Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Waterside House 41 Moathouse Lane West Wednesfield Wolverhampton WV11 3HA 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: Sue Woods
Date: 2 8 0 1 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home
Name of care home: Address: Waterside House 41 Moathouse Lane West Wednesfield Wolverhampton WV11 3HA 01902727766 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) : home.wlv@mha.org.uk Methodist Homes for the Aged care home 60 Number of places (if applicable): Under 65 Over 65 0 dementia Additional conditions: 60 The home is registered to provide care for up to 60 service users with dementia. The home must not fall below the following staffing levels: 1 full time Manager 37.5 hrs per week off rota. Early shifts (08.00 - 15.00) 2 x assistant managers/seniro care assistants 10 x care assistants Late shifts (15.00 - 22.00) 2 x assistant managers/senior care assistants 10 x care assistants 1 x shift per week Assistant Home Manager Assistant home manager Night shift (22.00 - 08.00) 4 x night care assistants 1 x senior/manager on call Up to 5 (five) service users aged 55 years plus, other service users must be over 60 years. Date of last inspection Brief description of the care home Waterside is a purpose built residential care home which opened in November 2005. The home accommodates sixty older people with dementia type illnesses. The building is on two floors, with a lift to the upper floor. All the bedrooms have ensuite facilities. The home is split into four units each with its own lounge/ dining area. In addition to there are themed lounges. One of these units is mainly dedicated to support people visiting the home for respite. The home has assisted bathing and showering facilities and uses hoists and other aids Care Homes for Older People
Page 4 of 28 Brief description of the care home to help people with mobility problems. The home has a large enclosed garden and is situated in a quiet residential area approximately one mile from Wednesfield shopping centre. The service is run by Methodist Homes for the Aged but welcomes people of any faith or culture. The responsible individual is Carol Artis and the registered manager is Ms Sharon Gentle. Formal consultation with people who live at the home takes the form of regular surveys that also seek the views of relatives and their representatives. Residents and relatives meetings enable people to discuss issues and make suggestions for improvement and the senior management team also meet regularly to discuss arrangements within the home. People who use the service and their representatives are able to gain information about the home from the Statement of Purpose and Service User Guide. Additional information is contained within the Welcome Pack that also contains details of fees charged and what is included in that fee. Inspection reports about this service can be obtained direct from the provider or are available on our website at www.csci.org.uk 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 quality rating for this service is 2 star. This means that people who use this service experience good quality outcomes. The unannounced key inspection of the Waterside House took place on 28th January 2009.The inspection lasted just over 7 hours. The inspection reviewed all twenty two of the key standards for care homes for older people and information to produce this report was gathered from the findings on the day and also by review of information received by CSCI prior to the inspection date. A quality rating based on each outcome area for service users has been identified. These ratings are described as excellent, good, adequate or poor based on findings of the Care Homes for Older People
Page 6 of 28 inspection activity. As part of the inspection we, the commission, met and spent time people who live at Waterside House. We spoke at length with six people and spent time observing practice when it was not possible to speak directly with people. We also spoke with ten staff on duty and with the registered manager. We also spoke with three relatives who were visiting the home at the time of the inspection. At the start of the inspection we left surveys for people to complete if they wished to make comments towards the inspection. Ten were completed and returned from staff, two from relatives and one from a health care professional. We looked at four care files in detail and extracts were seen from others. Two staff files and other records referred to within the report were also seen. Prior to the visit taking place we looked at all the information that we have received, or asked for, since the last key inspection that took place on 6th February 2008. This included notifications received from the home. These are reports about things that have happened in the home that they have to let us know about by law, and an Annual Quality Assurance Assessment. (AQAA). This is a document that provides information about the home and how they think that it meets the needs of people living there. What the care home does well: What has improved since the last inspection? Since the time of the last inspection of Waterside House significant changes and improvements have been made within the home to improve the overall quality of the service provided. The manager has prioritised areas for improvement and actioned them. A major improvement was achieved by splitting the home into four individual wings Each wing has a dedicated staff team and staff fell that they now know more about the people they support and can offer more consistency which helps the people they support. Medication arrangements within the home have also improved with the moving of the room where they are kept and separating medication into separate trolleys for each Care Homes for Older People Page 8 of 28 wing. The new room has given staff more space and so they can be better organised and medication recording has also improved. Regular in house and external audits have maintained this standard and as a result people receiving medication are protected by safeguards to ensure they receive the medication that they need when they need it. Care plans have also improved and they are now developed around the identified individual needs of the person and reflect peoples current and changing health and social care needs. Staff training opportunities have improved with records showing staff attend all required training and are receiving regular updates to ensure they are confident and competent to do their jobs. A relative of someone living at the home thought that Laundry has improved and as a result I always find my relative in her own clothes. A health care professional though that Staff morale has improved and varied activities introduced. All of the above improvements were also reflected by staff comments and written feedback at the time of the inspection. They also felt that the appearance of residents and the standard of cleanliness within the home had also improved. These improvements will enhance the quality of the lives of the people living at Waterside House. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 Care Homes for Older People Page 9 of 28 240 7535. Care Homes for Older People Page 10 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 11 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. People who may like to live at Waterside House, or their representatives, are provided with sufficient information by the home prior to moving in to enable them make a decision as to whether the home will be able to meet their needs. People living at Waterside House have an individualised care plan to enable staff to meet their care and support needs, as they prefer. Evidence: We met the person who had most recently moved in to the home and looked at the information that the home had in order to help them assess and meet his personal care needs. Staff felt that his move had been successful and his assessment suggested he was appropriately placed and that the home had summarised his assessed needs and developed a care plan to show how they could support him. All four files seen contained assessment summaries that showed the home had assessed peoples needs
Care Homes for Older People Page 12 of 28 Evidence: prior to them moving in. People are involved in the assessment process as far as they are able. The home provides good information in writing to people prior to their admission. The service user guide was very easy to read and informative of the services offered at the home. A welcome pack contains additional information to people about fees charged. The home does not offer intermediate care. Care Homes for Older People Page 13 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. The personal and health care needs of the people who live at Waterside House are met enabling them to have a good quality of life. People are safeguarded by the homes system for handling, storing and administering medication. Evidence: People who live at Waterside House and were able to talk with us were very complimentary about the care that they receive. A visitor commented that staff are always pleasant with residents and relatives and always informative about residents. Through observations and from feedback it was evident that people are treated with respect. Care is offered discreetly and in private. Staff were sensitive to the needs of people and no one was hurried or rushed. Decisions made by people as to where they wanted to sit were respected and staff responded promptly when people were calling them or were distressed.
Care Homes for Older People Page 14 of 28 Evidence: A relative said he was very happy with the home and he would be happy to come and live here himself. He particularly liked the attention to detail for example his wife is always clean and well dressed. She also has her nails done. Four care plans were reviewed in details as part of this inspection and extracts were seen from others. Plans focussed around individual needs and likes and dislikes were well recorded, as were individual preferences as to when and how care and support is to be given. Care files seen were well organised and up to date. There was clear evidence that they are regularly reviewed by the senior team. Staff were knowledgeable about the content of the care plans and key workers who spoke with us were knowledgeable about the individual care and support needs of the people they worked with. This means that people can be confident that their needs can be met in ways that they prefer. Peoples health care needs were seen to have been recorded and systems were in place to monitor changing health needs. Arrangements for the recording and administration of medication were seen to be much improved. A new medication room has meant that staff have space to prepare medication and storage is appropriate. Detailed monitoring systems are now in place and regular audits are carried out by senior staff. Staff who administer medication have been trained to do so. The administration of medication was well recorded and protocols were in place on the majority of records seen. When they were unavailable staff committed to developing them without delay. The Chaplin who works at the home said that the care afforded to the two residents who had recently passed away was a credit to the home. Both people were well cared for and had all of their needs met. Care Homes for Older People Page 15 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. People who live at Waterside House have opportunities to be stimulated and motivated by the improved range of activities on offer and visitors are welcomed meaning that people living at the home are able to stay close to the people that matter to them. People enjoy a varied diet according to their assessed needs and individual choice. Evidence: People living at Waterside House are able to spend their days as they choose and activities within the home are being improved meaning that people are able to be stimulated and motivated. An activities coordinator has just started work within the home and it is planned that she will work along side the staff team to develop activities as part of peoples daily routines. Staff told us that activities have improved within the last six months. There were minimal activities taking place on the day of the inspection. Only on one wing were people engaged in an activity and they were making valentines cards. People also liked to sing and staff were very active in joining in impromptu sing a longs and also spent time talking with people. Outside entertainers visit the home on a planned regular basis and staff say they are very popular with people living at the home.
Care Homes for Older People Page 16 of 28 Evidence: Visitors to the home told us that they are always made very welcome. Family and friends are welcome to visit at any time and one visitor regularly stays for a meal with his relative. Relatives who spoke with us were very happy with the home. One person said I would be happy to live at this home myself. Residents meetings take place every three months, more regularly if required and provide an opportunity for peoples views to be voiced and listened to. Key workers support people to express their wishes and the home works with an advocacy service if needed. Lists of activities have been put together at these meetings and outings planned as a result. A group of people recently went to the Sea Life Centre and there are trips planned through out the year to different places of interest. People tell us that they like the meals at Waterside House and menus offer a variety of foods on offer each day. The chef told us that he caters for special diets as well as responding to individual requests. The menu seen looked nutritious and varied. Care Homes for Older People Page 17 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. People living at Waterside House are protected by procedures in place for managing complaints and can be confident that their views and concerns will be listened to. People living at the home can be assured that the home operates with their best interests at heart by effectively using local safeguarding procedures. Evidence: Everyone we spoke with at the time of the inspection were more than satisfied with the service that they receive. They also knew what to do if they had any concerns and complaints. The homes Annual Quality Assurance Assessment (AQAA) states that over the last twelve months the home has received twelve complaints. The manager deals sensitively and professionally with complaints and people are happy to approach her with any concerns. The home also supports people to make comments anonymously by providing forms and envelopes in the main reception. All staff complete Adult Protection Awareness training and records showed that staff refresher training in this area is also being offered. The manager has worked with health and social care professionals to investigate safeguarding referrals made to the adult protection team. Four incidents have been referred in the last twelve months. The only outstanding investigation was referred by the home to the team and they have implemented safeguards to protect the person.
Care Homes for Older People Page 18 of 28 Care Homes for Older People Page 19 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. Waterside House is clean and well maintained providing the people who live there with a comfortable place to live. Evidence: At the time of the inspection we found the home to be clean and tidy. Bedrooms seen were spacious and personalised. The corridors of one wing were being decorated and workers were seen to be being very respectful of people walking past and were happy to move and remove floor protection sheets to ensure people did not trip over them. Bedroom doors are painted in individual colours and pictures of people are posted outside each room to help people recognise their rooms. Staff also said that colour schemes and matching floor covering and bedding through out the home have been developed to further assist people to know where they are. The manager has further plans to systematically redecorate the home. A relative commented Glad to see the decorators in. Laundry arrangements within the home are an area where relatives, staff and managers all said have improved. We spoke to the staff member who was working in the laundry and she was very knowledgeable of infection control procedures. Surveys completed by staff also showed that cleanliness of the home and decoration
Care Homes for Older People Page 20 of 28 Evidence: are both areas where improvements have been noted. The Environmental Health Officer visited the home in January 2008 and awarded them 4 stars. Care Homes for Older People Page 21 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. The people who live at Waterside House receive good care and support from well trained, well supported and committed staff team enabling their needs to be effectively met within the home. Evidence: Everyone who we spoke with said that enjoyed working at Waterside House. They felt they had good support and training opportunities and the recent unitisation of the home had meant that staff could get to know the people they supported really well and thus be better able to meet their care and support needs. Staff gave examples of ongoing training courses and the training matrix and certificates seen at the time of the inspection reflected that mandatory training takes place and is updated when required. The majority of staff have attended dementia training and there is additional more specialist training being offered in the near future by staff who have been trained to be trainers. Staff files are well organised and contained all required information. The manager is aware of her responsibility in carrying out pre employment checks before anyone can work at the home. Care Homes for Older People Page 22 of 28 Evidence: Staff receive formal support from a named member of the senior team on a regular basis. Staff said they were very happy with the support they receive from both the manager and the Chaplin of the home. A new member of staff to join the team said she had started her on line induction programme and was finding it relevant to her job. Staff felt that staffing levels were adequate although feedback through the questionnaires said that staffing at night was not. The manager said she had already identified this as a need and from April 1st 2009 there would be a fifth staff member on duty throughout the night. People who spoke with us said that care staff were lovely. A visitor said staff are always pleasant with residents and relatives and always informative about residents. Observations made at the time of the inspection reflected that staff are polite and courteous, respecting peoples privacy and dignity while carrying out personal care tasks and not rushing people when moving from one room to another. People smiled when staff spoke with them. People called out when they wanted staff support and staff responded immediately. Staff files were well organised and contained all required information. Care Homes for Older People Page 23 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 people who live at Waterside House benefit from being supported by an approachable and caring management team enabling them to lead a good quality of life. The health and safety and welfare of people living at the home and the staff team is promoted and protected People living at the home can be assured that the home operates with their best interests at heart by having effective procedures to safeguard peoples money. Evidence: The impact of the new manager at Waterside House has been significant. She is motivated and dedicated to improving standards within the home. She is respected by staff. One person said she is stabilising the home, has a list of priorities and is good with staff. She has high expectations.
Care Homes for Older People Page 24 of 28 Evidence: The home carries out regular health and safety checks and any issues are reported directly to the manager. Audits are carried out on a regular basis as per the organisations requirements and the managers audits are checked by senior managers. As a result high standard are maintained within the home meaning people are safe and well supported. The home has an effective quality assurance process that enables people living at the home and the relatives and advocates to express their wishes informally and formally. People feel that they are listened to. The home has a fire risk assessment and regular checks are carried out of safety equipment. This ensures that peoples safety can be promoted and people are protected in the event of a fire or other serious incident. The home keeps detailed records to account for any money that they hold on behalf of people living at Waterside House. As far as possible relatives manage money for their family member. When the home does hold money, amounts are recorded and any spends are signed by two staff members. Records are monitored by the manager for additional safeguards. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 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 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 27 of 28 Helpline: 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 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!
