Inspection on 17/11/09 for The Willows Care Home

This is the latest available inspection report for this service, carried out on 17th November 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Similar services:

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Keer Sands Residential Home

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Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 18/02/2010.

Key inspection report Care homes for older people Name: Address: The Willows Care Home 397 Midgeland Road Marton Moss Blackpool Lancashire FY4 5ED     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: Jacqueline Riley     Date: 1 7 1 1 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: The Willows Care Home 397 Midgeland Road Marton Moss Blackpool Lancashire FY4 5ED 01253762554 08451305625 paul@hatpeg.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Olivia Josephine Care Limited Name of registered manager (if applicable) Mrs Susan Margaret Haughton Type of registration: Number of places registered: care home 13 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: 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 category: Old age, not falling within any other category - OP The maximum number of service users who can be accommodated is 13. Date of last inspection Brief description of the care home The Willows is situated on the outskirts of Blackpool in a rural setting. It is a detached single storey property, providing ten single rooms and one double for up to twleve people who require residential care. Many of the rooms overlook the large garden and orchard and have access directly onto the garden area. All rooms have en-suite facilities including a shower. Care Homes for Older People Page 4 of 25 Over 65 13 0 Brief description of the care home There is a communal lounge and dining area as well as a conservatory. A bathing facility is available with a hoist for people with limited mobility. The home is equipped with aids and adaptations which meet the needs of people living there. The home has a Statement of Purpose and Service User Guide, which includes information about the service, care and qualifications and experience of the owner and staff and what people can expect if they choose to live at the home. Information received on the day of inspecting the service (08/12/09) told us the fees range from £383.00 to £495 per week. Additional costs may be incurred but are included in peoples individual contracts. 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: A key inspection of the home was undertaken which included an unannounced visit to the service on 17th November 2009 and lasted approximately five hours. It was the first inspection of the service since registration with the Care Quality Commission in May 2009. We spoke to a director of the service, four staff members, and a number of people using the service. In addition we received a number of surveys from people using the service. In general the comments were positive and some are included in the report. The care records and other records relating to the care people receive were looked at. We also looked around the home and spent some time talking to people who live there. Every year the person in charge or manager is asked to provide us with written information about the quality of the service they provide, and to make an annual assessment of the quality of their service. This document is called an Annual Quality Care Homes for Older People Page 6 of 25 Assessment (AQAA). We use this information, in part, to focus our inspection activity. Care Homes for Older People Page 7 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 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. There are admission and assessment procedures in place to ensure the care needs of people are being met Evidence: We looked at the records of three people living in the home. We saw they had assessment details from social workers and other healthcare professionals. The information we looked at shows the home is provided with a full history of the care and medical requirements of the person to be admitted so that they know what their needs are and whether they will be able to manage them. In addition the home has its own assessment format which they use to determine how the needs of the person will be met when admitted to the home. Staff we spoke to said they find the information useful and it informs them of the persons individual needs at the point of admission. People we spoke to said they had been given all the information they felt they needed before they came into the home, and that staff had been extremely helpful and made Care Homes for Older People Page 10 of 25 Evidence: them feel comfortable when they arrived. Comments included, they made me feel very comfortable, and showed me around the place so I knew where everything was. 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. Promotion of health is taken seriously, peoples welfare is monitored and their needs are met. Evidence: We looked at the care planning records for three people using the service. We found they have been reviewed were accurate and up to date. There was clear information about individual healthcare needs as well as how those needs are going to be met. The way the records are being developed means staff can follow the information easily. Comments from staff included, we put in a lot of the information about peoples needs onto the records, Other staff told us they find the records easy to follow which helps them maintain and provide the support people need. The records we looked at showed there are individual risk assessment in place, however they are being reviewed and in instances where a high level of risk is identified additional information is in place to show how this is being managed, with review dates for staff to follow. We saw risk is identified in a number of areas including moving and handling, nutrition, falls risk, and environmental risk. All records Care Homes for Older People Page 12 of 25 Evidence: were seen to have regular reviews so risk is being monitored and any changes are clearly recorded. We saw there is a good link between the home and other healthcare professionals, including doctors, district nurses, and social workers. The records we looked at show there is a good record of when people attend appointments and what the outcome is so that the staff team can monitor visits and help staff keep updated on any changes which may occur or any treatment which may be necessary. Staff told us they have good relationships with healthcare professionals, comments included, we have a good working relationship with them, and we share information so nothing gets missed. The way the home manages its medication procedures is good. We saw the home has dedicated storage facilities for all medication used by the home. Records we looked at showed medication is administered by senior staff and that the records were up to date. The three records we looked at showed prescribed medication corresponded with the administration sheets so people were receiving medication as prescribed. During observations made around the home we found two containers of prescribed cream in the bathroom. We say they must be stored with the medication so that it is safe and does not put people at risk. By making observations throughout the time spent at the home we confirmed staff respect peoples privacy and dignity by way of talking to people sensitively, and the way they went about assisting people. Staff spoken to said they would always respect a persons right to privacy and dignity. Comments included, I treat people as I would expect to be treated. We looked at how the home is implementing assessment of Deprivation of Liberty Safeguarding (DOLS) for each person, under the Mental Capacity Act 2005. The aim of this assessment is to identify if a person is being deprived of their liberty in any part of their life as part of their care planning. If this is identified an application for this to be monitored and reviewed must be made. To date there has been no assessment made and this is an area the home needs to consider developing. 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. Social activities and meals provide daily variation and interest for people living in the home. Evidence: We spoke to some of the people living at the home and staff about what the routines are. They told us they are flexible so people can choose how they want to spend their time. We saw people using the communal areas available to them and some choose to stay in their rooms and use the dining area at meal times. Comments included, I like to stay in my room and go to the dining room at mealtimes, where I can have a natter with people. I have everything I need in here its like my own little piece of home. The home is currently developing an activity programme which includes a variety of themes including entertainment, trips out and board games etc. People we spoke to said they had enjoyed a trip to the Illuminations, others said they like to do their own thing. Staff spoken to said they have the time to spend with people and there is now a designated activities coordinator who told us she is currently putting things in place so that people have a range of activities afforded to them. Staff said they respect peoples rights if they choose not to join in. Care Homes for Older People Page 14 of 25 Evidence: We spoke to people about meals in the home. They told us they enjoyed all the meals and the staff know if they dont like something. We spoke to the cook who was preparing lunch. They told us they use fresh ingredients wherever possible and they are provided with information about peoples individual nutritional needs when they are admitted, so they can identify any specific nutritional need if necessary. 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. Complaints are handled well and taken seriously ensuring people feel listened to. Staff have access to safeguarding protocols to protect people. Evidence: We looked at the homes complaints procedure. It is made available to people using the service so they know how to raise any concerns or complaints. Surveys we received told us people know how to make a complaint. People we spoke to said, I havent had to make a complaint but if I had to I would know what to do and who to talk to. We spoke to the owner and senior care about how people are protected and they told us staff receive training in safeguarding people. A staff record looked at showed this has taken place in July 2009. Staff we spoke to told us they are confident in how the home provides information on protecting people. I have received training in this area and know what to do should I suspect any form of abuse. There is one safeguarding investigation ongoing and the owner is working with the investigation team for a satisfactory outcome. One complaint has been made and was found to be unsubstantiated following investigations made. 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. People live in suitably adapted, clean and comfortable surroundings. Evidence: The home is situated in a rural position and surrounded by extensive grounds and an orchard, which people told us was pleasant and they enjoyed the views. We looked around the home during the inspection and found it to be clean and free from any odours. All rooms are on ground floor level with many of the bedrooms overlooking the garden. People we spoke to said they liked using their rooms as they were spacious and they had made them homely. Comments included, I like to have my own things with me and there is space here for that, I like to look out into the garden, I can feed the birds and watch them from the window. There is a large bathroom which has in place lifting equipment for people with limited mobility. All of the rooms have their own shower facilities in place for people to use if they are able to. The home is well furnished and decorated. The owner told us there is ongoing improvement for the interior of the home and this is included in the business planning of the service. People we spoke to told us, I like my room its cosy and I have what I want in it, I like to use my room as I please, its got everything I need. Care Homes for Older People Page 17 of 25 Evidence: There is a communal lounge with a dining area to the side, as well as a conservatory with seating and views over the patio and garden area. There is a range of seating for people in the lounge area so people have choice. There is also a range of mobility aids for people with mobility issues. We checked water temperatures and found them to be satisfactory, so people are not at risk. There have been handrails fitted along the corridors so people can move around the home with support. Comments included, I can get around myself now without relying on staff. 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. The procedures for recruiting staff are good, ensuring the safety and protection of people. People are supported by well trained and effective staff so their needs can be met. Evidence: We spoke to the owner and senior staff about how staff are deployed for the benefit of people using the service. We looked at the staffing rota which showed there are sufficient numbers of staff on duty at any one time so the needs of people living there can be met. We noted there have been some changes in the staff team and the staffing rota reflects the changes made so it is clear who is on duty at any one time and what their role is. We saw that there is a good skills mix on any one shift in order to provide consistent levels of support and for the staff team to develop further. Staff we spoke said they thought they were well supported, and listened to. Comments included, We work well together as a team, we are supported and know who to go to if we need advice. We looked at the homes training records and found this is being developed further so staff have the necessary training , including mandatory training in moving and handling, first aid, health and safety and safeguarding people. In addition all staff Care Homes for Older People Page 19 of 25 Evidence: either have a national care qualification or are currently undertaking training in a qualification. Staff spoken to said they are encouraged to attend training for their personal development. We looked at three staff files. They showed us staff are recruited safely using procedures which take into account, qualifications and experience, their suitability for the role, references, Protection of Vulnerable Adults (POVA), Criminal Record Bureau (CRB), in order to make sure people are protected. We found the recruitment application form asks for a ten year employment history. This should be a full employment history with any gaps explained so that there is a clear history of the applicants previous work experience. 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 home is being run in the best interests of people who live there. Evidence: We found the home is being run on a day to day basis by the owner and senior care staff in the absence of the registered manager. The owner told us he is currently looking at staff skills and experience and utilizing the skills to manage the home. This is a short term measure in the absence of the registered manager. We looked at the systems in place and found they are currently being managed effectively and updated regularly. Staff we spoke to and surveys we received told us people are satisfied with the way the home is run. We looked at how the home gains the views of people using the service and found there are systems being put into place to record comments from people by way of meetings and questionnaires so that the views of people are taken into account. People we spoke to and comments we received told us people are satisfied with the Care Homes for Older People Page 21 of 25 Evidence: way they are cared for. Comments included, I have been here for a while now and I think they do a good job. We saw there is a clear line of management responsibility and staff communicated well with the owner throughout the inspection at the home. By looking at records we saw regular tests and servicing of essential equipment including lifting equipment, electric and fire were up to date. The homes gas certificate was out of date and must be updated so that the system is safe and people are protected. We were informed by the owner that this is to be carried out with immediate effect. 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 All prescribed medication must be stored safely so that people are protected. By storing prescribed creams in the bathroom means that you are putting people at risk. 31/12/2009 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 8 In order to meet the requirements of the Mental Capacity Act 2005, the home should consider implementing Deprivation Of Liberty Safeguards so that people are protected from having their liberty impeded. The home should ensure the application form asks for a full employment history with any gaps explained. 2 29 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!