Inspection on 12/05/09 for Washington Grange

This is the latest available inspection report for this service, carried out on 12th May 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Washington Grange 30/05/07

Washington Grange 20/06/06

Washington Grange 27/09/05

Washington Grange 05/05/05

Washington Grange 21/12/04

Washington Grange 17/06/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Washington Grange Burnhope Road Barmston Washington NE38 8HZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Eileen Hulse     Date: 1 2 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 28 Information about the care home Name of care home: Address: Washington Grange Burnhope Road Barmston Washington NE38 8HZ 01914191955 01914170100 washingtongrange@barchester.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Barchester Healthcare care home 40 Number of places (if applicable): Under 65 Over 65 40 40 dementia old age, not falling within any other category Additional conditions: 0 0 The maximum number of service users who can be accommodated is: 40 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 categories: Old age, not falling within any other category - Code OP, maximum number of places: 40 Dementia, over 65 years of age - Code DE(E), maximum number of places: 40 Date of last inspection Brief description of the care home Washington Grange owned by Barchester Healthcare Limited is a purpose-built care home situated on the edge of the Barmston housing estate in Washington. The home is close to a local health centre, pharmacy and a social club. A short walk to the nearest bus stop provides access to the Galleries shopping centre and all its amenities, Sunderland City centre and to other parts of the surrounding areas. The home is a two-storey building offering single bedrooms with en-suite facilities that are easily reached by a passenger lift and stairways. There are 19 bedrooms for older Care Homes for Older People Page 4 of 28 Brief description of the care home people on the ground floor and 21 bedrooms for older people with dementia care needs on the first floor. There is a range of bathrooms and showers, WCs, lounges and dining rooms on both floors. All parts of the building are easily reached. The home cannot provide nursing care. The weekly fees are #412:00 to #564:00 per week depending upon care needs. Additional charges are made for personal items, hairdressing, and toiletries. Care Homes for Older People Page 5 of 28 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: The last inspection on this service was completed on 12th March 2008 This is an overview of what the inspector found during this inspection The quality rating for this service is 2 STAR. This means that people who use this service experience good quality outcomes. How the inspection was carried out. Before the visit we looked at information we have received since the last visit on 12th March 2008; Care Homes for Older People Page 6 of 28 How the service dealt with any complaints and concerns since the last visit; Any changes to how the home is run; The providers view of how well they care for people; The views of people who use the service their relatives and staff. During the visit we observed staff practices and talked with people who use the service and looked at how well their needs are met; We looked at other records which must be kept; Checked that staff had the knowledge skills and training to meet the needs of the people they care for; We looked around the building to make sure it was safe clean and comfortable and checked if any improvements had been made. 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 set out 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 28 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 28 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. Good assessments are included within the plans of care for all service users that help to form the basis of the individual care plan. This ensures that before admission takes place the home is able to know if the care needs can be met by them. Evidence: All service users currently living in the home have had needs assessments carried out by a care manager and the manager of the service, prior to their admission. When a vacancy occurs, a care manager makes a referral to the home and the prospective service user makes several visits, either having a meal with the people who live there and spending some time in the home and in some instances an overnight stay is offered. Care Homes for Older People Page 10 of 28 Evidence: This gives the person the time to decide if they would like to move in and ensures the correct equipment and care plans are made available prior to their admission. The homes admission and assessment procedure ensures that people have an informed choice about moving into the home. They are given information before visiting the home that informs them how their care needs are to be met. Following admission, each service user has a care plan developed from information gathered during the assessment, so that when followed by staff, it helps the care needs to be met on a daily basis. The person lives in the home for six weeks to see if they want to live there permanently and to ensure the home can meet their needs. This period is followed with a review meeting held between the service user and their representatives, the home staff and the care manager. In discussions with visitors they confirmed they had attended a meeting. Comments they made included, The home were very good and made sure my mam was happy and we were happy about her living there I was given lots of information and any questions I asked were answered by the staff Always somebody around to answer any questions I have I am kept fully informed of what is happening and how my mam is but sometimes clothing goes missing. Care Homes for Older People Page 11 of 28 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. Service users living in the home have individual plans of care, however, they are not fully completed and therefore do not give staff the guidance they need to ensure that the care needs are met. Evidence: All service users have an individual care plan that is completed by staff and gives the staff guidance on how the care needs of people living in the home will be met . The care plans were organised and included areas such as medical histories, personal information, healthcare and assessment details but the day to day care plans did not include enough information to inform staff if the care needs are met everyday. One care plan stated that (name) will shout out for long periods of time and that the person can become anxious and depressed but there was no detail to tell staff how to manage this situation; another area of the care plan discussed the personal areas of care but did not state if the person preferred a bath/shower or preferred bathing times Care Homes for Older People Page 12 of 28 Evidence: and the risk assessment in this area did not refer to the care plan at all. One person had a serious health complaint that had to be dealt with on a daily basis but it was not referred to at all within the plan of care. One care plan had various sentences such as minimise difficulties, does not go to bed and encourage to socialise but gave no instruction on how staff were to deal with these areas in order to meet the needs. Risk assessments are linked to each individual plan of care but again information is limited and does not always apply to areas of the care plan. There are regular visits from local GPs and other healthcare professionals such as district nurses, chiropodists, dental service and opticians. Service users needing to attend to hospital out patient appointments are escorted by a member of staff or if the person prefers a family member. The home uses a monitored dosage medication system that is delivered to the home on a monthly basis, at the same time any un-used or un-wanted medicines are returned to the local pharmacy. Medicine administration records were signed and up to date and a medication audit confirmed medication held by the home was correct. Administration of the lunchtime medications was observed, this was carried out in line with the homes medication procedures. Care Homes for Older People Page 13 of 28 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. A range of social activities are made available and this gives service users the opportunity to exercise some control over their daily lives and provides social stimulation, however, they need to be more varied to give a range of choice for the people living in the home. Service users are offered nutritional and wholesome food choices but the dining room arrangements need to be reviewed to ensure it is a positive experience for people. Evidence: An activity co-ordinator is employed by the service seventeen hours per week to provide social activities every day and to organise social events for service users. A notice board is up on the wall so that service users and their friends and families are kept informed of events taking place. It shows there are various entertainments organised but the activities programme is not very varied and shows a limited amount of activities, such as every morning watching television, jigsaws and hairdresser. During the visit some service users were decorating cakes to raise funds for the Barchester Foundation. All activities are recorded on a daily basis so that staff know Care Homes for Older People Page 14 of 28 Evidence: who has attended them. During the visit time was spent chatting with some of the people who live in the home and their comments included the following, I have been here a few weeks and up to now I am quite happy I have a canny room and dont have any complaints Sometimes it bothers me that I dont get out now The staff are all very nice and they are helpful I think at times I do miss my own home We dont go out much its very poor in that area During the visit, a lunchtime meal was taken with service users and it staff were observed being very helpful and attentive to people requiring assistance throughout the meal in a discreet and sensitive manner. However, the lunch was served late, as prior to the lunch being served, the cutlery was not very clean and had to be collected in and re-washed, as it was stained and dirty. Tables were set with tablecloths, serviettes and condiments but there were no milk jugs or sugar basins on the tables and one service user had to use a dessert spoon to put sugar in her cup of tea and was unable to stir it. There were no teapots on the tables and tea was served from a large communal teapot which is not safe and does not allow service users to maintain the skills they have. A choice of cold drinks were offered to people, as well as a choice of hot drinks and service users are given two choices for their main meal and plated meals were shown to service users by the staff to enable people to make a choice. The dinner was hot and well presented but the choice of meal offered was limited as both meals were very similar, sausage or irish stew mashed potatoe and vegtables and the sweet consisted of banana or apple with custard. No extra servings were offered and one service user at the end of her meal stated she was still hungary but would get something when she got home. Care Homes for Older People Page 15 of 28 Care Homes for Older People Page 16 of 28 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. Service users and their families have the information they need should they have a concern or complaint about the service and good safeguarding policies and procedures are available, which help to protect service users, should an abuse situation arise or be suspected. Evidence: The home has a complaints policy and procedure that is followed whenever anyone has a complaint or concern about the service. It is given to service users and their representatives before moving into the home and tells them how to make a complaint and the length of time it will take before a response is received. it also tells the complainant how the service will deal with the complaint. Staff have received complaints training and protection of adults training and in discussions with them it was clear they would know what to do should an abusive situation arise or a complaint be received whilst they were on duty. All complaints are clearly recorded by the person receiving the complaint and includes the nature of the complaint, the complainant details and the outcome of the complaint. Compliments about the service are also recorded. Care Homes for Older People Page 17 of 28 Evidence: Safeguarding procedures are made available to staff so that they know what to do should they suspect an abusive situation has arisen. Service users were aware of how to make a complaint if they were not happy and they were all confident thet the manager would sort it, one service user stated we have a very good manager who is the same with everybody. Care Homes for Older People Page 18 of 28 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. The home is clean, well maintained and a number of home improvements have been made since the last inspection which ensure that service users are offered a comfortable and safe place to live. Evidence: The home is a purpose built property offering accommodation in a homely setting. There are a variety of communal areas for service users to choose from and the large entrance area is a popular space where service users can see the comings and goings of the home. A large number of improvements have been made to the home in recent weeks, all corridors and lounges have been redecorated, furniture in the upstairs lounge has been replaced and carpets have been replaced in several areas of the building including the conservatory and upstairs lounge. A handyman is employed by the service for twenty five hours a week to ensure all maintenance issues are addressed quickly and effectively and that checks and schedules are completed when they need to be. There are large, well maintained gardens with ample seating areas that are used Care Homes for Older People Page 19 of 28 Evidence: regularly in the summer months by service users and their families. Care Homes for Older People Page 20 of 28 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. Staff are well trained and competent and good recruitment procedures ensure that service users are kept safe and that they receive a good quality of care. Evidence: The duty rota reflected the numbers of staff on duty on the day of the visit and the staffing levels were adequate to meet the current needs of service users. The staff on duty included one senior care, four care staff with an extra member of staff on duty from lunchtime through to after tea, new staff are supernumary to the rota and shadow a member of staff for three days as part of their induction training. Most of the care staff currently employed in the home have achieved an NVQ qualification in care. The manager uses a training matrix that identifies the training needs and shows training that has taken place for members of staff and confirms that all the necessary mandatory training had been completed and iss up to date. Inspection of the staff files for two members of staff recently recruited was carried out. Both personal files were organised and kept up to date and the information included all of the necessary documentation that the home is required to keep, such as job application, interview, references, personal identity and criminal record bureau checks. Care Homes for Older People Page 21 of 28 Care Homes for Older People Page 22 of 28 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 well managed by a person who is appropriately qualified and shows strong leadership skills. Risks to the health and safety of people are minimised. This ensures that the home is run in the interests of people using the service and they are kept safe. Evidence: The home is well managed by a person who is appropriately qualified. They are very competent and have strong leadership skills in managing a staff team, which ensures risks to the health and safety to people are minimised. This makes sure the home is run in the interests of people using the service and they are kept safe. Staff meetings and service user meetings are held every four months and minutes are taken and recorded. However, advice was given to hold meetings more regularly. During service user meetings relatives and friends are also invited to attend. Care Homes for Older People Page 23 of 28 Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 7 15 The manager ensure that the 01/09/2008 care plans set out in detail the action needed to be taken by staff and must include monitoring and evaluation to ensure the content is up to date (Previous timescale of 01/08/07 not met) (Previous timescale of 01/09/08 not met) 2 7 12,13,15 The manager must ensure the care plans have all the relevant information to ensure the needs of service users is met. (Previous timescale of 01/08/07 not met) (Previous timescale of 01/09/08 not met) 01/09/2008 Care Homes for Older People Page 25 of 28 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 7 15 Risk assesments must include up to date information This will ensure service users are kept safe 17/07/2009 2 7 15 Care plans must include all details regarding the care meeds of service users To ensure staff are made aware of the needs to be met 14/08/2009 3 15 12 Dining arrangements need to be reviewed and changes made to ensure it is a pleasant and social occasion for service users 18/08/2009 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 Care Homes for Older People Page 26 of 28 1 38 Manager advised to hold staff and service users meetings on a more regular basis to ensure service users and staff are kept up to date with information Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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!