Inspection on 13/07/07 for Waterloo House Care Home Ltd

This inspection was carried out on 13th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Waterloo House Care Home Ltd 09/10/09

Waterloo House Care Home Ltd 02/10/08

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Waterloo House Care Home Ltd 36 Waterloo Road Bedford Bedfordshire MK40 3PQ Lead Inspector Katrina Derbyshire Unannounced Inspection 11:45 13 & 16th July 2007 th 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 Waterloo House Care Home Ltd DS0000067025.V338527.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. Waterloo House Care Home Ltd DS0000067025.V338527.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Waterloo House Care Home Ltd Address 36 Waterloo Road Bedford Bedfordshire MK40 3PQ 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) 01234 351608 F/P 01234 351608 Waterloo House Care Home Ltd Mrs Patricia White Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (24) of places Waterloo House Care Home Ltd DS0000067025.V338527.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd June 2006 Brief Description of the Service: Waterloo House is located in a residential suburb of Bedford within walking distance of the town centre, which has a range of shops, riverside walks and links with national rail. It is registered to provide care services for up to twenty-four people over the age of 65, ten of who may also have dementia. The current proprietors are Mr and Mrs Camiah, who have been registered care home providers for a number of years and have owned this home since 2002. The building has been converted from its original use as a domestic dwelling. The accommodation is arranged over three floors that have additional levels to its upper floors. Rooms on the upper floors were accessed by a series of staircases and a shaft lift. Staff at the home provided the following information on charges in July 2007. The fees for this home vary from £410.00 per week, to £460.00 plus per week, depending on the funding source and assessed need of the person. Additional charges are made for hairdressing, barber services and newspapers. Waterloo House Care Home Ltd DS0000067025.V338527.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was to undertake a key inspection. This unannounced inspection was carried out on 13th and 16th July 2007. During the inspection several areas of the home were visited and the inspector spent time with many of the people who live at the home in the ground floor communal area. The care of three people was examined by looking at their records and interviewing them and staff who look after them. The views of people living at the home and their relatives were also received through returned comment cards and their feedback has been used alongside information from the home, through written evidence to assess the outcomes within each standard. Evidence used and judgements made within the main body of the report include information from this visit. Observations of care practice and communication between the people living at the home and staff was also made at the inspection. The focus of this inspection was to look at the key standards and to follow up on previous requirements. What the service does well: People living at this home feel that staff are friendly and kind to them. One person said, “l really do like the staff here and so does my family”, another person said, “they always have a kind word to say when you’re not feeling yourself”. Staff are also good at contacting a Doctor or a District nurse if someone at the home needs their help. When someone feels unwell the staff will contact a Doctor very quickly so they can receive the care and treatment that they need. The people living and working at the home think that the manager is very organised, supportive and knowledgeable. All the staff that we spoke to said that she always tries and makes it better for the people living at the home. One staff member said, “ l have worked here for many years and she is the best manager we have had, she listens and makes sure we go on training and the home is just so much better since she has been here”. This means people living at the home benefit from a manager that is organised in her work and who ensures staff receive the training they need to carry out their work properly. Waterloo House Care Home Ltd DS0000067025.V338527.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. Waterloo House Care Home Ltd DS0000067025.V338527.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 Waterloo House Care Home Ltd DS0000067025.V338527.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&6 People who use 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. Pre admission information on the home is sufficient to ensure people can make an informed choice as to whether to move into the home or not. EVIDENCE: The statement of purpose and service user guide were viewed. These documents contained information on the range of services that staff would provide, the experience and qualifications of the owners, management and staff alongside how to complain. The manager and staff confirmed that these documents were supplied to people who had showed an interest in moving into the home to assist them in their decision-making. Intermediate care is not provided at this home. Waterloo House Care Home Ltd DS0000067025.V338527.R01.S.doc Version 5.2 Page 9 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 & 10 People who use this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Staff are good at supporting people to access health care support so that their health needs are met however improved systems for medication are needed and monitoring of peoples weight who are at risk of weight loss needs to improve. EVIDENCE: Care plans were seen to be in place within the care documents of people whose care was tracked at this inspection. The plans contained a summary of the needs of the person under specific headings, for example communication and personal care. There was then guidance in brief to staff in the support that they would need to provide to meet these needs. However not all plans had been reviewed on a monthly basis, one plan relating to the hobbies and Waterloo House Care Home Ltd DS0000067025.V338527.R01.S.doc Version 5.2 Page 10 interests of one person for example had not been reviewed since 14/03/2007. In addition one person had a record of their weight, this had been undertaken only 4 times since January 2007 even though it should have been done at least monthly and the person had been losing weight. Documents examined within the care records; staff and people living at the home indicated that access to healthcare is arranged when required. Entries seen within daily records showed that General Practitioners had visited. At the time of both visits to the home a District Nurse was seen to be visiting to carryout nursing support. An audit of the medication used by the peoples whose care was tracked was undertaken. Medication had been ordered and was seen to be locked securely in a cupboard within the office area. Medication records had been signed to indicate when a medication had been given by staff. However the system in place to record the balances of medication was not sufficient. There was no carrying forward of balances, therefore it was not possible to ascertain if medication had been given. The stock of one medication for example did not match the balance recorded when subtracting the amount of entries within the signature section. Waterloo House Care Home Ltd DS0000067025.V338527.R01.S.doc Version 5.2 Page 11 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 & 15 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People living at this home feel that arrangements in place for activities are good and meet their social needs. EVIDENCE: Menus were on display within the home; these showed that a varied and balanced diet including all the main food groups was on offer. Observations of lunch showed people had been given a choice in their main meal, staff were seen to assist those who required help to eat their meals. Many of the people living at the home commented that the food was good and they enjoyed their meals. Information seen within the individual care records of people and people themselves confirmed that a programme of activities were in place. Examples included going to the local pub, gardening, music and movement and quiz’s, all activities detailing the time and date is on display in the home. Waterloo House Care Home Ltd DS0000067025.V338527.R01.S.doc Version 5.2 Page 12 People living at the home spoke of the flexibility in when their friends and families could visit them at the home, one person said “ my daughter visits anytime really sometimes we sit here in the lounge other times if we want to be alone we sit in my room”. Information on peoples families and friends was seen within the care records examined, this included how staff should contact them if the person needed them. Observation of the interaction between all staff and people living at the home was made throughout this inspection; a good level of communication was noted during this time. Within the communal areas of the home staff were seen to instigate communication with people living at the home, offering an explanation of the actions that they were taking so that the resident were kept fully informed at all times. Waterloo House Care Home Ltd DS0000067025.V338527.R01.S.doc Version 5.2 Page 13 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 & 18 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Staff have a good understanding of safeguarding adults and awareness of local policy to protect the people living at the home. EVIDENCE: Records supplied by the home to the Commission for Social Care Inspection show that staff had undertaken training in safeguarding adults. Staff through interviews demonstrated a sufficient level of knowledge on the types of abuse including physical and psychological. In addition the homes procedure in this area was examined, it’s reflected the local guidance. The management had sought a copy of the local protocols and these were seen. The management and staff at the home did demonstrate through discussion an understanding of the need to refer any allegation or suspected abuse. As reported within the choice of home section guidance on how to make a complaint had been included. The home also had a separate complaints procedure. On viewing the documents retained at the home, no complaints had been received since the previous inspection; therefore how the manager may respond to a concern could not be fully assessed. Waterloo House Care Home Ltd DS0000067025.V338527.R01.S.doc Version 5.2 Page 14 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 & 26 People who use this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Several areas in the home provided an environment suitable for people at the home however improvements and changes are needed in other areas to ensure all of the home is of a standard and provides a pleasant environment for people to live in. EVIDENCE: Seven bedrooms had en-suite facilities. The garden, with a patio area accessible from the conservatory, provided an opportunity for people to sit comfortably outside. The shaft lift inside the building allowed access to all three floors and additional levels for people with limited mobility. Waterloo House Care Home Ltd DS0000067025.V338527.R01.S.doc Version 5.2 Page 15 Bedrooms seen contained many personal items, televisions, teddy bears, photographs and ornaments. Grab rails were installed on the stairway. However one bedroom was noted to have an odour of urine. Staff had been cleaning the carpet regularly to no avail; therefore a replacement of this flooring now needs to be made. In addition several people living at the home and staff commented that the conservatory area was to hot. They felt the temperature in this area when sunny was not comfortable; even though the owners had purchased mobile air conditioning units they felt that this was not effective. Other areas in the home had recently been painted and people commented on “how nice it looks”. Waterloo House Care Home Ltd DS0000067025.V338527.R01.S.doc Version 5.2 Page 16 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 & 30 People who use 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 training arrangements for staff are sufficient with staff demonstrating a clear understanding of their role. EVIDENCE: The induction and training of staff was recorded in the individual records of all employees. Staff through interviewing confirmed that they had undertaken a variety of courses these included health and safety, moving and handling and national vocational qualifications in care. The homes recruitment policy and procedures as previously assessed are clear and comprehensive, documents submitted by the home to the Commission for Social Care Inspection show that no change has taken place to these policies. References are taken prior to staffs’ commencement and the relevant Criminal Records Bureau check is also carried out and evidence of this having been undertaken was seen. Certificates of qualifications are present within staff files. Several of the people living at the home made positive comments on the skills of the staff team, one person said “the staff here are wonderful and very good at their jobs”. Waterloo House Care Home Ltd DS0000067025.V338527.R01.S.doc Version 5.2 Page 17 Senior care workers, care assistants, catering and housekeeping staff are employed at the home. The rotas supplied by the home show that there are sufficient numbers of staff on duty throughout the day and night to meet the needs of the residents at this time. Residents confirmed that staff were available to help and assist them when they need help. Staff were questioned on the individual needs of some of the people who live at the home, through this they demonstrated a good level of understanding of the needs of the person. One staff member had a very good level of knowledge relating to one person, and was able to describe their individual likes, dislikes, family history and the level of care and support needed. Training records examined that were supplied by the home show that staff had undertaken statutory training, including moving and handling, fire safety and food hygiene. In addition staff confirmed that they had attended a variety of courses including dementia awareness. People living at the home who were spoken with felt that the staff had a satisfactory level of knowledge and felt confident in their abilities to meet their needs. Waterloo House Care Home Ltd DS0000067025.V338527.R01.S.doc Version 5.2 Page 18 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 & 38 People who use 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 manager provides an encouraging and supportive style of leadership to staff so they feel valued in their work. EVIDENCE: Everyone spoken to throughout the two days of inspection spoke very highly of the manager. All staff felt that she provided the support and guidance that they needed to carryout their roles. Two long-standing staff both expressed their opinion that they felt she had improved the standards of care since she had been in post and the home had improved under her leadership. People Waterloo House Care Home Ltd DS0000067025.V338527.R01.S.doc Version 5.2 Page 19 living in the home also praised the manager describing her as thoughtful and kind. Other things people said were, “she is very organised and likes things to be done properly” another person said, “she is encouraging and supportive”. Documentary evidence was seen that showed that the home had undertaken a survey to gain the views of people living at the home and their representatives. Where areas had been raised the staff at the home had taken action to remedy this and make improvements for example the laundering of clothes. Balances of small amounts of monies managed by the staff on behalf of people living at the home were checked. All balances were noted to match the amount entered onto the balance sheet. Receipts were also in place for any expenditure, examples of spending included toiletries and hairdressing. Health and safety records maintained by the home show that safety checks are carried out to ensure equipment in the home is kept in good working order. Copies of the most recent inspections undertaken by the fire service and environmental health were seen and evidence was also seen that work had been undertaken in response to any recommendations made. Staff and training records confirmed that they had undertaken training in this area including, moving and handling, fire safety and food hygiene. Waterloo House Care Home Ltd DS0000067025.V338527.R01.S.doc Version 5.2 Page 20 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 2 8 3 9 2 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 2 X X X X X X 2 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 Waterloo House Care Home Ltd DS0000067025.V338527.R01.S.doc Version 5.2 Page 21 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 OP7 Regulation 12(1)(a) 15(1) Requirement Care plans must be reviewed at least every month to ensure that their content is up to date and people receive the support that they need. People must be weighed at regular intervals if assessed at being at risk of weight loss to provide sufficient monitoring to alert medical practitioners of the changes. Staff must ensure the balances of medication are maintained correctly to ensure an audit be carried out to show if people are receiving their medication as prescribed. Measures must be taken to ensure the temperature in the conservatory is at a level that is comfortable for people to sit in. The level of lighting in the dining room must be sufficient so the risk of falling is reduced for people living at the home. A replacement of the flooring in one persons room must now be carried out as there is an odour of urine despite cleaning by staff, DS0000067025.V338527.R01.S.doc Timescale for action 30/09/07 2. OP8 12(1)(b) 31/08/07 3. OP9 13(2) 31/08/07 4. OP19 16 30/10/07 5. OP19 16 31/08/07 6. OP26 16(2)(k) 30/09/07 Waterloo House Care Home Ltd Version 5.2 Page 22 this will provide a pleasant environment for the person to sleep in. 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 Waterloo House Care Home Ltd DS0000067025.V338527.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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 Waterloo House Care Home Ltd DS0000067025.V338527.R01.S.doc Version 5.2 Page 24 - 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. 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