Inspection on 21/07/08 for Wardhayes

This is the latest available inspection report for this service, carried out on 21st July 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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.

Other inspections for this house

Wardhayes 17/02/06

Wardhayes 11/07/05

Wardhayes 23/02/05

Wardhayes 15/06/04

Wardhayes 16/03/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Wardhayes Wardhayes Simmons Way Okehampton Exeter Devon EX20 1PY Lead Inspector Anita Sutcliffe Unannounced Inspection 07:15 21st July 2008 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 Wardhayes DS0000032463.V366805.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. Wardhayes DS0000032463.V366805.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wardhayes Address Wardhayes Simmons Way Okehampton Exeter Devon EX20 1PY 01837 52570 01837 55381 kay.westbrook@devon.gov.uk http/www.devon.gov.uk Devon County Council 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) Kathleen Mary Westbrook Care Home 20 Category(ies) of Dementia (6), Dementia - over 65 years of age registration, with number (6), Old age, not falling within any other of places category (9), Physical disability (5), Physical disability over 65 years of age (5) Wardhayes DS0000032463.V366805.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Categories DE and PD for 55 years and over. No more than 5 people falling into the categories PD or PD(E) to be accommodated at any one time No more than 6 people falling into the categories DE or DE(E) to be accommodated at any one time 7th August 2006 Date of last inspection Brief Description of the Service: Wardhayes is a purpose built care home run by Devon County Council. Health care needs are met through the community services, such as district nurse and physiotherapy. The home is situated on a housing estate on the edge of Okehampton. The home provides the following services: the ‘Poppy’ day centre (which does not need to be registered). A ‘Reablement Service’ for five people providing short-term rehabilitation. Accommodation, known as The Firs, for six people who have dementia and who would benefit from a short stay away from home. Accommodation for nine older people who are need support due to general frailty related to their age. Accommodation is over two floors with a shaft lift between floors. The home has a number of disabled access bathrooms and hoists. There is level access throughout the building. The home is staffed 24 hours a day. Each Unit has its own staff and assigned manager. There is a ‘duty manager’ in the home at all times. The fees for Wardhayes are £584 per week, additional charges are made for the optician, hairdressing, chiropody, dentist, taxi fares, hospital care, newspapers/gardens, alcohol, telephone calls, personal telephone installation, TV licence, draw tickets, WRVS trolley shop, mobile clothing shop, mobile book/ gift shop, stationary/postage stamps, fish and chip suppers. Wardhayes DS0000032463.V366805.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 3 star. This means that people who use this service experience excellent quality outcomes. Information about the home has been collected towards this inspection since August 2006. This key inspection included two unannounced visits to Wardhayes. Surveys were sent to people who use the service and staff and we talked with a community psychiatric nurse who has involvement with the home. The annual quality assurance assessment (AQAA) was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service such as now many people are resident and how many staff employed. As part of the visit to the home we looked at all communal areas and several bedrooms. We spoke with several people who use the service and some staff. We also watched staff going about their work and sat in on the sharing of information between one group of staff and the next. We looked closely at the care and support that three people received, speaking with them and looking at their records. The registered manager provided information and we saw the home’s policies and procedures. These inform staff what they should be doing and how they should do it. People who use the service may be described within this report as residents, clients or service users. What the service does well: People are treated with respect and dignity and the care they receive is individual to them. Staff understand the importance of personal choice and work hard to enable people to direct their own care and live as they prefer. The environment is very ‘homely’. With small kitchenettes and separate lounge space for people it is easy to feel at home. There is a good supply of equipment available. This enables people to maintain their independence and helps ensure safety and well-being. The home is spotlessly clean, fresh, very well maintained and well furnished. The gardens are accessible and full of interest. Wardhayes DS0000032463.V366805.R01.S.doc Version 5.2 Page 6 People have activities arranged which promote physical, mental and emotional well-being. Staff take time to ensure life is interesting for people. There are regular trips away from the home, which people said they enjoyed. Staff are well liked, recruited so that they are safe to work with vulnerable people, properly trained and supervised. We were impressed by staff commitment to their work; they took the time to find ways the home might improve. The manager is very keen to uphold people’s rights as citizens and has a good understanding of how to do this. The management of the home is well structured and all staff are fully aware of what is expected of them. What has improved since the last inspection? What they could do better: 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. Wardhayes DS0000032463.V366805.R01.S.doc Version 5.2 Page 7 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 Wardhayes DS0000032463.V366805.R01.S.doc Version 5.2 Page 8 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): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be assured that all necessary information will be sought to ensure their needs are known by the home prior to admission and all are helped to maximise their independence. EVIDENCE: People said through survey that they received enough information before moving in. One person said: “Very good. (The information) defines homes responsibilities”. Another said: “Very well spoken of in the community and I was invited to visit prior to my stay”. We looked at the admission of three people to the home, two to the reablement unit and one to the Firs dementia care unit. In each case there was detailed information available to the home so staff were aware what care and support were needed and so could plan how to provide it. Where the Wardhayes DS0000032463.V366805.R01.S.doc Version 5.2 Page 9 admission was emergency additional information and support from health care professionals was sought. A community psychiatric nurse confirmed that the home was good at ensuring professional help was sought as necessary where needs are more complex. People resident on the reablement (intermediate care unit) said they are helped and encouraged to follow their programme of rehabilitation, which is very structured. We saw them undertaking daily living tasks, such as washing up, which help enable them to regain the skills needed so as to move back to their own home. One person confirmed that all necessary equipment and professional help, such as physiotherapy, is available to them. Wardhayes DS0000032463.V366805.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Peoples’ personal and health care needs are fully met by a professional and caring staff. EVIDENCE: Asked through survey if they receive the care and support they need two people said always and one said usually with comments: “Everyone is very caring” and “Over and above what I could have ever expected”. Asked to score the standard of care one person said ten out of ten and one said nine out of ten. We asked a health care professional who has regular contact with The Firs dementia unit their opinion and they said they had much confidence in staff ability and absolutely no concerns. A person who is resident on the rehabilitation unit confirmed that her planned physiotherapy and exercise Wardhayes DS0000032463.V366805.R01.S.doc Version 5.2 Page 11 programme is always achieved with staff help and support adding: “Staff are experienced, kind and very good”. We looked at the records of care planning at Wardhayes, and attended a staff hand over of information. We found that the care planning was sufficiently detailed and that staff used the plans to inform them about the care they should deliver, updating them and ensuring sufficient detail is included. We discussed the use of alarms and door locks to restrict the movements of individuals. We saw that now, unlike previously, there is sufficient discussion and recorded agreement before a decision is made to use these. The manager has an understanding of new legislation concerning deprivation and restriction of people’s liberty and intends to study this further. We were shown care records on health care needs, specifically that of diabetes, which was insufficient at the last inspection visit. On this occasion the plan of how to deliver the necessary care was sufficiently detailed. We were told that staff have received training on diabetes, catheter care and stoma care from the community nursing team. Asked through survey if they receive the care and support they need two said always one adding: “Everyone is very caring” and “Over and above what I could have ever expected…” and one said usually. Each confirmed they received the medical support they needed. We looked at how the home manages medicines. Where people are able to manage their own risk is properly considered and safe storage provided. We observed one of the senior staff administering medicines. This was done in a very thorough manner. We looked at medication records and found them to be clear, detailed and fully completed. There are two checks by staff that the information written is correct, so as to reduce the likelihood of mistakes. People told us that they are treated with respect and their privacy is upheld. We saw staff knocking before entering bedrooms and people were very complimentary about the staff. Wardhayes DS0000032463.V366805.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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People are fully supported to lead fulfilled and valued lives and maintain their independence. EVIDENCE: People said that there are activities arranged at the home which they can take part in. People who used the service gave some recent examples, which include quizzes, trips out in the mini bus to local beauty spots and ball games/exercise. We saw a programme of activities displayed in the residential unit of the home and staff organising a ball game on The Firs dementia unit. A health care professional who visits the home said staff are good at providing activities. The domestic set up of the home encourages activities, thus maintaining people’s independence. People were observed washing up and laying the table for the meal. People who are at Wardhayes for reablement have a daily programme of activities set for them. They confirmed that they are Wardhayes DS0000032463.V366805.R01.S.doc Version 5.2 Page 13 encouraged and supported to complete the programme. This helps them return to independent living. Choice and independence is strongly supported at the home. One person said: “You can do more or less what you want to do. I can go out when I want”. The manager gave an example of how they supported a person to do as they preferred despite difficulties. The domestic scale of the three units is one way in which individual choices and preferences do not get overlooked. Asked if they liked the food at the home people said: “Very happy”, “Excellent food and menu for all needs” and “Very good food”. People confirmed that there are three choices of main meal and we saw that the dining areas were attractive, extremely clean and provided the opportunity for social interaction, rather than just eating for the sake of it. We saw no visitors to the home but were assured by people that they are always made welcome and there are no visiting restrictions. Wardhayes DS0000032463.V366805.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are safe and any concern is properly addressed. EVIDENCE: There is information about how to complain in the Service User Guide. People said through survey that they knew who to speak to if not happy and how to make a complaint. One person added: “Had no cause to”. Staff said they knew how to respond if a person, their family or friend has concerns about the home one adding: “Listen carefully to their concerns. Always refer them to my manager as quickly as possible”. People we spoke with about making complaints said: “Very pleased. Absolutely no concerns” and “No concerns at all. I would talk to the manager”. The Commission have received no complaints about the home. We looked at how staff are supported to protect vulnerable people who use the service. We found that the Whistle Blowing policy (how to report concerns outside the home) was kept in a file in the office and therefore not very open to staff who may wish to consult it in private. Nor did it clearly state that concerns could be taken outside the home and that staff who alert concerns are protected by law. Neither did it contain the contact details for the local Wardhayes DS0000032463.V366805.R01.S.doc Version 5.2 Page 15 authority Safeguarding team, although many other contact numbers were available. The manager had made those changes by the second inspection visit. We saw that communication and relationships within the home are relaxed and informal. We also found staff to be extremely professional in their approach to the work and clear that bad practice would be dealt with promptly. There have been no concerns raised about the home. Wardhayes DS0000032463.V366805.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 & 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People benefit from a home which is well furnished, very clean, well maintained, domestic in style and contains all necessary equipment to promote independence. EVIDENCE: We spoke with people resident at the home and visited some bedrooms, all communal rooms, the laundry and the garden. The home was warm, clean, fresh, domestically furnished and appeared well maintained. The bedrooms are spacious. People said that their room was comfortable and contained everything they wanted. The bathrooms are well equipped and nicely decorated. Staff and people who use the service said they have all the equipment they need and we found the standard of equipment was high. It Wardhayes DS0000032463.V366805.R01.S.doc Version 5.2 Page 17 including specialist baths, seated weighing scales and adaptations which help people to be independent. People benefit from a variety of communal spaces, which include small dining areas and kitchenettes. These lesson the impact of shared living. The lounge and dining rooms appeared very ‘homely’ and comfortable. One lady said how she liked to spend time in the conservatory. The laundry equipment fully meets the needs of the home. The laundry was clean and orderly. Staff confirmed that they use a non-touch system for handling soiled laundry, they have protective clothing available for use and all receive training in the control of infection. These measures help prevent cross infection. The gardens are well tended and attractively laid out. One section is a sensory garden. There is level access so that people with poor mobility are able to use them. Wardhayes DS0000032463.V366805.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from a staff which is properly recruited, trained, competent and for the most part in sufficient numbers to meet people’s needs. EVIDENCE: People who use the service said of staff: • “Always attentive and ready to help”. • “The staff are all very helpful”. Two people said that staff are always available when needed and one said they usually are. We saw no evidence of needs unmet and the atmosphere was relaxed and unhurried during the two visits. However, staff interviewed felt that there were not always sufficient staff to provide a good level of service one adding: “We could do with extra staff at times when we are doing group activities with clients i.e. playing games or taking them out for trips etc.”. Staff said they received adequate training when they were new. One added: Everything concerning the job was covered fully by having 2/3 induction days and two shadow shifts. I feel free to approach other members of staff for advice or assistance. Another said: “Like all occupations caring has to be Wardhayes DS0000032463.V366805.R01.S.doc Version 5.2 Page 19 ‘done’ in order to fully understand all that is needed by clients and their carers”. Staff said the training they receive is good with comments including:Plenty of courses and advice offered”. Staff spoke of their training, which included: protection of vulnerable adults, safe handling of medicines, dementia care and first aid. A community psychiatric nurse confirmed staff ability to provide a high level of care to people with dementia and we saw no evidence to suggest that staff are not competent and well trained. Some staff are trained as NVQ (National Vocational Training) assessors, so they are able to help other staff achieve qualifications. The manager reports that no staff are employed under the age of 18 and all management staff are over 21, over 50 of staff have NVQ (National Vocational Qualifications) in care and there has been no need to use agency staff to meet staffing shortfalls. Staff confirmed through surveys that all safety checks were completed before they start employment at the home. This protects people from staff who might be unsafe or unsuitable to work with them. Wardhayes DS0000032463.V366805.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, 35 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is run by a committed management that puts the best interest of people who use the service as the priority and looks for ways to continually improve what is provided. EVIDENCE: The Registered Manager at Wardhayes is Kay Westbrook. Mrs Westbrook is qualified and competent to fulfil this role. She ensures that her knowledge is kept updated through training, which has recently included dementia care, deprivation of liberty and domestic violence and the support of staff. Wardhayes DS0000032463.V366805.R01.S.doc Version 5.2 Page 21 Mrs. Westbrook and staff approach to their work is very professional. They look for ways to improve the service provided. One staff had sought information on fall prevention and brought this to the home for discussion. One staff said through survey: “We make every effort to help clients feel at home. Because our staff work very well together we all talk to each other about aspects of concern to all clients. We seek each others help if necessary. Our managers’ emphasis that our clients’ needs must always come first and we all work hard to make sure they do. Wardhayes is the best place I have ever worked”. People are asked to complete surveys so the quality of the service can be assessed. There are also regular meetings for people who use the service and staff. Staff have regular supervision of their work and the key working scheme helps for a better knowledge of a person’s needs. The manager confirmed that there are no changes in the management of finances on behalf of people who use the service. These systems include keeping receipts and noting all transactions. The manager confirmed that the provider keeps no persons money within business accounts. We saw regularly reviewed risk assessments and the manager said she is currently completing a fire evacuation plan as part of the fire safety management strategy. Staff receive regular health and safety training such as moving and handling and first aid. We discussed the safe handling of cleaning chemicals in the home which were seen stored in unlocked cupboards easily accessible to people who might be confused and be put at risk. This was made safe immediately. We saw no other risk through the two visits. There were only positive comments received about the management of the home and the way the home operates. Wardhayes DS0000032463.V366805.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 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X 3 X X 3 Wardhayes DS0000032463.V366805.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 Wardhayes DS0000032463.V366805.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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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