evidenced that there were sufficient staff available to meet people�s daytime needs.

We found that night staffing within the home had been reduced from three to two members of staff. An incident had occurred during a night shift following this reduction. Our review of records relating to night time staffing, together with our conversations with the manager and staff evidenced that Woodbank House had failed to ensure that appropriate numbers of night staff were in place to safeguard the health, safety and welfare of people living at the home.

The home had taken action to address the medicines issues identified at our last inspection; however, further concerns were identified during this inspection. These related to the administration and recording of some medicines, staff knowledge of medicines, protocols in place to administer �when required medicines� and the security and storage of medicines.

We found that a clear induction process was in place for each staff role. We also noted that staff were supervised, received training and were given opportunities for further training.

Inspection carried out on 27 December 2012

During an inspection in response to concerns

We completed this inspection due to concerns raised with us on 20 December 2012. On 21 December 2012 Sheffield Local Authority Contract and Commissioning staff visited the home and confirmed the issues. We found that the home had been without the registered manager since the middle of November and this had an impact on the leadership of the home. On the day of the inspection the registered manager had returned to work.

We spoke with three people who used the service. People told us: "I've had no problems up to now," "all the staff are very nice to me, there�s always somebody around," and "Its alright here. The food isn�t all that good, it wasn�t the best today."

We looked at the management of medicines. Evidence showed that not all people were protected against the risks associated with the management of medication because the provider did not have appropriate arrangements in place to manage, obtain, record, handle and administer medicines safely.

Evidence showed there were not enough qualified, skilled and experienced staff to meet people's needs. We found that not all staff had received appropriate training and professional development.

We looked at the personal files of two members of staff who had recently started working at the home. We found that they had not received an induction. A comprehensive induction is important to ensure staff are supported, trained and supervised to enable them to deliver care safely and to an appropriate standard.

Inspection carried out on 7 June 2012

During a routine inspection

We spoke with four people who lived at Woodbank House in order to gain their experience of living at the home. One person said, �the staff are amiable and good to me.� They also told us that they had enjoyed the activities recently organised within the home in order to celebrate the Queens diamond jubilee. Another person told us that they, �never had any complaints�. They also said that the food at Woodbank House was, �nice,� and that, �there�s always plenty of it.�

People were positive about cleanliness within the home. One person told us that their room was cleaned each morning and that housekeeping staff also involved and supported them to clean areas of their room. Another person said, �it�s very clean here, my room is always clean, it never smells.�

We spoke with three people who used the service about staffing levels within the home. Generally people felt that there were sufficient staff on duty to meet their needs during the day and at night-time. One person described the staff as, �great� and told us that staff always ensured that they had their buzzer, but, if they did use it they, �sometimes have to wait for them, but only a few minutes.� Another person told us that staff, �come quickly if you need them and help you out, I only have to ask.�

Inspection carried out on 21 March 2012

During an inspection looking at part of the service

This service accommodates older people both with and without dementia. The service for older people with dementia is not provided in a separate unit. Because people with dementia are not always able to tell us about their experiences, we sat in the lounge to observe their mood, how they interacted with staff, their environment and the interaction with people who did not have dementia.

Throughout the observation we saw all staff treat people with respect and courtesy. We observed one particular staff member being very kind and supportive. We saw this staff member hold and touch one person who was distressed and this seemed to provide comfort and reassurance to the person.

The atmosphere in the home was generally relaxed, the TV was on but the volume was at an acceptable level.

Staff frequently smiled at people to offer reassurance and spoke clearly and at a steady pace with people.

Staff seemed generally comfortable when they were talking and interacting with people using the service.

We saw that people were well dressed in clean clothes.

In the main, people were offered drinks with their meal, although we had to intervene for one lady, as they were not given a drink with their sandwich at lunchtime. People were offered a choice of meal and an alternative if they didn�t like either, which we saw a number of people do. People were offered a choice of where to sit, both in the lounges and the dining room.

We saw that plate guards were used to assist people in eating meals, where the guard had been assessed for and identified in their plan of care.

Staff sat with people assisting them to eat their meal. This was done discreetly and sensitively with staff speaking to people whilst assisting them to eat their lunch.

Whilst acknowledging the positive observations we observed the environment did not support people with dementia, in their care and welfare. This was because the environment did not reflect published research evidence and guidance issued by the appropriate professionals and expert bodies as good practice in relation to the care and treatment of people with dementia. For example, there was a clock in the lounge where the date was the 14 February 2012. People with dementia are disorientated to time and place and something as simple as incorrect dates can exacerbate this disorientation. There was little other information, if any, showing for example, the date, weather or a news event that would also help orientate people.

The home was not user friendly to help keep people orientated, for example, no bright doors to identify different areas such as bathrooms etc and tactile boards.

We will be holding a meeting with the provider for them to explain to us how they will improve the service and demonstrate their responsibility in meeting regulations established by the Health and Social Care Act 2008.

During our SOFI observation we saw that there were sufficient staff on duty, to meet people�s assessed needs. Although it was busy around the lunchtime period, people�s needs were attended to in a timely way.

We gathered people�s views about the service from those people who were able to describe their experiences to us. They described the choices they made on a daily basis. This included the times they got up and went to bed and meals. One described how the staff treated them with respect, because they didn�t speak to them like a child and that in fact they didn�t speak to anyone like children.

One person told us they�d been to the dentist to �sort their teeth out, as they were driving them mad�. They said, �There�s some things you like and others you don�t, such as people banging on your door at night, but everyone seems to get on really.�

Another person told us how the nurse visits to dress their foot where they have an ulcer. They commented how they don�t like it when people with senile dementia come wandering in at night when they�re watching the television.

Everyone we spoke with said they felt safe living in the home. However, one person told us how some people have senile dementia and they always seem to come to you when there�s no staff about.

One person said, �There�s some nice girls, but the men are good. They see to you if you�re stuck.�

Everyone we spoke with thought there was enough staff.

Inspection carried out on 22 November 2011

During an inspection in response to concerns

This service accommodates both older people and older people with dementia. The service for older people with dementia is not provided in a separate unit. Because people with dementia are not always able to tell us about their experiences, we sat in the lounge to observe their mood, how they interacted with staff, their environment and the interaction with people who did not have dementia.

We saw that a number of people were asleep. One person was in a positive mood, which was demonstrated by them talking to themselves and ourselves, clapping and rolling their skirt up and down. Four people were engaged in conversation between themselves, which also gave them a positive experience. Not all of those people had dementia. The TV was playing, but people did not appear to be watching it as staff changed what was being played and there was no objection.

There were times when we experienced shouting/confrontation indicating signs of distress from people without dementia, because of the behaviours of people with dementia. For example, one person was walking around repeating whether they could help, moving chairs, talking inappropriately about people eating their breakfast when they weren�t and reading from the television, rather than watching and listening to it. We saw two people who didn�t have dementia whilst waiting for a meal to be served, shouting at people with dementia not to sit with them.

We saw one member of staff enabling someone to help by giving them some serviettes to fold. This provided a positive experience for this person.

Staff did treat people with respect along with a well meaning and kind approach. We saw staff in the main, explaining what they were going to do when they needed to provide care for people, for example, asking someone to go with them to attend to their soiled clothing.

Our observations told us, in general, people looked cared for. They looked clean and wore clean clothing, indicating they had received a good standard of personal care and support.

We gathered people�s views about the service from those people who did not have dementia. They described the choices they made on a daily basis. This included the times they got up and went to bed and meals. One said they had been asked if they wanted to move rooms. The same person said they liked to spend time in their room and knew the codes on the doors to be able to go to their room when they wished.

People�s comments about the service included, �It�s alright�, �You get a bit bored on your own�, �Staff spend quite a bit of time with me�, �They have activities every so often, like singers, but I�m not bothered�, We go out once in a blue moon�, �It�s not bad here. We usually have a laugh�, �Nothing�s too much trouble�, �It�s clean. That�s what I like about it�, �They do, do games�, �We do painting and now and again quizzes� and �There�s a bloke that comes and plays the accordion and sings�. One person said they would like to go out more.

They said staff were alright � kind and respectful. They told us their relative�s visit and are made to feel welcome.

Everyone we spoke with said they felt safe living in the home. One commented, �Staff are alright. There�s no swearing or shouting�.

People told us they thought staff were caring. One described how they had a buzzer to summon assistance, which was usually provided within 10 minutes. People�s comments about staff included, �They�re alright. They leave me alone� and �They�re nearly all, alright�.

When we spoke to people they told us they�d no complaints. If they weren�t happy, they said they would explain why to the manager, but they�d never had to do that. People said, �I speak my mind�, �I give �em a bit of a � now and then� and �If I�m not happy, I�d get one of gaffers�.