Inspection on 03/10/05 for 162 Wellington Hill West

This inspection was carried out on 3rd October 2005.

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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

162 Wellington Hill West 27/07/07

162 Wellington Hill West 05/09/06

162 Wellington Hill West 09/05/05

162 Wellington Hill West 16/11/04

162 Wellington Hill West 07/04/04

Similar services:

Radfords

Honeybourne House

32 Beaumont Way

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Wellington Hill West, 162 Henleaze Bristol BS9 4QP Lead Inspector Karen Walker Unannounced Inspection 3rd October 2005 01:30p Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 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 Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 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 Adults 18-65. 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. Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Wellington Hill West, 162 Address Henleaze Bristol BS9 4QP 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) 0117 9859918 0117 9699000 The Brandon Trust Mrs Louise Helena Westlake Care Home 5 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (1) of places Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate persons aged 45 years and over. Date of last inspection 9th May 2005 Brief Description of the Service: 162 Wellington Hill West is operated by the Brandon Trust and is registered with the Commission for Social Care Inspection (CSCI). The manager is Ms Louise Westlake. The home provides care to 5 residents aged 45 years and over in the learning disability category. The categories of registration are: Learning Disability (LD) 4, Learning Disability over 65 years (LD(E)) 1. The residents have lived at the home for many years and the Trust have taken the decision to extend and adapt the property to better suit the aging residents needs. Residents have complex communication difficulties. Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this second visit was to examine the environmental changes as the property has been extended and adapted to better suit the mobility needs of the ageing resident group. Residents were spoken with and records examined in respect of them. Discussions were held with the manager. The requirements of the last inspection were reviewed. What the service does well: What has improved since the last inspection? The environment has been adapted to suit the needs of those residents who require greater support with mobility. Two residents now reside on the ground floor, which is a great improvement and lessens the risk of falls. One resident was observed in her environment and was clearly pleased to be back home. The requirements made at the last inspection have been actioned. Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 6 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. Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Contracts continue to be out of date and residents do not have a clear understanding of their contractual agreements. Residents’ needs and aspirations are assessed. EVIDENCE: There are currently no vacancies. At the last inspection the inspector saw that Bristol Social services assessments were in place, these covered: • Education and training • Family/social contact • Cultural/religious needs • Physical health • Mental/emotional health • Self help skills/risks • Communication needs The assessments linked to the homes care plans and there was evidence of 6 monthly reviews taking place. There have been no new admissions to this home. Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 9 Although there are contracts in place these were not up to date and fees are not current. This was a requirement of the last inspection and the manager said she has made the relevant changes but has not yet transferred the information to the planning for life packs in all cases. Residents do not have a clear understanding of their contractual agreements and would benefit from contracts being available in a different format suited to each individuals’ level of understanding. Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6-9 Residents care plans reflect their assessment of need carried out by the relevant social services and are regularly reviewed. Risk assessments for individuals are in place but need to be brought up to date reflecting the environmental changes and lifestyle. EVIDENCE: The risk assessments were examined for one resident and it was noted that some of them still refer to the temporary accommodation used whilst building works were carried out. Risk assessments need to be up to date and reflect the new environment and current risks. Assessments needed include: • Use of the patio doors and the risk of trips and falls (no ramp yet in place). • Use of the garden and negotiating steps before the ‘lift’ is added, risk of trips and falls. • Use of and accessibility of the electric hob which stays hot after use. Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 11 The inspector noted that a requirement of the last inspection regarding safety at night has been actioned. One resident’s bed is now situated against a wall thus reducing the risk of falling out of bed. This must be reviewed on a regular basis. The planning for life folder was examined and was not fully completed. Although the home has had a period of instability with the temporary move care plans and associated documentation must be updated to ensure the most relevant information is given to support workers. Care plans seen reflect the needs of the individual and have been reviewed on a six monthly basis. These would benefit from reviewing within a shorter timescale. It was pleasing to note that professional advice was sought regarding pressure area care and pressure-relieving cushions have been obtained. The mattress has also been replaced. Daily records show that one person is ‘happy to be home and has settled well into her new environment’. The inspector found this person to be especially chatty and mobilising more easily unsupported. Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11-14 Residents are able to participate in activities of their choice and have opportunities for personal development. EVIDENCE: ‘Choices for learning’ provide a day service to all residents’ and the manager said they all enjoy attending. It was clear that the service is reviewed and adequate records of the review kept. All of the residents’ require support with communication and the manager said ‘choices for learning’ facilitate these needs. One resident continues to attend church with the support of day care services; the inspector was told it was more for the singing and socializing than for religious beliefs. This activity has been reviewed. All residents are offered the opportunity to attend church services but usually decline. Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 13 The inspector saw that care plans identify the residents’ choice to participate in household tasks i.e. cooking and making drinks. At the last inspection the inspector saw one resident offering staff a cup of tea and helping out in the kitchen. One resident told the inspector that residents had gone on holiday before returning to Wellington Hill West. This was confirmed by a staff member who said two holidays were arranged to ensure residents went on the holiday of their choice. One resident said ‘I had a lovely time’. Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21 Specialist support and services are accessed where necessary and relevant support given to residents. EVIDENCE: Specialist support and services were accessed where necessary this was evidenced by documentation and was confirmed by residents and staff. There was evidence to show that there was also input from the district nurse and the continence advisor as well as dietician and community nurse. There was chiropody input in and various assessments were in place regarding hearing therapy. The manager said the Occupational Therapist had input into the placing of the handrails around the home. There is adequate equipment available for residents and the physiotherapist had signed some of the risk assessments related to mobility. It was noted that one persons ‘wishes in the event of their death’ had been recorded. Although it was agreed that this resident had limited understanding of the concept of death this was written respectfully and appropriately. Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Residents are protected from abuse. EVIDENCE: One staff member spoken with at the last inspection was not aware of the policies in place to protect a resident from abuse. She did however confirm that she would act on any suspicion or concern. This was pointed out to the manager who agreed to inform all staff of the ‘No secrets in Bristol’ Department of Health document that must be used in conjunction with the Protection of vulnerable Adults policy ‘POVA’. The manager confirmed that this has taken place and the ‘No Secrets’ document was readily available as was informative leaflets. Bristol Social Services provided ‘protection from abuse’ training to the manager and one other staff member. The rest of the team are waiting for confirmation of a place. Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24-30 Residents’ bedrooms meet their needs and lifestyles. The environment requires some maintenance to ensure it is safe and suited to its stated purpose. EVIDENCE: The inspector was disappointed that there were still areas of ‘snagging’ needed to ensure the environment is comfortable and safe. It was noted that the lights were not working in areas of the extended part of the building. The manager said this was being investigated. The sockets are in working order so residents were able to use their lamps. The ramp that has been built leading up the front path does not extend to the front door. The manager said this is due to cables sited underground. There will be a portable ramp made available that is being made to measure. It was noted that there is a step over the rear patio door that is a tripping hazard. The manager said a ramp would be put in place. Risk assessments are needed. Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 17 The rear garden is accessed via steps but the manager said there will be a ‘lift area’ available for wheelchair users. The railing has been extended along the wall so this will need cutting out to allow access to the ‘lift’. There is an electronic door lock on the patio doors but the manager was unaware as to why this has been fitted. She will make enquires. The two new bedrooms on the ground floor require ‘homely touches’; one would benefit from a vanity unit to store toiletries and a place to store continence aids out of sight. Both rooms have a washable floor covering and are easily accessed by the residents whose mobility needs are changing. The bathroom now has the added benefit of a walk in shower with fitted shower seat and arm rails. There is a whirlpool bath with a static hoist. It was noted that large cracks are appearing in the freshly plastered and painted walls. The buildings inspector who will return when the wall has fully dried back has inspected this. The manager feels the sink is too big and a smaller one will be provided. The upstairs shower room still requires attention, as the shower is mouldy and black. The manager confirmed this was being replaced in December. It was noted that there are adequate bathing and toileting facilities available to the resident group. The bedrooms upstairs were individualised and comfortable. One resident who has moved from a downstairs room said ‘this is nice, I picked it’. It is required that an action plan with dates be forwarded to the CSCI detailing the following: • Lighting in the extension • Provision of ramp for front access • Provision of ramp rear access • Access into garden for wheelchair users • Supply date of vanity/storage unit in bedroom • Cracks in the bathroom wall • Replacement of the upstairs shower • Details of fitted ‘alarm’ to patio doors • Any other works due to take place or needed. Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): X EVIDENCE: None of these standards were assessed on this occasion. However they were all fully assessed in May 2005 and will be revisited at the next inspection. Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 41,42 Residents’ rights and interests are safeguarded by the homes policies and procedures. Residents will be better protected from the risk of fire when the risk assessment has been reviewed and the fire drill has taken place. EVIDENCE: The Service Development Manager will be reviewing the quality assurance system with the manager in the next few weeks and the system will be fully examined at the next inspection. Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 20 The fire logbook was examined and it was noted that weekly alarm testing was recorded as taking place. Although fire training and a fire drill has taken place within the last 6 months the fire drill must be carried out at Wellington Hill West to ensure staff are familiar with the new layout of the building. The manager said she is arranging this. The fire risk assessment was full and detailed but needs to be reviewed taking into account the changes in the environment. The Brandon Trust has a number of policies and procedures and to accompany these the home has developed their own which are designed to be resident specific. A number of these policies were examined at the last inspection. The homes registration certificate and insurance certificates are clearly displayed. The manager has some control over the homes budget and financial requirements are discussed with the Clinical Service Manager. Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X 2 Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Wellington Hill West, 162 Score X 3 X X Standard No 37 38 39 40 41 42 43 Score X X X X 3 2 X DS0000026646.V254627.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? 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 YA9 Regulation 13(4)(c) Requirement Risk assessments need to be up to date and reflect the new environment and current risks. Assessments needed include: Use of the patio doors and the risk of trips and falls (no ramp yet in place). Use of the garden and negotiating steps before the ‘lift’ is added, risk of trips and falls. Use of and accessibility of the electric hob which stays hot after use. 2 YA24 13(4)(a) 23(2) It is required that an action plan with dates be forwarded to the CSCI detailing the following repairs and alterations: Lighting in the extension. Provision of ramp for front access. Provision of ramp rear access. Access into garden for wheelchair users. Supply date of vanity/storage unit in bedroom. 01/11/05 Timescale for action 01/11/05 Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 23 Cracks in the bathroom wall. Replacement of the upstairs shower. Details of fitted ‘alarm’ to patio doors. Any other works due to take place or needed. 3 YA42 12(1)(a) 17(3)(a) Review the fire risk assessment 01/11/05 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 Refer to Standard YA5 Good Practice Recommendations Residents will benefit from contracts being available in a different format suited to each individual’s level of understanding. Care plans will benefit from shorter review times. 2 YA6 Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: 0845 015 0120 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 Wellington Hill West, 162 DS0000026646.V254627.R01.S.doc Version 5.0 Page 25 - 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!