Inspection on 07/03/08 for Wildashs

This is the latest available inspection report for this service, carried out on 7th March 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

Wildashs 10/11/05

Wildashs 07/07/05

Wildashs 06/01/05

Wildashs 10/09/04

Wildashs 14/01/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Wildashs 68/70 Greentrees Avenue Tonbridge Kent TN10 4NE Lead Inspector Joseph Harris Unannounced Inspection 7th March 2008 10:00 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 Wildashs DS0000024047.V359542.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. Wildashs DS0000024047.V359542.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wildashs Address 68/70 Greentrees Avenue Tonbridge Kent TN10 4NE 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) 01732 356815 Miss Corina Mary Wildash Miss Corina Mary Wildash Care Home 8 Category(ies) of Old age, not falling within any other category registration, with number (8) of places Wildashs DS0000024047.V359542.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One place is restricted for care of one person whose date of birth is 13/05/1905. Date of last inspection Brief Description of the Service: Wildash’s is a residential home for up to seven older people. The owner and senior members of staff are qualified nurses. The stated intention of the owner is to provide a high standard of care for older people and where possible, to provide a home for life. All service users have single bedrooms. They have easy access to the rear conservatory and to the garden. Prospective service users and their representatives are able to obtain information from the owner about the homes services and facilities. Each prospective service user receives a full assessment to ensure the correct level of care can be provided. Care services are provided by both registered general nurses and care assistants. The home is in a residential area close to Tonbridge and a bus-route is nearby Car parking is readily available. At the time this report was written fees ranged from £309.00 to £700.00 per week. Visits from the hairdresser cost from £7 to £30. Newspapers can be delivered to the home and charged at cost. Phone calls on residents’ private phone lines are billed direct. Long distance phone calls made on the homes phone line are charged at cost, there is no charge for local calls. Escort to hospital appointments are provided at cost of petrol and token £10 to staff cost. Physiotherapy will be charged at cost to the resident unless judged necessary to assist staff handling. Wildashs DS0000024047.V359542.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection process culminated in a site visit to the home on 7th March 2008. The site visit commenced at approximately 10am and concluded at 3.30pm, lasting for around 5.5 hours. During the course of the visit a tour of the premises was undertaken and discussions were held with the registered manager, staff members and service users. A range of documentation was examined relating to the residents, staff, medication, health and safety and the day-to-day running of the home. The registered manager completed and returned the Annual Quality Assurance Assessment (AQAA) prior to the site visit, which also informed the inspection process. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. What the service does well: Wildash’s provides a comfortable, relaxed, friendly and homely environment for up to 7 older people requiring residential care. All records seen relating to service users, staff and the running of the business were well maintained and up to date. Residents were wholesome in their praise for the home, staff and manager. No one spoken to on the day of the visit expressed any dissatisfaction with the service that they receive. There is an experienced, loyal and committed staff team who are provided with appropriate training to meet the needs of the service users. Staff were observed to have a relaxed and unhurried attitude enabling residents to live their lives as they wish. Three care staff spoken to said that they enjoy working in the home and demonstrated a good understanding of the needs of the service users. The registered manager provides strong leadership, support and good principles of care to ensure the smooth running of the home. Residents have opportunities to engage in chosen activities and a healthy balance is struck between maintaining an active life and relaxation. Wildashs DS0000024047.V359542.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Wildashs DS0000024047.V359542.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wildashs DS0000024047.V359542.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is good. Prospective service users are able to make an informed and considered decision to move into the home. Residents receiving intermediate care are enabled to retain their independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All prospective service users are assessed by the registered manager prior to moving into the home. Three service user files were examined during the course of the visit. In each case a detailed pre-admission assessment had been completed addressing key areas of need and risk. They also noted preferences and relevant history. Wildashs DS0000024047.V359542.R01.S.doc Version 5.2 Page 9 One resident said that she remembered having been able to visit the home before moving in and felt that the whole process had been handled well. The home does offer short-term and intermediate care if there are rooms available. Some residents have entered the home for respite care in the past, but have chosen to stay. However, the staff at Wildash’s enable residents to retain their independence and return home if they wish. Separate facilities are not offered, but the focus of any respite service is to provide social support as well as assistance with health and personal care needs. Wildashs DS0000024047.V359542.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. The health and personal care needs of people who use the service are planned for met. Residents are treated with dignity and respect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three individual service user files were examined during the course of the visit. In each case a well developed plan of care was in place that referred to assessed and changing needs. The plans show clear evidence of regular review and provide suitable direction to enable staff to meet the individual needs of each resident in the way that they prefer. The home uses a range of assessment tools to monitor healthcare needs such as pressure area care, mobility, manual handling and nutrition. The results of Wildashs DS0000024047.V359542.R01.S.doc Version 5.2 Page 11 these assessments and other information from healthcare professionals are incorporated into the plans of care as and when required. The home operates with a Registered Nurse available at all times. It was also reported that excellent working relationships have been established with the local community health teams. There was clear evidence through correspondence, care plans and daily notes to demonstrate that all healthcare needs of each resident are monitored and issues referred appropriately. Where specialist input is required the registered manager and senior staff ensure that referrals are made. The medication systems employed by the home are well-established and are managed in a safe way by competent practitioners. Storage facilities are adequate for the needs of the home and there is space to store controlled drugs securely should they be required. Adequate policies and procedures are in place and the medication administration records are kept up to date. Medication is only dispensed by registered nurses, however some of the care staff have completed medication training courses and do assist in the administration process. The registered manager has an in-depth knowledge of medications, their usage and side-effects and ensures the well-being of service users in this regard. All residents spoken to throughout the visit confirmed that all of the staff in the home treat them with dignity and respect. One person said, “I am so happy here, the staff are wonderful. It feels like my home.” Another person said, “Miss Wildash is so good to me; all the carers are nice.” Staff were observed to knock before entering bedrooms and spoke to all residents in a calm and sensitive manner. All personal care is provided in privacy. Wildashs DS0000024047.V359542.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. Service users have a lifestyle that suits their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents have the opportunity to spend their time as they wish in a relaxed and friendly environment free from pressure and expectation. The staff in the home provide a range of activities from simple 1:1 informal chats throughout the day to games and organised activities. Some visiting entertainers provide recreation from time to time and seasonal events and anniversaries are celebrated. It was noticeable that throughout the visit care staff never appeared rushed and always had time to spend with residents. One person said, “I’m never bored. There’s always someone to chat to or something to do.” The home manages to strike a comfortable balance between providing activities and allowing people their own space and time. Wildashs DS0000024047.V359542.R01.S.doc Version 5.2 Page 13 Some residents choose to help out around the home whether in the garden, the kitchen or dining room. Staff actively encourage residents to keep involved recognising that this is an aspect of retaining one’s independence. Family and friends are welcomed into the home at all reasonable times. One relative was visiting and said, “I’m always made welcome, it’s a pleasure to come and visit my mother and she’s so well cared for.” The atmosphere in the home was noticeably relaxed and friendly with everyone including staff and residents happy to take time out to chat. The home employs a full-time and part-time cook who have developed a varied menu with a range of choices at each mealtime depending on the individual preferences of service users. All residents stated that the food in the home is of good quality, appetising and well presented. The kitchen is suitable for the needs of the home and adequate food was appropriately stored. A delivery of local fruit and vegetables was brought into the home during the inspection. Wildashs DS0000024047.V359542.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. The views of service users are listened to and acted upon. Residents are protected from abusive practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is an appropriate complaints procedure in place and the Registered Manager stated that she aims to address all concerns or ‘niggles’ however seemingly minor to ensure that residents are happy with their experience of the home. There have been no recorded complaints since the last inspection. There are adequate policies and procedures in place relating to protection from abuse and safeguarding vulnerable adults. Staff receive instruction regarding these issues through the induction process and additional training. The registered manager and staff demonstrated a sound knowledge of the issues that encompass this topic. There have been no Safeguarding Vulnerable Adult alerts since the last inspection. Wildashs DS0000024047.V359542.R01.S.doc Version 5.2 Page 15 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. The home is comfortable and suitable for the needs of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is situated in a quiet residential road away from traffic. It comprises of two semi-detached bungalows formed into one home. There is easy access throughout the house and garden and some doors have been widened to improve this. There is sufficient communal space including a conservatory, lounge and dining room. All of the bedrooms are single occupancy and have been personalised to suit the needs of each individual. The registered manager Wildashs DS0000024047.V359542.R01.S.doc Version 5.2 Page 16 has some plans to improve and develop the environment over the coming year, however acknowledges that a restriction to this may be available finance. There are sufficient toilets and bathrooms in the home and it was reported that the equipment available is suitable for the needs of the service users. The laundry facilities in the home meet relevant requirements and are suitable for the needs of the home. It was reported that the premises meet the requirements of the environmental health and fire departments. Appropriate policies and procedures are in place to minimise the possibility of crossinfection and contamination. There is an attractive garden to the rear of the property, which is accessible to all service users. The registered manager/owner lives in the home having separate accommodation in the home and further quarters located in the garden. Wildashs DS0000024047.V359542.R01.S.doc Version 5.2 Page 17 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 good. Service users are supported by competent, appropriately recruited staff in sufficient numbers. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home operates with a minimum of two staff on duty at all times. The registered manager/owner takes a hands on role providing care during the day and as a sleep-in carer at night. There is always a registered nurse on duty in the home. The care staff team are supported by housekeepers and cooks. A maintenance man also provides input as required. Staff were observed working at a relaxed and unhurried pace ensuring that there was time to spend with residents. The people who use the service were unanimous in their praise for the attitude and caring nature of all staff. “It’s like a big happy family” was the comment of one resident. Another person said, “the staff are always lovely, we get on very well.” A proportion of the staff including the manager/owner are registered nurses. The majority of the staff team have worked in the home for a number of years and are very experienced care workers. Some staff have chosen to gain Wildashs DS0000024047.V359542.R01.S.doc Version 5.2 Page 18 National Vocational Qualifications (NVQ) and there is an expectation that new staff will work towards this award. The registered manager has addressed the shortfalls noted in the recruitment process at the last inspection. Three staff personnel files were examined and found to have all the required information and security checks in place. The manager ensures that staff training requirements are kept up to date. All staff work through an induction programme and complete all statutory training within the first 6 months of employment. Refresher course are organised on a rolling basis thereafter. Staff competency is also monitored and addressed by the home through observed practice, supervision and in-house training. Wildashs DS0000024047.V359542.R01.S.doc Version 5.2 Page 19 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. The home is well run and in the best interests of the service users. Financial interests are safeguarded and health, safety and welfare protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Miss Wildash, the Registered Manager, has owned and run the service for approximately 16 years. She is a qualified nurse and possesses a wealth of experience in the field of healthcare. She lives on the premises and has devoted her time and energy to the smooth running of the home and care of Wildashs DS0000024047.V359542.R01.S.doc Version 5.2 Page 20 the residents. Staff, residents and visitors alike were fulsome in their praise for Miss Wildash. It was not possible to speak to any visiting professionals, but evidence from previous inspections demonstrates that she is held in high regard. Wildash’s is run very much as a home, which was evident by the feedback from everyone spoken to. Miss Wildash lives and works in the home and is constantly monitoring the performance of the service, the views of service users and visitors and areas for development. These issues are managed largely on an informal level, but in the context of the home suitable measures are taken to ensure the quality of the service provided and the outcomes for service users. The home does not take control of any resident’s finances and this is all managed through people independent of the service or residents themselves. All documents and records examined in relation to the health and safety issues in the home were up to date and well maintained. It was reported that the home meets with the requirements of the environmental health and fire departments and appropriate checks are carried out. Accidents and untoward incidents are recorded and reported correctly. Wildashs DS0000024047.V359542.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 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 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Wildashs DS0000024047.V359542.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Wildashs DS0000024047.V359542.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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