Please wait

Inspection on 12/11/08 for Wellesley House Nursing Home

Also see our care home review for Wellesley House Nursing Home for more information

This is the latest available inspection report for this service, carried out on 12th November 2008.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service has good pre admission procedures ensuring that people have the required information about care needs and the service prior to moving in. Staff have a good knowledge of how to deliver the individual care needs to people. The home is comfortable and clean and provides a good environment in which to live. People living at the home stated that the staff and food are very good. Visitors to the home commented `The care is wonderful, no concerns whatsoever, the staff have been very good to mum and to us as well. Cant speak highly enough of the owner and her staff`.

What has improved since the last inspection?

The refurbishment and extension to the premises has been completed, people stating that they are very satisfied with the accommodation. The garden has been landscaped and now provides an additional area for people to enjoy.

What the care home could do better:

All evidence following this inspection indicates that the service continues to provide good quality outcomes for the people living at the home. The owner and staff acknowledge and are aware of any areas within the service where improvements could be made and have plans to address them.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Wellesley House Nursing Home 186 Penn Road Penn Wolverhampton West Midlands WV3 0EN     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: Joy Hoelzel     Date: 1 2 1 1 2 0 0 8 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. the things that people have said are important to them: They reflect 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 26 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 26 Information about the care home Name of care home: Address: Wellesley House Nursing Home 186 Penn Road Penn Wolverhampton West Midlands WV3 0EN 01902342195 01902342195 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Stephen Cadman,Mrs Christine Cadman care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 38. The registered person may provide personal care with nursing and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories: - Old age not falling within any other category (OP38) Physical disability (PD38) Date of last inspection Brief description of the care home Wellesley House is a registered care home providing accommodation, personal and nursing care for up to thirty eight older people. Situated just over a mile from the centre of Wolverhampton, Wellesley House is a converted two storey building, dating from around 1845 and standing in its own grounds. The home is on the main bus route, with easy access to local shops and pubs. Information of the home and the provision of the service are available in the statement of purpose and service user guide, both documents are currenly being revised and updated. Weekly fees for the Care Homes for Older People Page 4 of 26 Over 65 38 0 0 38 Brief description of the care home service range from £428:00 - £460:00, the reader may wish to obtain more up to date information from the care service. Commission for Social Care Inspection reports for this service are available from the provider or can be obtained from www.csci.org.uk Care Homes for Older People Page 5 of 26 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: This unannounced inspection took place over five and three quarter hours on Wednesday 12th November 2008. A registered nurse was in charge of the home, supported by nursing and care staff and ancillary personnel. The owner of the service was on the premises. A look around the home took place, which included a number of bedrooms as well as communal areas. The care documents of a number of people using the service were viewed including care plans, daily records and risk assessments. Other documents seen included medication records, service records, some policies and procedures and staffing records. Discussions were held with people living, visiting and working at the home. Some people were unable to fully comment about their experience of life at the Care Homes for Older People Page 6 of 26 home. Observations were made of how they spent the day and of the interactions offered by staff in an attempt to obtain an overview of how they may be feeling. Prior to this inspection an Annual Quality Assurance Assessment (AQAA) document was posted to the home for completion. The AQAA is a self-assessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for providers to share with us the areas that they believe they are doing well. It is a legal requirement that the AQAA is completed and returned to us within a given timescale. The acting manager completed this document and returned it the commission. Comments from the AQAA are included within this inspection report. The last unannounced key inspection was on 20th September 2006 with the service judged as providing good outcomes for people living at the home. An annual service review was completed on 21st November 2007 which resulted in no changes being made to the planned inspection programme. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 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 26 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. The home understands the importance of having sufficient information when choosing a care home. Admissions are not made to the home until a full needs assessment has been undertaken Evidence: Information of the service provision is detailed in the service user guide and incorporates the statement of purpose. It is available upon request at the home. Both documents are currently being reviewed to ensure that the information in the documents is correct and up to date. The service user guide specifies the weekly fees for the service, from 428:00 to 480:00 pounds per week, and what is and what is not included in the fee. The case file of the person who recently moved into the home was looked at to see if information had been sought regarding this persons needs prior to moving into the Care Homes for Older People Page 10 of 26 Evidence: home. Information had been gathered from various outside agencies and a pre admission assessment was completed by the service. Other case files looked at included a pre admission assessment by the home in addition to social worker reviews, assessments from Primary Care Trusts and community care services. This gathering of information ensures that the service can be confident of meeting a persons care needs. The home does not provide an intermediate care service. Care Homes for Older People Page 11 of 26 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. Each individual has a care plan, it includes the information necessary to deliver the persons care. The plans are written in plain language, are easy to understand and are reviewed at regular intervals. The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Evidence: All people have a plan of care that is initially generated from the assessments obtained prior to the person moving into the home. Four plans were selected for inspection with people being at the home for varying lengths of time. Each plan contained assessments for maintaining a persons safety and when a risk is identified it is linked with a corresponding plan of care. For example one person is experiencing episodes of anxiety and distress due to a specific condition. A care plan has been developed with details for staff of what the possible triggers are to these periods and the action needed to reduce any distress. One person was having some difficulty with maintaining effective communication again due to a specific condition. The care plan recorded the Care Homes for Older People Page 12 of 26 Evidence: actions needed to assist with communication and staff described the way they helped this person. Another plan indicated that a specific intervention was required by the nursing staff on a regular basis. The care plan indicated the frequency and treatment of this task with the nursing record confirming the action taken. Some tick box documents for recording daily interventions had not been fully completed. Staff spoken with, however, were able to provide a verbal account of the care and described the individual and diverse care needs. Medication is administered to people by the registered nurses using a monitored dose system with additional boxes and bottles of medicines. The procedures were looked at, staff explained the processes and all evidence points to good arrangements being in place for the safe administration of medications. Staff were observed throughout the day to be assisting people with care needs in a discreet and respectful way. The Annual Quality Assurance Assessment completed by the acting manager states The care plan is updated on a monthly basis and this determines the type of care and service we provide. It goes on to state the plans for improvement over the next twelve months - To build on the good practices and to provide a high standard of care, promoting training of all staff to achieve the high standard. Care Homes for Older People Page 13 of 26 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 are involved in daytime activities of their own choice and according to their individual interests, diverse needs and capabilities. The meals are balanced and nutritious and cater for the dietary needs of individuals. Care staff are sensitive to the needs of people who find it difficult to eat and give assistance with feeding. Evidence: Social,leisure and recreational activities within the home and in the community are arranged by the care staff. People living at the home described the recent entertainment within home and stated how very much they enjoyed this event. Other activities outside of the home have been arranged through out the summer months with people saying they enjoyed going out. People who were able to express an opinion stated that they thought there could be more activity arranged but did not offer a view of what they would like arranged. One person stated that they would like to see a religious minister, staff stated they would try and arrange for someone to visit this person. The owner discussed the activities and stated that it was quite difficult to arrange visits to places of interest for some of the residents due to very frail physical and mental conditions of these people. Where possible in house entertainment is Care Homes for Older People Page 14 of 26 Evidence: arranged on a monthly basis. During the morning of this inspection there was little structured activity but people were engaging with each other or visitors, watching the television, listening to music or just watching the activity of other people. The AQAA completed by the acting manager highlights plan for improvement during the next twelve months We propose to employ a dedicated person to concentrate on organizing and undertaking a variety of activities for the residents. We will add to our collection of materials for use in activities which can be utilized by the residents either supervised or unsupervised. Visitors to the home expressed a great satisfaction with the service and the visiting arrangements The care is wonderful,the staff have been very good to us all, and I can visit whenever I like. One person living at the home discussed the very regular visits from his family and stated that it was very important to keep in contact with family and friends. The main front door is kept locked for security reasons, entry to the home is gained by staff answering the door. A number key pad is used for exiting the premises. No other doors were observed as locked, with the exception of storage cupboards, people have free unrestricted access to all areas. Should people wish to obtain advice from the advocacy service, contact details are displayed of the local service at the entrance to the home. The dining area is prepared in advance of meals with people being encouraged to sit at the table, but people are able to have their meals in their preferred place. People confirmed a satisfaction with the meals provided with one person stating they have a full English breakfast most days to get the day off to a good start. The owner commented of there being no restrictions on food, people can have anything they want, when they want it. Staff were observed to be assisting people with the midday meal where needed in a discreet and sensitive way. Care Homes for Older People Page 15 of 26 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. Residents and others involved with the service say that they are satisfied with the service provided and know what action to take if they have concerns. The home understands the procedures for safeguarding adults and will attend meetings or provide information to external agencies when requested. Evidence: The complaints procedure in the information documents is currently being reviewed and revised and will include our contact details, should any one wish to do so. A copy of the complaints procedure is displayed at the entrance to the home. One person stated that they would speak with their daughter if there were any concerns and that she would sort it out. A visitor to the home stated that they had no concerns whatsoever but if they did they would have no hesitation but to speak with the owner and were confident that it would be dealt with. The owner discussed the opportunities for people with any concerns to speak with staff members and that generally the problems are sorted out quickly. A referral has recently been made to the safeguarding adults multi agency team following concerns of the care of a person at the home. It has not as yet reached a satisfactory conclusion. The owner is fully involved in this procedure and we are aware of the situation. Care Homes for Older People Page 16 of 26 Evidence: The home offers a facility for residents to deposit personal monies for safekeeping; records relating to this have been maintained and fully receipted. Care Homes for Older People Page 17 of 26 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 provides a physical environment that is satisfactory to the specific needs of the people who live there. It is well furnished, comfortable and has a programme for the maintenance and redecoration of the premises. Evidence: Wellesley House is situated on the main Penn Road in Wolverhampton. It is a period building that has been extended and developed over the years and now provides accommodation for up to 38 people. There is one main lounge where most people tend to spend the day, this is well furnished, comfortable and warm. The bedrooms are well furnished with the furniture provided by the home of a good quality. Many of the bedrooms looked at during the tour or the premises were personalised with many possessions and belongings of the resident. The AQAA includes the improvements made to the home Recently we have undertaken fitting of a new conservatory,and the gardens have been landscaped and access to the garden has been made easier by taking into account the comments from the residents. The local fire safety officer and the environmental health officer have both visited during the year. Any recommendations they may have made have been complied with Care Homes for Older People Page 18 of 26 Evidence: by the owner. One bedroom door was being kept open with a wooden wedge. The person living in the room stated they they preferred to have the door open so that they didnt feel so isolated. The owner acknowledged the increased risk to this person in the event of an emergency and confirmed that a self closing device will be fitted without delay. The laundry facilities are satisfactory with laundry attended to by dedicated staff. All areas around the home were clean and hygienic. Hand wash facilities are provided in all areas for the effective control of cross infections. The Primary Care Trust conducted an infection control audit in February 2008 and awarded the service a score of 88 , this being a good standard. Care Homes for Older People Page 19 of 26 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. There are enough qualified, competent and experienced staff to meet the health and welfare of people using the service. Staffing rotas take into account the needs and routines of the people using the service. The service recognises the importance of training, and tries to delivers a programme to meet the statutory requirements. The owner is aware that there are some gaps in the training programme and plans to deal with this. The service is also able to recognise when additional training is needed. Evidence: A duty rota is maintained on a weekly basis to identify the people working in the home at any one time. During the morning, at peak activity times, the home is staffed by registered nurses and seven care staff. The numbers reduce during the afternoons and at night, the nurse in charge and the owner confirming that the staffing compliment is sufficient for the needs of the current resident group. People living in and visiting the home offered positive comments about the staff group staff are very good, look after my relative very well. Three staff personnel files were selected for inspection. Each file contained criminal record bureau disclosures and confirmation of identity. One of the files contained only one written reference, (the regulations state that two written references should be received before a person begins working). This person is a new employee, working Care Homes for Older People Page 20 of 26 Evidence: through an induction programme and supervised by senior staff. The administrator confirmed that the reference will be chased up. The training and development needs of all staff is being addressed. Staff have completed some of the mandatory, core topic areas with plans for all staff to have the updates and training by the end of the year. The owner stated that staff have received regular updates for moving and handling residents in the correct way. During this inspection staff were observed transferring a person using the underarm method. A practice that has been condemned for a period of time. This was discussed with the staff concerned and the owner at the time and an alternative method of transfer was arranged. The owner stated that one of the registered nurses has planned to completed a tutors course in moving and handling and will then be available to advise staff on the correct methods. Care Homes for Older People Page 21 of 26 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 management team have a clear understanding of the key principles and focus of the service, based on organisational values and priorities. Evidence: Jayne Whitehouse has been recruited as the acting manager of the service following the resignation of the previous manager. Mrs Whitehouse is a first level nurse, with the owner stating that she has the knowledge and experience to manage a social care home. Mrs Whitehouse was not at the service during this inspection. A formal application for the position of registered manager will need to be completed and sent to us for processing. The nurse in charge of the premises on the day offered her cooperation with the inspection and demonstrated a good knowledge of the current residents and their very individual care needs. Quality assurance and monitoring of the service is ongoing with satisfaction surveys being distributed to people living and visiting the home. Meetings are arranged for Care Homes for Older People Page 22 of 26 Evidence: staff at frequent intervals with the occasional resident meeting being held. The owner stated that there are numerous opportunities for residents, staff or visitors to discuss any concerns or to make suggestions for improving the service. The AQAA contains clear, relevant information that is supported by a wide range of evidence. The AQAA lets us know about changes they have made and where they still need to make improvements. It shows clearly how they are going to do this. The data section of the AQAA is accurately and fully completed. It describes the organisational structure of the service The registered provider is the owner who is actively involved in the day to day running of the oranisation supported by a care manager who is an experienced nurse. Other members of the owners family are involved in the financial management and day to day running of the organization. The administrator is involved communicating with the staff, residents and visitors and generally helping with the smooth running of the home. The home offers a facility for residents to deposit personal monies for safekeeping; records relating to this have been maintained and fully receipted. Weekly, monthly and annual testing of the equipment and premises are conducted with records kept and available for inspection. Care Homes for Older People Page 23 of 26 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 24 of 26 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 1 1 The statement of purpose and service user guide should be reviewed, updated and available to offer people a full view of what life is like at the home. Staff should receive training in moving and handling to ensure they are able to meet the changing needs of the people living at the home. A formal application for the position of registered manager of the service should be submitted to the commission as soon as practicably possible. 2 30 3 31 Care Homes for Older People Page 25 of 26 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 26 of 26 - 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!