HomeMy WebLinkAboutCarol Woods 2019-08-30
Community Advisory Committee Quarterly/Annual Visitation Report
County: Orange Facility Type:
Family Care Home X Nursing Home
Adult Care Home Combination Home
Facility Name/Address:
Carol Woods Skilled Nursing/ Carol Woods Health Center
750 Weaver Dairy Rd.
Chapel Hill, 27514
Visit Date: 08/30 / 2019 Time spent in facility: 1 hr 10 min Arrival time: 9:27 X am pm
Name of person exit interview was held with: Melanie Johnson (Nursing) Interview was held: X in Person Phone
X Admin: Gavin Locklear SIC (Supervisor in Charge) Other Staff Rep. (Name & Title)
Committee Members Present: Bill Morgan and Jackie Podger
Report Completed by: Jackie Podger
Number of Residents who received personal visits from committee members: 5
Resident Rights Information is clearly visible: X Yes No Ombudsman Contact Info is correct and clearly posted: X Yes No
The most recent survey was readily accessible: X Yes No
(Required for Nursing Homes Only)
Staffing information clearly posted: X Yes No
Resident Profile Yes/No/NA Comments/Other Observations
1. Do the residents appear neat, clean and odor free? YES
2. Did residents say they receive assistance with personal care
activities? Ex. brushing their teeth, combing their hair, inserting
dentures or cleaning their eyeglasses?
YES
3. Did you see or hear residents being encouraged to participate in
their care by staff members? N/A
4. Were residents interacting with staff, other residents & visitors? YES
5. Did staff respond to or interact with residents who had difficulty
communicating or making their needs known verbally? YES
6. Did you observe restraints in use? NO
7. If so, did you ask staff about the facility’s restraint policies? N/A
Resident Living Accommodations Yes/No/NA Comments/Other Observations
8. Did residents describe their living environment as homelike? YES
9. Did you notice unpleasant odors in commonly used areas? NO
10. Did you see items that could cause harm or be hazardous? YES
11. Did residents feel their living areas were too noisy? See Note Complaint was made by one of the residents
regarding another resident’s very loud verbal
demands and discomforts. The complaining
resident was moved to the other side of the
facility.
12. Does the facility accommodate smokers?
Where? X Outside only Inside only Both Inside/Outside
YES By regulation outside only.
13. Were residents able to reach their call bells with ease? See Note Complaint was made by one of the residents
regarding the unreachability of the call bell. Call
bell in resident room dropped to the floor and
resident in distress was unable to reach due to
paralysis on side nearest floor. Resident called
facility desk at 5AM and call went unanswered.
Resident called another resident outside the
facility and she came over to attend to resident
distress. Staff was present when she arrived.
Gavin and Melanie are aware and complaint has
been raised to the next level.
14. Did staff answer call bells in a timely & courteous manner?
If no, did you share this with the administrative staff?
YES
Resident Services Yes/No/NA Comments/Other Observations
15. Were residents asked their preferences or opinions about the
activities planned for them at the facility?
N/A
16. Do residents have the opportunity to purchase personal items of
their choice using their monthly needs funds?
Can residents access their monthly needs funds at their
convenience?
N/A
N/A
17. Are residents asked their preferences about meal/snack choices?
Are they given a choice about where they prefer to dine?
N/A
N/A
18. Do residents have privacy in making and receiving phone calls? YES
19. Is there evidence of community involvement from other civic,
volunteer or religious groups?
YES
20. Does the facility have a Resident’s Council?
Family Council?
YES
N/A
Areas of Concern Yes/No/NA Exit Summary
Are there resident issues or topics that need follow-up or review at a later
time or during the next visit?
YES Discuss items from “Areas of Concern” Section
as well as any changes observed during the visit
1. Two med carts were unlocked while
unattended. (Wren and Cardinal
Neighborhoods)
2. Staff Huddle Report was left on the
commons room table. The Report
contained resident names and care plan
information.
3. Family member complained she could
not find contact information to report
complaints. A list of regulatory contacts
appeared prominently, but not easy to
find ombudsman information, i.e. who to
call and contact information.
4. Both findings (#1 and #2) were reported
and discussed with Administrator and
Nursing.
This Document is PUBLIC RECORD. Do not identify any Resident(s) by name or inference on this form.
Top Copy is for the Regional Ombudsman’s Record. Bottom Copy is for the CAC’s Records.