Inspection on 15/04/08 for Werneth Lodge

This is the latest available inspection report for this service, carried out on 15th April 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.

Other inspections for this house

Werneth Lodge 16/01/06

Werneth Lodge 21/09/05

Werneth Lodge 02/03/05

Werneth Lodge 25/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

SignHealth

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Werneth Lodge 38 Manchester Road Werneth Oldham OL9 7AP Lead Inspector Michelle Haller Unannounced Inspection 15th April 2008 09:15a X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Werneth Lodge Address 38 Manchester Road Werneth Oldham OL9 7AP Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0161 624 4085 0161 345 8060 wernethlodge@tiscali.co.uk Werneth Lodge Limited Post Vacant Care Home 42 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (21), of places Physical disability over 65 years of age (7), Sensory Impairment over 65 years of age (6) Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 21 OP up to 8 DE(E) up to 6 SI(E) and up to 7 PD(E). 16th April 2007 Date of last inspection Brief Description of the Service: Werneth Lodge is a residential home providing 24-hour personal care and accommodation for 42 service users over the age of 65 years. Werneth Lodge Ltd privately owns the home. It is situated approximately one mile from Oldham town centre and is close to local shops, a doctor’s surgery and pubs. Bus services are available close by, providing access to Oldham Town Centre or Manchester City Centre. A cobbled driveway and garden area lead to the main entrance where a wheelchair lift is available. The home also incorporates what was once a coach house. Bedroom accommodation is available on both the ground and first floors. There are 38 single bedrooms and two are large enough to be shared. All bedrooms have en-suite facilities. Accessible toilets are situated close to bedrooms and communal areas. Access to the first floor is via a passenger lift. Bathing facilities include three assisted baths and one shower room. Communal areas are provided and include a number of quiet lounges, a sun lounge and a lounge designated as a smoking area. There is a separate dining room. Off the sun lounge there is a garden area with patio furniture available for service users. Werneth Lodge charges £360.00 per week. The Commission for Social Care Inspection report is on display outside the office. Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was a key inspection that included an unannounced visit to the service. This means the manager did not know in advance that we were coming to do an inspection. During the visit we looked around the building, talked to residents, relatives and staff, including the deputy manager and registered provider. We observed the interactions between people living at Werneth Lodge and examined care plans, files and other records concerned with the care and support provided to people in the home. We also looked at all the information that we have received or asked for since the last inspection. This included: The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Information we have about how Werneth Lodge has managed any complaints and any adult protection issues that may have arisen. What the manager has told us about things that have happened in the home through ‘notifications.’ We also received 14 Commission for Social Care Inspection (CSCI) surveys which were returned to us by people using the service and from other people with an interest in the service such as staff and relatives. We have not received any complaints or safeguarding referrals about this service since the last key inspection. Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Since the last inspection the majority of staff have received protection of vulnerable adults training and the adult protection protocol has been updated. A sanitizer machine is now used to disinfect bedrooms and lounges to remove bacteria and improve odour control. Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 7 The way in which accidents and incidents are recorded and managed has improved. The manager is now able to identify if there are any patterns to these occurrences. The information is used as a part of the home’s risk assessment process and remedial action is taken. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (standard 6 is not applicable) Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People at Werneth Lodge have their needs assessed prior to moving into the home so they can be confident that their needs can be met. EVIDENCE: Four care files were examined, including that of the most recent admission, each contained an assessment either completed by the deputy manager or referring social worker. Correspondence from a health professional based at a local hospital also confirmed people’s needs were assessed before a referral was accepted. The deputy stated that she completes a full assessment though studying referral information, speaking to the person and their families, the social worker and others involved in people’s care. Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 10 Assessments were detailed and provided a good picture of the psychological and physical health needs and social interests and skills. Information included personal preferences in relation to meals and diet, bedtime, how people wished to be addressed, communication, moving and handling needs and family contact. Files also held a contract and documents signed by people moving into the home, confirming that the routines of the home had been explained. All staff that returned surveys confirmed that they were always given enough information about people’s needs. One stated ‘This is done at every staff changeover.’ Those who returned surveys felt that they been given enough opportunity to make certain that the home could meet their needs. One person, who was an emergency admission, said ‘It was an emergency admission from hospital and me and the family liked the place.’ Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People living at Werneth Lodge benefit from care based on their individual needs and this is provided safely, respectfully and promotes their dignity. EVIDENCE: Each file contained care plans that provided detailed information about the actions required to make sure that personal care, health, social and psychological needs were met. These documents were individualised and had been reviewed frequently and updated according to the changing needs of the resident. It was clear that people’s views were respected, and this was the case even when in conflict with the outcomes of risk assessments. Advice and referrals were made to district nurses and social workers and other health and social care professionals. Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 12 We saw that the good practice in the area of health and social care identified at the previous key inspection was been sustained, evidence in correspondence, prescriptions and charts confirmed that routine health checks and care had taken place. This included dental care and checks, optical examinations, podiatrist, general health checks, flu vaccine and weight monitoring. Case tracking confirmed that monitoring was effective and staff recognised the need to take remedial action such as approaching the audiologist for a replacement hearing aid or the physiotherapist for additional moving and handling equipment. Weights are recorded monthly and it was easy to see when people had gained or lost weight from month to month. People who lost weight were put on weekly weights. The home uses sit and weigh scales. Effective steps had been taken to maintain and increase the weight of those who were vulnerable to weight loss, as prescriptions for fortified drinks were in place. Staff recorded that these were given and the weight charts seen on inspection showed that nutrition was well managed, in that, people generally gained weight or remained stable while living at Werneth Lodge. The comfort and safety of people living at Werneth Lodge continues to be promoted through the development of moving and handling risk assessments and care plans. It was observed that all wheelchairs had footplates that were used correctly and staff followed the moving and handling instructions in care plans. There was evidence that steps were taken to prevent the development of pressure sores; this included the use of pressure relieving mattresses and cushions and monitoring the condition of pressure areas. The home continues to allocate key workers. This is a member of staff who takes responsibility for ensuring specific tasks that promote comfort and wellbeing of an individual person are completed. The key-worker checklist includes maintaining hearing aids and batteries, making sure glasses are clean and fit well, dealing with clothes and underwear, including arranging for replacement when necessary, taking care of dentures, making sure that walking aids and other equipment are clean. The name of the person’s key-worker was displayed in their bedroom. This system continues to be effective because people at Werneth Lodge were well groomed, their hair was clean and nicely combed, clothes were neat and well fitting and people had clean and neat fingernails. Since the last inspection the cleanliness of slippers has been added and it was observed that everyone’s slippers were clean. Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 13 We discussed again the issue of people not wearing tights, socks or stockings, and it was stated by the deputy manager that people who wanted to wear them could. No comments were received in relation to underwear, however in keeping with aspects of good practice, it would be better if the home could demonstrate that people had been offered the opportunity to wear tights, socks or stockings. Throughout the day it was observed that people at Werneth Lodge continue to be approached with patience and respect; staff listened to what they were saying and took steps to meet their needs and make sure they were comfortable and free of pain and distress. All the medication administration record (MAR) sheets were examined and these were completed correctly, with no gaps and medication is stored in a locked room, which is safe. Pictures had been placed on individual sheets to aid with identification and prevent mistakes. A sample of the initials used to sign for medication was in the medication file. There are no concerns relating to the storage of medication. The training matrix demonstrated that staff that administer medication need updated medication training. The registered provider stated that she was in discussion with Oldham Metropolitan Borough Council (OMBC) in relation to accessing training in this and other health related topics. The storage and recording of controlled medication was checked. These were stored securely and the records showed that two people always checked them in and took responsibility for administration. No discrepancies were noted. The registered provider was informed that all controlled medication must now be stored in a cabinet designed for this purpose. Those who spoke to us commented felt that health and personal care provision was good. One relative said ‘Health care is always provided quickly and they do what the nurses and doctors tell them.’ All who returned service user surveys felt that their medical and health care needs were always met, one person commented ‘Not much needed but they got me checked for a hearing aid and new glasses have been arranged, flu jab undertaken, etc.’ Staff who returned surveys all felt that they were always given enough information about people so that needs could be met, they also felt that communication was good. Comments included ‘Care plans are always available and reviewed as needed or monthly’ and ‘A detailed daily report on individual clients is read out at handover.’ Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Social, recreational and cultural activities, including meals, are provided so that people have the chance to enjoy favourite pastimes and learn new skills. EVIDENCE: Activities are in place at the home. The record of activities and discussion with people living in the home, their family and staff confirmed that activities were organised on a daily basis. People who responded in the surveys felt that there was ‘usually’ enough going on in the home to keep them entertained. People’s social histories and interests continue to be recorded and those examined provided useful information about previous history and interests. Due to lack of funding, the luncheon club organised by a local volunteers group has folded, however the deputy manager plans to organise a regular tea dance. Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 15 Displays throughout the home and comments made by residents confirmed that special calendar dates, such as Easter, St Patrick’s day, birthdays and special anniversaries, were celebrated and that buffet teas and celebration cakes were provided. Records also showed that activities were varied enough to enable most people to participate in some form of recreation. Activities included craftwork, board and card games, sing-alongs, listening to visiting musicians, themed film evenings and discussing favourite events from the past. Comments included: ‘There’s always something going on - it was someone’s birthday yesterday and there was a party - and they keep me occupied with jobs such as drying the medicine pots.’ People said the routines in the home were flexible and that they were able to please themselves about what they did. Comments included ‘You’ve only to say you want a bath and they’ll fix it up - I go to bed when I’m ready - I don’t get up til about 8 - I buzz them when I’m ready and they soon come.’ When staff were asked what time people were got up, they answered that this depended on the person. Family and friends said that they always felt welcome in the home and able to visit at times convenient to them and those they were visiting. Most of the relatives who returned surveys felt that they were always able to keep in touch with people in the home. Mealtimes in the home are unhurried and people can have their meals when they like. Breakfast was a choice of bacon and eggs, cereals, toast or any combination. Hot and cold drinks and biscuits were served throughout the day and people were able to ask for drinks when they wanted them. The menu demonstrated that meals choices are available and meals were in keeping with the main culture of people living at Werneth Lodge, although curries and burgers were also offered. Dishes included corned beef hash, ham and gammon with chips, shepherd’s pie, cheese and onion pie, and other stews. Deserts included sponge cakes, milk puddings. Close examination of the four weekly menu highlighted that meals tend to be repeated week to week but in a different order, for example, stewed lamb is served on Monday in week one and again on Tuesday in week two, and stewed steak is served on Saturday on weeks two and four. Furthermore, puddings are generally a variation sponge pudding or cake, as this was offered 14 times in a two-week period. The midday meal on this inspection, which was lamb cooked in gravy, green beans and mashed potatoes, was the same as that offered at the previous inspection in 2006. People who were observed did eat most of this meal. The dessert was rice pudding. Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 16 We found that the menu had been discussed at the previous residents’ meeting held on 26th March 2008, the registered provider said that the menu was going to be changed to reflect suggestions, such as serving salmon and new potatoes and more salads. People commented that if they didn’t like a choice on the menu, then the cook would prepare something else. Daily records confirmed that the staff took note of food preferences and people were offered food that was liked. Everyone who returned CSCI surveys said that they ‘usually’ enjoyed the meals. Comments about the food on the day of inspection included, ‘Pretty good good variety and always offered an alternative if I don’t like it’ and ‘they come in and say what’s for lunch on the day, for example, cheese and onion flan but if I don’t like it, they’ll do something else such as sausages.’ The dining room is pleasant and clean. Lunchtime was observed; this was relaxed and those requiring additional support were treated as individuals and supported with dignity. Staff stated that they had access to the food stores at all times and people could have snacks and drinks whenever they wanted. The weight record for some people living at Werneth Lodge was checked and showed that people either remained stable or gained weight after moving into the home. There was also evidence, such as prescriptions for fortified drinks and appointments for further investigations, to confirm that steps were taken to keep people well nourished if they had poor appetites or experienced weight loss. Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. A comprehensive complaints procedure and adult protection policy are in place so that people can be sure that their views are treated seriously and that they are safeguarded from abuse. EVIDENCE: On reading the complaints record and incident files, we found that complaints and concerns voiced by people using the service continue to be investigated openly and fairly. It was clear that action was taken to resolve any problems and that people were informed verbally and, at times, in writing, about the outcome of investigations. People who returned CSCI surveys all felt that they could approach the manager and staff with any issues and that they would be listened to and dealt with fairly. Staff were aware that they could approach an advocacy service or social services if they had any concerns related to the rights or safety of people living in the home. They commented ‘I would approach CSCI if need be.’ Observations made during the day also confirmed that the manager took steps to safeguards people’s rights. Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 18 People said - Staff are always alright with me, if I had a complaint, I would talk to ...’ Since the previous inspection staff have received updated Protection of Vulnerable Adults (POVA) training from Oldham Metropolitan Borough Council (OMBC) training partnership. Comments from staff about this training included: ‘it has opened my eyes - it was good because everything was based on real life situations.’ This person felt that the training had changed the way in which she worked. The adult protection policy in the home was re-examined and this needed to be updated to inform staff about the actions they must take if there are incidents between people using the service. The registered provider ensured that this policy was amended and made clearer on the day of inspection. They must now ensure that staff are given this information. The training matrix identified that in December 2006, eight out of 16 staff had received POVA training from Oldham MBC training unit. Eleven staff also have National Vocational Certificates 2 (NVQ level 2) in health and social care and adult protection is included in this course. It is important that all staff receive updated POVA training from people who are expert in this area of practice. This is because policies and expectations change, staff need to know what behaviours and treatment are acceptable, they also need to have the chance to discuss different scenarios, circumstances and be confident in their responsibility to safeguard people against harm from others. There have not been any POVA investigations in Werneth Lodge since the last inspection. Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The layout and physical design of Werneth Lodge meets the needs of people by providing comfortable and accessible accommodation, and the home is clean. EVIDENCE: We had a look at all the communal spaces and ten of the bedrooms at Werneth Lodge and found that the home was clean and fresh. Bedrooms had been personalised and it was explained that rooms could be made homely from a stock of ornaments and pictures if people could not provide their own. People were observed walking around the home and using the facilities both independently and with staff support. The majority of the furniture was in good repair and free from stains. Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 20 Pictures were used to identify toilets and bathrooms. The accommodation continues to have a homely feel due to the display cabinets and shelves holding ornaments. Flowers were also set throughout the home. The achievements of the staff, and the arts and crafts completed by people living in the home are on display. Since the last inspection the registered provider has purchased a machine that sanitises the air and the washing machine in the home has been upgraded. Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. People at Werneth Lodge benefit from staff made available in sufficient numbers, with the skills and attitude to promote good health and psychological wellbeing. EVIDENCE: People who returned CSCI surveys and who we talked to confirmed that there were enough staff on duty to meet the needs of the residents at Werneth Lodge. The staff who returned surveys mostly felt that there were ‘always’ enough staff on duty, all residents felt that staff were ‘always’ available when needed. People also liked the staff and said: ‘They are alright and there’s always somebody there when you want them - I keep the call bell under my pillow so I can use it at night’, ‘There’s a jovial atmosphere, people talk to you, staff come and sit with me’ and ‘Yes there are enough staff.’ Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 22 We found that, since the previous inspection, training offered to staff continues to provide them with a range of skills that will meet the needs of people living at Werneth Lodge. Courses have included: NVQ levels 2 and 3 in health and social care; moving and handling training, although the training matrix showed that a number of staff requiring updated training; first aid; dementia care. Two recent recruits have also completed the skills for care induction into care workbook. Five staff files were examined and each contained: the original application form and confirmation that a Criminal Record Bureau check (CRB) had been carried out by the home, additional proof of identity and a picture of the worker, supervision and training records. The references for three of the most recent recruits were not adequate. This was because in two instances they did not have the address or contact information of the people giving the references, and for one person the references could not be found, although the manager was certain that these had been obtained. The need to improve in this area was discussed with the registered provider. Staff who returned surveys confirmed that CRB’s were completed prior to them starting work. One person said that she had worked at the home for a number of years prior to CRB’s but this was done as soon as the rules changed. Staff also felt that training provided was relevant to their role. People living at Werneth Lodge and their relatives felt that staff were kind and approachable. Comments included: ‘Staff are good – they always talk quietly’ and ‘we’ve got really nice carers, all the carers are nice’ and ‘I am filling in this form on behalf of my mother who as far as I am concerned receives the best emotional and physical care that the staff at Werneth Lodge are able to provide. I am quite happy with everything and everyone concerning my mother’s emotional and physical well being.’ Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People living at Werneth Lodge benefit from management and administration that is based on openness and a willingness to improve in line with what people say they want and management of health and safety concerns is effective. EVIDENCE: Since the last inspection the Registered Manager has resigned from her post at Werneth Lodge. The registered provider is in day-to-day management of the home and the deputy manager is currently applying to the CSCI to become the registered manager. Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 24 The deputy manager has recently completed the Registered Manager’s Award and is due to commence NVQ level 4 within the next calendar year. Werneth Lodge is one of two homes in a group and so the new manager has support from both a more experienced manager and the registered provider who has in the past managed the service. The Commission for Social Care Inspection’s Annual Quality Assurance Assessment (AQAA) was completed and returned. The information provided by the registered provider lacked detail and did not show that the service had identified areas for improvement. The data information, however, had been completed in full. Quality assurance questionnaires are distributed yearly and the registered provider stated that these had been distributed in January 2008, however due to other priorities identified since the departure of the longstanding manager, the progress of the quality monitoring has not been followed-up. The questionnaire distributed asks for comments about the helpfulness of staff, choice, quality and amount of food, suitability of activities or other concerns. Although the yearly quality monitoring assessment has stalled, notes confirmed that the registered provider had held a meeting where people were able to share information and to find out what people wanted. Relatives stated that ‘you get a lot of information and kept informed of what’s happening.’ Staff training is provided to promote health and safety; this has included infection control training and appointed first aid training, however the training matrix identified that a significant number of staff require updated training. The registered provider confirmed that she was in negotiation with the OMBC training partnership in respect of moving and handling and infection control. Information about the maintenance of equipment provided in the AQAA confirmed that the home’s electrical system, hoists, fire detection, emergency call and gas appliances had been serviced and checked in accordance with the manufacturer’s recommendation or as required by other regulatory bodies. Numbered receipts are kept for each person’s financial transactions. No individual money is kept on site and a float is available to pay for hairdressers, trips out and personal items. Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 25 It is custom and practice for the residents’ money to be paid into a pooled bank account, this is because the home receives a single cheque for personal allowances from social services. Care Standards Act 2000 regulations stipulate that people should have individual or named accounts. We acknowledge that this is difficult to arrange and we have not received any information to indicate that people have had any problems or concerns in relation to residents’ money. We recommend that the registered person looks at the home’s admission process and demonstrate that they have discussed this issue with new residents, their family or the referring agency. Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP38 Regulation 8 Requirement The registered person must appoint a suitable person to put forward for the Registered Managers process. This so people benefit from having a competent person running the home. Timescale for action 01/08/08 Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 28 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP12 OP15 Good Practice Recommendations The registered person should make sure that an activities calendar with planned activities is produced so that people benefit from having something to look forward to. The registered person should make sure the new menu offers a better variety of dishes from week to week, so that meals are not frequently repeated; this will help to broaden the experience of people living at Werneth. The registered persons should make sure that the guidelines relating to the actions staff must take if there are incidents between people using the service are clarified. The registered person should make sure that staff provide references that can be verified and that these are stored safely for future reference. This will reduce the risk of employing unsuitable people and so help to keep people safe. The registered person should make sure staff training is updated, this will ensure that people benefit from staff being aware of the current best practice in areas of health care and health and safety. The registered person should make sure the system for managing people’s money is revised so that, where possible, accounts are individual. 3 OP18 4 OP29 5 OP30 6 OP35 Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Manchester Local Office Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Werneth Lodge DS0000005524.V361951.R01.S.doc Version 5.2 Page 30 - 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!