Inspection on 19/05/08 for Walmer Care Centre

This is the latest available inspection report for this service, carried out on 19th May 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Walmer Care Centre 8/10 Marine Road Walmer Deal Kent CT14 7DN Lead Inspector Julie Sumner Unannounced Inspection 19th May 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Walmer Care Centre Address 8/10 Marine Road Walmer Deal Kent CT14 7DN 01304 366447 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) carletonmead@tesco.net Nicholas James Care Homes Ltd Manager post vacant Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies 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 categories: 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 37. Date of last inspection N/A Brief Description of the Service: Walmer Care Centre is registered for up to 37 people over the age of 65 requiring residential care. Walmer Care Centre comprises of two attractive buildings next to each other that are called Carelton Lodge and Carelton Mead. These are divided by an access drive to a private property further back. There is a large front garden/car parking area, which is accessible to service users. A smaller, but attractive garden is also accessible to the rear of the home. The premises benefit from a lot of communal space ensuring residents can participate in the organised activities, socialise, eat meals and find some quiet time in comfort. The home is on the Deal seafront around 1/2 mile from the centre of the town. Deal is an attractive seaside town with good amenities and public transport links. There is a range of shops, pubs and restaurants in the nearby vicinity. Current weekly fees are in the range of £320.37 to £661.50 with additional charges for newspapers, hairdressing, chiropody and toiletries. The statement of purpose and service user guides are available from the home. The inspection report is freely available to all who wish to read it and can be obtained from the CSCI website. Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This report is based on information received about Walmer Care Centre including an annual quality assurance assessment (AQAA) completed by the manager and an unannounced site visit to the home lasting around 7 hours. Information was gathered for this inspection in a variety of ways both prior to and during the visit to the home. Surveys have been sent out to residents, relatives, staff and visiting professionals. Those returned have been taken into account in this report. The visit included talking with residents, the manager, staff and some visiting relatives. General observations were made during the day of how people are supported. There was a tour of the building and various records were inspected. The people living in Walmer Care Centre were able to participate in the inspection by having conversations about their lifestyle and completing the surveys prior to the visit. It was not necessary to make any requirements or recommendations at this time as the new owner, responsible individual, area manager and deputy manager know what the issues are and have plans in place to address them. What the service does well: Clear assessments are carried out to make sure that people moving into the home can have their needs met. Care plans are clearly written giving a good impression of what is important to each person and how they would like to be supported. Residents said they enjoy the food and they like the choice of drinks they can have also. Residents said that they are well looked after and that staff are kind and know their likes and dislikes. Residents said that they feel safe. Staff interacted with the residents and each other in a calm and cheerful manner. Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 6 The manager involves the residents in the planning and development of the home. Residents can see that their suggestions are put into action. What has improved since the last inspection? What they could do better: The home is showing signs of wear and tear and various areas need refurbishment to make it an attractive and comfortable place to live. The plan to improve the environment has started and areas of priority have been identified. None of the bedroom doors and fitted with locks. The area manager said that this would be included on the refurbishment plan. This will make sure that each person has privacy when they want it. The majority of the staff team are experienced carers who have received training in health and safety and other areas required by law. Some of this training needs updating. The managers have prepared a new training matrix and training is being updated. Training is also being arranged to provide staff with other skills to reflect current practice and the changing needs of the people living in the home. This will make sure that the health and welfare of residents and staff will be promoted and protected. Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 7 The existing call bell system is not sufficient for the needs of the people living in the home. The call bells need to be in reach so that residents can use them in different parts of the room and be safe. The new owner had identified this before the inspection and a new call bell system has been ordered. The home has not had radiator covers fitted to protect the residents from the hot surface areas. The area manager explained that as soon as the owner bought the home this was discovered and they have been ordered and will be fitted as soon as possible. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Admissions are not made to the home until a full needs assessment has been carried out. Prospective individuals are given the opportunity to spend time in the home. EVIDENCE: Copies of the statement of purpose and service user guide were seen and have been updated to give current information. Two of the people living in the home spoke about their experience of moving in and said they had been well supported. A pre-assessment is carried out in the person’s own home, hospital or previous placement. The service user plan is based on this assessment and what the person tells them when they move in. Further assessments are completed as the service user plan is compiled and everyone gets to know each other. Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The staff team meets the health and personal care needs of the service users and their privacy and dignity are respected. EVIDENCE: A sample of 4 care plans were viewed and later discussed with the area manager and the responsible individual. The sample included 2 new residents and 2 people who have lived in the home for some years. Residents spoke positively about their lifestyle during the inspection visit. The home are introducing a new care plan format. Information was clearly presented in both formats. The new style contains more depth of information and the information is well organised and sectioned out. District nurses visit the home every 6 months. They check the general observations and assessments the care staff have made, to make sure that each person has received any medical intervention required. Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 11 Staff have all been updated with medication training. The home has a new administration procedure. Medication pods are going to be fitted into all the bedrooms in Carleton Mead. A new medication trolley has been purchased for Carleton Lodge. Part of the medication administration round at lunchtime was observed. The home uses a monitored dosage system. Controlled medication was seen to be stored and administered in line with the royal pharmaceutical guidelines. Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home are given the opportunity to take part in a variety of activities arranged in the home and are benefiting from more one-to-one activities and opportunities to go out. EVIDENCE: A person hired especially for exercise sessions was supporting residents in Carleton Lodge. In Carleton Mead, residents were having entertainment from a musician. In both parts of the home the people were enjoying these activities. An activities co-ordinator is allocated 10 hours a week to carry out activities with all the residents. She works as a carer at other times of the week. She carries out different activities including bingo, dominoes, and sitting talking one-to-one. Surveys are distributed amongst the residents about the activities provided and the feedback is used to develop the service or provide activities that have been requested. In recent surveys residents said they would like Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 13 more picnics and barbeques in the summer so some have been planned. Staff said families are invited. There were some visitors in the home and residents said there are no restrictions on visiting times. The inspector had lunch with some of the residents who were happy to chat about their lifestyle. They said the food is usually good and complimented the cook. One comment in a survey received: “The cooks are very good and will always give me the dinner I ask for.” Residents can choose when and where to eat if they wish to dine at different times or in their own rooms. One person was sat in the veranda and said that he has all his meals there as he likes to watch the sea view. He said it is very nice and the food is good. Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has an open culture that allows residents to express their views, and concerns in a safe and understanding environment. People living in the home are protected by the policies and procedures in place. EVIDENCE: All residents spoken to said they were happy with the home and were comfortable speaking to the deputy manager or staff. They said they feel safe. The home has a complaints log and the staff confirmed that they take complaints seriously. Surveys are given out to the residents every few months to give them the opportunity to air their views and these have different subject headings rather than general ones about the home. A sample of the surveys were viewed together with the home’s response. It was evident that the home do respond positively to suggestions and concerns. Residents said that the staff make an effort to find out how they are feeling and what they want. Staff spoke about their recruitment experience. The newest member of staff was employed by the previous owner. She confirmed that she had a POVA first check before starting work and her CRB came through 2 weeks later. The new owners have not employed any care staff. The activities part of one of the carers roles is a new addition from the new owner. They are in the process of employing a weekend domestic. The area manager is fully aware of Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 15 POVA/ CRB and safety checks with regard to identity. No staff files were viewed regarding recruitment at this time as it was not considered necessary. The AQAA states that staff have received training in the protection of vulnerable adults (POVA). The training matrix was viewed and discussed with the area manager and training is currently being updated for all areas. POVA training was given priority. Staff said they felt confident to support residents who wished to make a complaint. They said if there was anything untoward or of concern they would report it to the deputy manager. The deputy manager said if necessary she would pass it to the area manager. There have been no safeguarding adults alerts in the last 6 months since the homes have been under new ownership. Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23,24,25,26 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is clean and comfortable and has a programme to improve the decoration, fixtures and fittings. This is with particular reference to those required for the health and safety of the residents. EVIDENCE: The managers showed us around the home and when opportunities came up, left us to speak with residents in private. This allowed us to meet people in an informal way. There is a programme of redecoration, which has started. Parts of the home have been painted and new carpets are to be fitted when the painting is finished. Risk assessments had been completed for the planned refurbishment and these were read and discussed. Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 17 Both homes have more than one lounge or dining area to sit in. Residents spoke of the veranda in Carleton Mead and how lovely it is to sit there and watch the seaside activity. Some of the residents dine there. There are a good number of toilets and bathrooms. The refurbishment of these is also part of the overall plan to upgrade the home. Both homes have stair lifts to the first floor. Carleton Lodge has two tracks at present, as there are two stairways up to the next floor. It is necessary to walk from one stair lift to the other. A new stair lift has been ordered that will go round the turn and go continuously up both staircases to the first floor. At present no one in Carleton Lodge needs to use a hoist. There is a chair lift into the bath. One hoist is used in Carleton Mead. Each person has their own bedroom and they have brought their own furniture if they wanted to. Some people like to spend the majority of their time in their room and these have been furnished to suit their lifestyle. The home has not had radiator covers fitted and they do not have individual thermostats. The owner discovered this when the home was purchased and the covers were immediately ordered. A firm have undertaken to carry out the work. The area manager said they have contracted with this firm before. The area manager was not able to give a timescale when all the radiator covers would be fitted but it was evident that this had been treated as a matter of priority. There are two domestics employed during the week. Another domestic has recently been employed for the weekend and is due to start in the summer. The home looked clean and smelled fresh. Carpets have been cleaned although it has not been possible to remove all the stains on some and the area manager said they are going to be replaced. There is a laundry in Carleton Lodge which is functional and meets requirements. There are risk assessments in place as it is situated in the basement. There is no laundry facility in Carleton Mead and this is a subject of consideration for the owner although there is no easy solution. There are set times for laundry from the two houses to avoid loss and laundry becoming mixed up. Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There is a well established staff team who are motivated to provide residents with a good quality of life. The deputy and area manager are aware that there are some gaps in the training programme and plans to deal with this. EVIDENCE: There is a well established team of staff based in each home. The AQAA stated that some of the staff have worked in the home for over 10 years and some 20 years. Some of the experienced staff spoke in the inspection visit. There are 2 care staff on each shift including nights. The area manager is currently reviewing the staffing levels and routines during all the shifts. Changes made as a result of this, so far, are the introduction of the activities co-ordinator post and changes in staff break times. Residents said that the staff are nice and they have what they want. Three care staff spoke about their experiences in the home. One person spoke about the recruitment process. They have completed an induction and some of the initial mandatory training. Staff were positive about the home and were open to the changes proposed by the new owner and management. The new induction training pack has been designed in line with skills for care. Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 19 The training matrix has been updated and was on office wall. This was viewed and discussed with the area manager who said that the gaps in mandatory training have been identified and training is being arranged. Infection control and medication training have been completed. There is an NVQ training programme underway and staff are also updating mandatory training as part of this. 11 staff have NVQ 2 or above and 11 staff are currently studying NVQ. One staff spoke about her NVQ training and made positive comments about it. Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37, 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The deputy and area manager have good people skills and a clear understanding of the key principles and focus of the service. There is an atmosphere of openness and respect in which residents and relatives feel their opinions matter and where the safety and welfare of residents is most important. EVIDENCE: The area manager and the deputy manager are currently managing the home. A comment in one of the staff surveys received said “service users were attached to the old owner and were upset when they left but this company Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 21 especially management have dealt with it well and deserve credit. More improvements to come with time – its exciting.” The company has an established quality assurance system that the area manager is introducing to Walmer Care Centre and will incorporate the current monitoring processes. The area manager said that completing the AQAA would also be part of this process from now on. The deputy manager completed the AQAA. It was very clearly written giving all the information asked for and included the homes’ plans for improvement. All areas of improvement identified during the inspection visit had already been identified by the new management and were included in the AQAA. Surveys are routinely given out to residents and relatives to gain their feedback on a variety of specific areas including: entertainment and activity in the home, the laundry, staff and key workers and food. There are resident meetings where issues are also discussed. Some of the feedback was viewed and it was evident that the home had responded and made the improvements the residents suggested. Fire risk assessments have been competed for both buildings. The risk assessments are very clearly written with photos are the areas highlighted. Door closures have been fitted and are connected the fire system so that they will automatically close in the event of fire. The home has environmental risk assessments that have been completed. The risk assessments for the first phase of the refurbishment were viewed and cover everything needed. Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 x 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 2 Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Walmer Care Centre DS0000071142.V363337.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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