Inspection on 09/05/05 for 162 Wellington Hill West

This inspection was carried out on 9th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

162 Wellington Hill West 27/07/07

162 Wellington Hill West 05/09/06

162 Wellington Hill West 03/10/05

162 Wellington Hill West 16/11/04

162 Wellington Hill West 07/04/04

Similar services:

Radfords

Honeybourne House

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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 18-65 162 Wellington Hill West Henleaze Bristol BS9 4QP Lead Inspector Karen Walker Unannounced 9th May 2005 9.00 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 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 Stationary 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. 162 Wellington Hill West Version 1.10 Page 3 SERVICE INFORMATION Name of service 162 Wellington Hill West Address Henleaze Bristol BS9 4QP Telephone number Fax number Email 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 Louisa Helena Westlake PC Care Home 5 Category(ies) of LD Learning Disability (4) registration, with number LD (E) Learning Disability - over 65 (1) of places 162 Wellington Hill West Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate persons aged 45 years and over. Date of last inspection 16 November 2004 (Announced) 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. 162 Wellington Hill West Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector gained information for this report by case tracking and meeting residents and staff. The appropriate records were examined and discussions held with the manager. What the service does well: What has improved since the last inspection? All of the requirements from the last inspection have been actioned. The manager has identified staff training needs as well as her own and this will ensure that residents’ benefit from a staff team that have the competencies and qualifications to meet their needs. Major environmental work will be carried out to ensure the needs of residents with reduced mobility will be met. Action plans have been put in place to ensure the best transition and the least disruption to residents’. 162 Wellington Hill West Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 162 Wellington Hill West Version 1.10 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 Standards Statutory Requirements Identified During the Inspection 162 Wellington Hill West Version 1.10 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 standard(s) 1,2,3,5 Residents are as clear as is possible about the terms and conditions of their stay. Residents are fully assessed and their needs fed into the current care plans thus Informing staff members on how to better support residents’. EVIDENCE: The inspector was shown the statement of purpose and saw that it contained lots of pictures and symbols. There was one resident’s view of the service added along with relevant policies and procedures. Contracts were examined and were signed in 2003. These documents need to be updated to include the current fees to keep within legislation. The manager confirmed and the inspector’s observations evidence that most residents would not understand the contracts in any format. There are currently no vacancies. 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 162 Wellington Hill West Version 1.10 Page 9 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. 162 Wellington Hill West Version 1.10 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 standard(s) 6,9 Whilst residents are supported to take risks to improve independence more detail is needed on the risks relating to health and safety. Action is not always taken to minimise identified risk and action is needed to protect residents. Risk assessments are not always current and so do not contain updated information needed to adequately support the person. EVIDENCE: The two residents case tracked both have decreasing mobility and require ground floor accommodation. The refurbishment of the home will allow both residents’ to have ground floor accommodation some time during October 2005 when the works are completed. In the meantime assessments are in place regarding poor mobility and the risks associated with falls. However one assessment needs to be updated in light of the resident recently breaking her ankle after a fall. This was discussed with the key-worker who was aware of her responsibility to add this to the care plan. The second resident with poor mobility has been appropriately assessed by the relevant professionals and recommendations made by the Learning Disability Community Nurse. However these recommendations were never actioned or addressed. It is known that this resident is at risk of falling from his bed at night during a seizure. No action has been taken to reduce this risk. 162 Wellington Hill West Version 1.10 Page 11 This persons care plan recognises the need for pressure area care and has received input from the appropriate specialist. However the inspector noted that the mattress designed to reduce the risk of pressure sores developing was covered by a sheet. This was due to continence issues. The inspector is of the understanding that this will greatly reduce the effectiveness of the mattress. There are no pressure relieving cushions available for use in the wheelchair and for placing in an easy chair. It is required that the appropriate professional advice be sought. Risk assessments seen were in need of updating to ensure all relevant information is added. Some were written 4 years ago and would benefit from rewriting completely. 162 Wellington Hill West Version 1.10 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 standard(s) 12,13,14,15,16 Residents feel a part of their local community and are able to engage in appropriate leisure activities. Residents are supported to make and maintain appropriate relationships and friendships. EVIDENCE: The inspector met with one resident who was waiting for his transport to arrive. ‘Choices for learning’ provide a 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 attends church with the support of day care services; the inspector was told it was more for the singing and socializing than for religious beliefs. All residents are offered the opportunity to attend church services but usually decline. 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. 162 Wellington Hill West Version 1.10 Page 13 Two residents have a holiday planned and one resident will be stopping off to visit his relative who lives some distance away. The Brandon Trust has a ‘visitors’ policy where visitors are encouraged to visit at any reasonable time of the day. Members of the staff team said that friends and family members are encouraged to visit when they choose. A member of the staff team has supported a resident to visit an elderly relative in Devon. One resident has a family member who visits on a weekly basis; this was evidenced throughout the diary. Residents are also supported to use the telephone to keep in touch with distant friends and relatives. Another resident is supported to visit a friend at her home but has never been invited to Wellington Hill. The inspector suggested that an invitation be sent. 162 Wellington Hill West Version 1.10 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 standard(s) 18,19,20 Residents receive personal support as needed, they are protected from medication abuse by the appropriate policies and procedures and a trained workforce. EVIDENCE: The appropriate assessments have taken place for those residents whose needs have changed. It was noted that residents had been assessed by the physiotherapist and occupational therapist with regards changing mobility needs. 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. Residents have received care plan review’s to be sent to Bristol Social Services. One staff member confirmed medication training had taken place as part of her induction. The inspector noted that some headway had been made with training all staff and the manager confirmed she would be contacting the pharmacist for further training. The medication administration record sheets were well kept and the appropriate medication policies and procedures were in place. 162 Wellington Hill West Version 1.10 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 standard(s) 22,23 Staff members advocate on behalf of residents although some staff members do not have direct knowledge of the Protection of vulnerable adults policies and procedures and associated documentation. Therefore residents are at risk from not having a correct response to a suspicion of abuse. EVIDENCE: One staff member spoken with 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 was informed that the Bristol Social Services provide excellent ‘protection from abuse’ training and is free. It is a requirement to ensure all staff receive the appropriate training and are given the information necessary to prevent residents being placed at harm. The complaints log was examined and the inspector noted this was on looseleaf paper. The manager came up with the idea of numbering each page in case one was taken out at any time. It was also noted that there was no structure to the recording of complaints. The inspector recommended using the same format when recording complaints i.e. date, nature of complaint, action taken and by whom, outcome, follow up and signature of person dealing with the complaint. 162 Wellington Hill West Version 1.10 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 standard(s) x Residents’ needs will be fully met with regards the environment when the appropriate changes take place. EVIDENCE: Standard 24–30 was not thoroughly assessed due to the forth-coming refurbishment of the environment. The plans are to move two people from the first floor to the ground floor to meet their decreasing mobility needs. The inspector has met with the Clinical Service Manager to discuss the interim arrangements whilst the works take place. Residents’ will be moved to a recently closed home in Clevedon and the staff team are due to go to a team day on the premises to ensure knowledge of the fire system, call bells, room layout etc. The inspector saw an action plan was in place to support the smooth transition this includes temporary healthcare provision, continuation of day-care, maintaining friendships and visits etc. A ‘design team’ meeting has taken place to ensure all the necessary building changes can be made. Input will be sought from the occupational therapy team to ensure an accessible environment. This is good practice. The Brandon Trust will complete a ‘variation’ for the CSCI and provide the necessary information to ensure meeting residents’ needs are paramount and 162 Wellington Hill West Version 1.10 Page 17 that staff are able to continue to adequately support the residents’ through the transition. The action plan shows the works will take approximately 10 weeks. 162 Wellington Hill West Version 1.10 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36 Residents’ will benefit from the additional training planned for the staff team. Staff will be responsive to the needs of the residents’. Residents benefit from a well supervised and motivated staff team. EVIDENCE: The inspector spoke with one staff member regarding, recruitment and induction, training and supervision. She confirmed she had completed the induction programme and records show she has almost finished the foundation training. Supervision agreements were seen and records show supervision takes place approximately every 4-6 weeks. The staff member spoken with was aware of her role and responsibilities within the home and was enjoying her job. The inspector is aware that all staffing records relating to recruitment is kept at the Brandon Trust HQ. The manager was able to demonstrate that she had examined all the records relating to staff at Wellington Hill. She kept a checklist detailing references and CRB information, personal identification etc. One staff member confirmed she had undertaken a POVA first check and had got a CRB certificate prior to employment. The manager has booked training relevant to the needs of the residents’ and courses include: Person Centred Planning (PCP) Epilepsy awareness 162 Wellington Hill West Version 1.10 Page 19 Supporting the needs of older people Dementia and Learning Disabilities Loss and bereavement. 162 Wellington Hill West Version 1.10 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39,40,41,42,43 The health and safety of residents is at risk and staff members must carry out the appropriate training to ensure their safety. Residents’ rights and interests are safeguarded by the homes policies and procedures. EVIDENCE: The manager has recently returned to the home after a period of leave. She has identified her own training needs and has booked courses accordingly. The manager confirmed she receives regular supervision from the Clinical Services Manager and will be commencing the Registered Managers Award in November 2005. The inspector examined the fire logbook and noted that some staff had not received fire training/instruction or fire drill practice for over one year; an immediate requirement was left in respect of this. All staff must receive training within the timescales specified by the Avon Fire Brigade. For staff working days this is every 6 months, every 3 months if staff are on night duty. 162 Wellington Hill West Version 1.10 Page 21 The inspector saw a resident involvement policy. At the last inspection one of the residents confirmed he attended the ‘service user forums’ and received the minutes from each meeting. 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. The manager said she was not currently using a quality assurance monitoring system. This must be put in place based on the views of the residents’ depending on their comprehension and should measure success in achieving the homes aims and objectives as stated in the statement of purpose. This standard will be further examined at the next inspection. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 5 162 Wellington Hill West Score 3 3 3 x 2 Standard No 22 23 ENVIRONMENT Score 3 2 Standard No Version 1.10 Score Page 22 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 2 x Score 24 25 26 27 28 29 30 STAFFING x x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 2 3 3 1 3 162 Wellington Hill West Version 1.10 Page 23 no 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. 2. Standard 5 6 Regulation 5(1)(b) 13(1)(b)( 4)(c) Requirement contracts must be updated to include all necessary information include fees. seek appropriate professional advice with regards pressure area care and the covering of the specialist matress. Also the provision of pressure relieving cushions for wheelchair and comfy chair use. risk assessments must be updated to protect one resident who is at risk of falling out of bed. The advice given by the appropriate professional must be followed. All residents must be adequately protected at night. Arrangements must be made by training staff or by other measures to prevent residents being put at risk. Staff must be made aware of the NO Secrets in Bristol document and the POVA policy. put in place a quality assurance system to measure success in achieving the homes aims and objectives as stated in the statement of purpose. Ensure all staff fire instruction and attend fire drills within the Version 1.10 Timescale for action 1/08/05 1/06/05 3. 9 13(4)(a)( b)(c) 1/06/05 4. 23 13(6) 1/06/05 5. 39 24(1)(a)( b) 1/08/05 6. 42 23(4)(d) 9/05/05 162 Wellington Hill West Page 24 timescales specified by the Avon Fire brigade. 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 Good Practice Recommendations 162 Wellington Hill West Version 1.10 Page 25 Commission for Social Care Inspection 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 162 Wellington Hill West Version 1.10 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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